{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T17:58:05Z","timestamp":1790531885222,"version":"4.1.0"},"reference-count":77,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical &amp;amp; Exp Dental Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this systematic review was to evaluate the skeletal and dental effects of skeletally\u2010anchored (SA) maxillary protraction compared with conventional facemask (FM) therapy in growing patients with Class III malocclusion, while controlling for the confounding effect of rapid maxillary expansion (RME).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A systematic literature search (MEDLINE, Cochrane Library, Virtual Health Library, Web of Science, Google Scholar), which involved two screening stages, was performed until January 2026 and identified prospective clinical trials comparing SA with conventional tooth\u2010borne FM therapy. Only studies in which expansion protocols were applied uniformly across groups were included. Risk of bias was assessed with RoB 2 and ROBINS\u2010I tools, and random effects meta\u2010analyses were conducted for cephalometric outcomes. The certainty of the evidence was evaluated according to the grading of recommendations, assessment, development, and evaluation (GRADE) approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five prospective trials (3 RCTs, 2 CCTs;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009194 participants) met the inclusion criteria. Random\u2010effects meta\u2010analyses showed a modest but significant greater increase in SNA for SA (MD 0.65\u00b0; 95% CI 0.18\u20131.13,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.0%) and consistently fewer dental side effects with SA: upper\u2010molar mesialization (\u22121.14\u2009mm; \u22122.12 to \u22120.17,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200910.3%), molar extrusion (\u22120.74\u2009mm; \u22121.07 to \u22120.40,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.0%), and maxillary incisor proclination (\u22122.47\u00b0; \u22124.14 to \u22120.80,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.0%). The mandibular plane rotation did not differ significantly (\u22120.38\u00b0; \u22121.67 to 0.91,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200945.6%). Risk of bias was assessed as \u201csome concerns\u201d in RCTs and \u201cserious\u201d in non\u2010randomized studies. The certainty of evidence ranged from very low to moderate according to GRADE.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Within the limitations of the available short\u2010term evidence, and given the low\u2010to\u2010moderate certainty of the pooled estimates, SA was associated with fewer dental side effects and a statistically significant, though not clinically relevant, gain in skeletal efficacy. Future long\u2010term, age\u2010stratified randomized trials are needed to confirm the long\u2010term stability of these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cre2.70466","type":"journal-article","created":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T17:30:11Z","timestamp":1790530211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison Between Skeletally\u2010Anchored and Conventional Maxillary Protraction in Growing Class \u0399\u0399\u0399 Patients: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2038-0599","authenticated-orcid":false,"given":"Christianna Iris","family":"Papadopoulou","sequence":"first","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopedics Center for Oral Health Sciences CC3, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4623-1535","authenticated-orcid":false,"given":"Nusha","family":"Paschaei","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopedics Center for Oral Health Sciences CC3, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1436-0085","authenticated-orcid":false,"given":"Giulia","family":"Brunello","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopedics Center for Oral Health Sciences CC3, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Berlin  Berlin Germany"},{"name":"Department of Oral Surgery University Hospital of D\u00fcsseldorf  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Jungbauer","sequence":"additional","affiliation":[{"name":"Department of Orthodontics University Medical Centre Regensburg  Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1936-4683","authenticated-orcid":false,"given":"Kathrin","family":"Becker","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopedics Center for Oral Health Sciences CC3, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Berlin  Berlin 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