Methods for Anterior Torque Control during Retraction: A Systematic Review

Abstract

BackgroundThere are various methods to control the inclination of the incisors during retraction, but there is no evidence as to the advantages of some methods over others. The purpose of this systematic review and meta-analysis was to determine the effectiveness of the methods used to control torque during anterior teeth retraction.MethodsIn accordance with the PRISMA guidelines, the main research question was defined in the PICO format [P: patients with complete permanent dentition; I: the maxillary incisor torque after (I) and before (C) retraction with straight-wire appliance and different modes of torque control; O: statistically significant differences in torque values of the upper incisors after orthodontic treatment]. The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched for keywords combining: retraction orthodontics, torque control orthodontics, torque orthodontics, inclination orthodontics, torque control retraction. The articles were subjected to risk of bias and quality analyses with the ROBINS-I protocol and the modified Newcastle–Ottawa QAS, respectively. Meta-analyses were performed with both fixed and random effects models.Results13 articles were selected in which total number of 580 subjects took part. In all studies incisors were retroclined during retraction by 2.46° (mean difference), which was statistically significant. Considering articles separately, differences in torque between the study group and the control group were statistically significant in 6 articles. The Q statistic value was 36.25 with p = .0003 and I2 = 66.9% which indicate a high level of study heterogeneity.ConclusionBoth properly performed corticotomy and en-masse retraction using orthodontic microimplants seem to be the most effective and scientifically validated methods of torque control. Further high-quality research is needed to perform better quality analyses and draw more reliable conclusions.