Treatment effects of the mandibular anterior repositioning appliance on patients with Class II malocclusion

Pangrazio-Kulbersh, Valmy; Berger, Jeffrey L.; Chermak, David S.; Kaczynski, Richard; Simon, Eugene S.; Haerian, Andre

doi:10.1067/mod.2003.8

Cited by 95 publications

(157 citation statements)

References 28 publications

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“…The meta-analysis showed a 1.16 mm/y increase in the total mandibular length of the MARA group over controls (WMD 5 1.16; 95% CI 5 0.61, 1.72; x 2 test 5 7.32; 5 df; P 5 .20; I 2 5 32%; test for overall effect, Z 5 4.11 and P # .0001) (Figure 1). Sensitivity analysis excluding the three lowquality studies 5,6,19 showed comparable findings (WMD 5 1.12; 95% CI 5 0.60, 1.63) ( Table 5).…”

Section: Short-term Effects Of Maramentioning

confidence: 61%

“…5,6,8,9,[19][20][21] The participants were growing subjects with Class II division 1 malocclusion in all studies except for one in which the type of Class II malocclusion was not specified. 6 The age ranges were 10.11-12.3 years for the MARA subjects (N 5 180) and 11.63-11.9 years for the control subjects (N 5 126). One study 20 did not specify the age range or the sample size for the control group.…”

Section: Resultsmentioning

confidence: 99%

“…Different cephalometric variables were used among the studies. Two of them used Go-Me 5 and Go-Po, 6 respectively; the other two studies 8,9 used Go-Gn. Statistical pooling of the four studies showed no significant differences between the groups and a medium heterogeneity (WMD 5 0.21; 95% CI 5 20.16, 0.57; x 2 test 5 9.73; 3 df ; P 5 .02; I 2 5 69%; test for overall effect, Z 5 1.11 and P 5 0.27).…”

Section: Short-term Effects Of Maramentioning

confidence: 99%

“…Six studies 5,6,8,9,19,21 evaluated this outcome using the cephalometric variable Co-Gn. The meta-analysis showed a 1.16 mm/y increase in the total mandibular length of the MARA group over controls (WMD 5 1.16; 95% CI 5 0.61, 1.72; x 2 test 5 7.32; 5 df; P 5 .20; I 2 5 32%; test for overall effect, Z 5 4.11 and P # .0001) (Figure 1).…”

Section: Short-term Effects Of Maramentioning

confidence: 99%

“…4 The efficacy of the MARA on mandibular growth has been evaluated in numerous studies, but contradictory results have been reported. [5][6][7] Some studies found significant mandibular dimensional changes with MARA, 6,8 whereas others found no significant differences between MARA and untreated control subjects with Class II malocclusion. 5,9 Therefore, the objective of this review was to evaluate the short-and long-term effects of the MARA appliance on mandibular dimensions in growing patients (10-16 years old) and to assess the postretention stability of the MARA results.…”

Section: Introductionmentioning

confidence: 99%

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Meta-analysis on the mandibular dimensions effects of the MARA appliance in patients with Class II malocclusions

Al-Jewair

2014

The Angle Orthodontist

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Objectives: To evaluate the short-and long-term effects of the mandibular anterior repositioning appliance (MARA) on mandibular dimensions in patients with Class II malocclusion and to assess the stability of the MARA results. Materials and Methods: Multiple electronic databases were searched for articles published in any language until March 2014. A manual search was also performed of reference lists of retrieved articles. The primary outcomes were the short-and long-term effects of the MARA appliance on mandible dimensions. The secondary outcome was postretention stability. Outcome measures were total mandibular unit length, corpus length, and ramus height. Two reviewers examined all articles independently and assessed their methodologic quality. Meta-analyses were conducted using random-effects models. The Cochrane test and the I 2 statistic were used to assess heterogeneity. Sensitivity analyses were performed and publication bias was evaluated. Results: Seven retrospective clinical controlled studies that compared MARA with controls were included. Three of the studies were medium quality; the rest were low quality. Meta-analysis of the short-term effects revealed a significant increase in total mandibular unit length (1.16 mm/y) and ramus height (1.58 mm/y) with MARA and a nonsignificant increase in corpus length (0.21 mm/y). Analyses of the long-term effects showed a statistically significant advantage of MARA over controls for all three variables, but the effect sizes were small. More high-quality studies are warranted. Conclusions: The MARA appliance produced statistically significant mandibular growth enhancement in the short-and long-term. These findings, however, may not be clinically significant. (Angle Orthod. 2015;85:706-714.)

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Section: Short-term Effects Of Maramentioning

confidence: 61%