title: Effectiveness of orthodontic miniscrew implants in anchorage reinforcement during en-masse retraction: A systematic review and meta-analysis.
abstract: BACKGROUND
  The aim of this systematic review was to compare the effectiveness of orthodontic miniscrew implants-temporary intraoral skeletal anchorage devices (TISADs)-in anchorage reinforcement during en-masse retraction in relation to conventional methods of anchorage.
  
  
  METHODS
  A search of PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science was performed. The keywords were orthodontic, mini-implants, miniscrews, miniplates, and temporary anchorage device. Relevant articles were assessed for quality according to Cochrane guidelines and the data extracted for statistical analysis. A meta-analysis of raw mean differences concerning anchorage loss, tipping of molars, retraction of incisors, tipping of incisors, and treatment duration was carried out.
  
  
  RESULTS
  Initially, we retrieved 10,038 articles. The selection process finally resulted in 14 articles including 616 patients (451 female, 165 male) for detailed analysis. Quality of the included studies was assessed as moderate. Meta-analysis showed that use of TISADs facilitates better anchorage reinforcement compared with conventional methods. On average, TISADs enabled 1.86 mm more anchorage preservation than did conventional methods (P <0.001).
  
  
  CONCLUSIONS
  The results of the meta-analysis showed that TISADs are more effective than conventional methods of anchorage reinforcement. The average difference of 2 mm seems not only statistically but also clinically significant. However, the results should be interpreted with caution because of the moderate quality of the included studies. More high-quality studies on this issue are necessary to enable drawing more reliable conclusions.
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Antoszewska-Smith
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Sarul
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Wroclaw Medical University, Wroclaw, Poland. Electronic address: jan.lyczek@gmail.com.
authors.forename: Jan
authors.initials: J
authors.lastname: Łyczek
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Konopka
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Kawala
mesh_terms: D001863:Bone Screws; D006801:Humans; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation*; D016382:Orthodontic Appliance Design; D009967:Orthodontic Appliances; D014087:Tooth Movement Techniques / Q000295:instrumentation*