Adverse Effects of ‘Two-by-Four Fixed Orthodontic Appliance’ in Mixed Dentition Period - A Systematic Review
Malocclusion is a global public dental health problem with higher prevalence and treatment needs. However, there is a perplexing literature regarding early orthodontic intervention in the mixed dentition stage. ‘2 × 4 orthodontic appliances’ have been highlighted in the literature as versatile appli...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Indian Journal of Dental Research |
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| Online Access: | https://journals.lww.com/10.4103/ijdr.ijdr_217_24 |
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| author | Mohammad Kamran Khan Ramanandvignesh Pandiyan Shakir Hussain Rather |
| author_facet | Mohammad Kamran Khan Ramanandvignesh Pandiyan Shakir Hussain Rather |
| author_sort | Mohammad Kamran Khan |
| collection | DOAJ |
| description | Malocclusion is a global public dental health problem with higher prevalence and treatment needs. However, there is a perplexing literature regarding early orthodontic intervention in the mixed dentition stage. ‘2 × 4 orthodontic appliances’ have been highlighted in the literature as versatile appliances for the effective correction of various malocclusions in children. However, dental clinicians and researchers should also have updated knowledge about the negative aspects of ‘2 × 4 orthodontic appliances’, which are reported in the exiting literature. Hence, this systematic review aimed to find out the evidence about the adverse effects/complications of 2 × 4 orthodontic appliance therapy in mixed dentition phase of paediatric patients by extensively exploring and critically appraising the pertinent literature. This systematic review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Its protocol was registered in International Prospective Register of Systematic Reviews. Literature was searched comprehensively in six databases and also manually. After the screening of the records (n = 1234) as per the eligibility criteria, finally, nine (n = 5) articles were included and critically analysed using different Joanna Briggs Institute critical appraisal tools. Eligible studies including Randomized Controlled Trial (RCT) (n = 1), non-RCT (n = 2), retrospective study (n = 1), case-report (n = 1) published from 1999 to 2023 in which 82 patients with mean-age of 10-year, mostly with pseudo class-III malocclusion, anterior cross-bite and crowding treated using 2 x 4 appliance were found. The literature-based evidence related to the adverse effects of 2 × 4 orthodontic appliances was found to be inadequate in quantity, but majority was of high quality (low risk of bias). However, various negative aspects/complications of this particular fixed orthodontic therapy were reported by the included primary studies. |
| format | Article |
| id | doaj-art-632b1664fcee4f3c97e2dde7eef3735d |
| institution | OA Journals |
| issn | 0970-9290 1998-3603 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Dental Research |
| spelling | doaj-art-632b1664fcee4f3c97e2dde7eef3735d2025-08-20T02:02:10ZengWolters Kluwer Medknow PublicationsIndian Journal of Dental Research0970-92901998-36032025-01-013619410210.4103/ijdr.ijdr_217_24Adverse Effects of ‘Two-by-Four Fixed Orthodontic Appliance’ in Mixed Dentition Period - A Systematic ReviewMohammad Kamran KhanRamanandvignesh PandiyanShakir Hussain RatherMalocclusion is a global public dental health problem with higher prevalence and treatment needs. However, there is a perplexing literature regarding early orthodontic intervention in the mixed dentition stage. ‘2 × 4 orthodontic appliances’ have been highlighted in the literature as versatile appliances for the effective correction of various malocclusions in children. However, dental clinicians and researchers should also have updated knowledge about the negative aspects of ‘2 × 4 orthodontic appliances’, which are reported in the exiting literature. Hence, this systematic review aimed to find out the evidence about the adverse effects/complications of 2 × 4 orthodontic appliance therapy in mixed dentition phase of paediatric patients by extensively exploring and critically appraising the pertinent literature. This systematic review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Its protocol was registered in International Prospective Register of Systematic Reviews. Literature was searched comprehensively in six databases and also manually. After the screening of the records (n = 1234) as per the eligibility criteria, finally, nine (n = 5) articles were included and critically analysed using different Joanna Briggs Institute critical appraisal tools. Eligible studies including Randomized Controlled Trial (RCT) (n = 1), non-RCT (n = 2), retrospective study (n = 1), case-report (n = 1) published from 1999 to 2023 in which 82 patients with mean-age of 10-year, mostly with pseudo class-III malocclusion, anterior cross-bite and crowding treated using 2 x 4 appliance were found. The literature-based evidence related to the adverse effects of 2 × 4 orthodontic appliances was found to be inadequate in quantity, but majority was of high quality (low risk of bias). However, various negative aspects/complications of this particular fixed orthodontic therapy were reported by the included primary studies.https://journals.lww.com/10.4103/ijdr.ijdr_217_24adverse outcomessectional fixed orthodonticssegmental orthodonticstwo-by-four applianceunfavourable outcomes |
| spellingShingle | Mohammad Kamran Khan Ramanandvignesh Pandiyan Shakir Hussain Rather Adverse Effects of ‘Two-by-Four Fixed Orthodontic Appliance’ in Mixed Dentition Period - A Systematic Review Indian Journal of Dental Research adverse outcomes sectional fixed orthodontics segmental orthodontics two-by-four appliance unfavourable outcomes |
| title | Adverse Effects of ‘Two-by-Four Fixed Orthodontic Appliance’ in Mixed Dentition Period - A Systematic Review |
| title_full | Adverse Effects of ‘Two-by-Four Fixed Orthodontic Appliance’ in Mixed Dentition Period - A Systematic Review |
| title_fullStr | Adverse Effects of ‘Two-by-Four Fixed Orthodontic Appliance’ in Mixed Dentition Period - A Systematic Review |
| title_full_unstemmed | Adverse Effects of ‘Two-by-Four Fixed Orthodontic Appliance’ in Mixed Dentition Period - A Systematic Review |
| title_short | Adverse Effects of ‘Two-by-Four Fixed Orthodontic Appliance’ in Mixed Dentition Period - A Systematic Review |
| title_sort | adverse effects of two by four fixed orthodontic appliance in mixed dentition period a systematic review |
| topic | adverse outcomes sectional fixed orthodontics segmental orthodontics two-by-four appliance unfavourable outcomes |
| url | https://journals.lww.com/10.4103/ijdr.ijdr_217_24 |
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