title: Intraoral distalizer effects with conventional and skeletal anchorage: a meta-analysis.
abstract: BACKGROUND
  The aims of this meta-analysis were to quantify and to compare the amounts of distalization and anchorage loss of conventional and skeletal anchorage methods in the correction of Class II malocclusion with intraoral distalizers.
  
  
  METHODS
  The literature was searched through 5 electronic databases, and inclusion criteria were applied. Articles that presented pretreatment and posttreatment cephalometric values were preferred. Quality assessments of the studies were performed. The averages and standard deviations of molar and premolar effects were extracted from the studies to perform a meta-analysis.
  
  
  RESULTS
  After applying the inclusion and exclusion criteria, 40 studies were included in the systematic review. After the quality analysis, 2 articles were classified as high quality, 27 as medium quality, and 11 as low quality. For the meta-analysis, 6 studies were included, and they showed average molar distalization amounts of 3.34 mm with conventional anchorage and 5.10 mm with skeletal anchorage. The meta-analysis of premolar movement showed estimates of combined effects of 2.30 mm (mesialization) in studies with conventional anchorage and -4.01 mm (distalization) in studies with skeletal anchorage.
  
  
  CONCLUSIONS
  There was scientific evidence that both anchorage systems are effective for distalization; however, with skeletal anchorage, there was no anchorage loss when direct anchorage was used.
authors: Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil. robertogrec@usp.br
authors: Roberto Henrique da Costa
authors: RH
authors: Grec
authors: Guilherme
authors: G
authors: Janson
authors: Nuria Castello
authors: NC
authors: Branco
authors: Patrícia Garcia
authors: PG
authors: Moura-Grec
authors: Mayara Paim
authors: MP
authors: Patel
authors: José Fernando
authors: JF
authors: Castanha Henriques
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation*; D016382:Orthodontic Appliance Design; D009967:Orthodontic Appliances / Q000145:classification*; D014087:Tooth Movement Techniques / Q000295:instrumentation*; D016896:Treatment Outcome