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RCTs and controlled non-randomized studies were included in this systematic review. The GRADE framework was applied to evaluate the quality of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty studies were included in this review, of which sixteen were appropriate for quantitative synthesis. The age range fell between 6.6 and 12.3 years. The FM\/RME protocol resulted in a 1.58\u00a0mm increase in upper lip protrusion and a 4.73-degree decrease in the nasolabial angle compared to the control group. Chincup treatment led to a 2.13\u00a0mm increase in upper lip protrusion and a 2.63\u00a0mm decrease in lower lip protrusion compared to the control group. The pooled estimate demonstrated a significant increase of 1.82\u00a0mm in upper lip protrusion, a significant retrusion of 3.14\u00a0mm in the lower lip, and a backward movement of the chin by 4.8\u00a0mm in patients treated with miniplate-anchored orthopaedic facemask (FM\/MP) compared to the untreated group. However, no significant difference was found between FM\/RME and FM\/MP, except for a noticeable decrease in the nasolabial angle in the FM\/RME group. The analysis of FM\/Alt-RAMEC versus FM\/RME did not reveal any difference in soft tissue outcomes, except for the upper lip protrusion. The Alt-RAMEC group showed a more pronounced anterior movement of the upper lip by 0.67\u00a0mm compared to the RME group. The quality of evidence supporting these findings ranged from low to moderate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is low to moderate evidence suggesting that early treatment positively influences the soft tissues in Class III patients. However, these conclusions are based on a two-dimensional analysis of cephalometric images, which may not provide complete or accurate information. Therefore, more RCTs using comprehensive 3D analysis are needed to confirm these results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>\n                      PROSPERO (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?RecordID=517924\" ext-link-type=\"uri\">CRD42024517924<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40510-025-00558-2","type":"journal-article","created":{"date-parts":[[2025,3,16]],"date-time":"2025-03-16T20:03:26Z","timestamp":1742155406000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Soft tissue changes associated with Class III orthopaedic treatment in growing patients: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"26","author":[{"given":"Ahmad Marwan","family":"Alhamwi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Sharafeddin","family":"Burhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fehmieh Rafik","family":"Nawaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinda","family":"Sultan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"558_CR1","doi-asserted-by":"publisher","first-page":"39731","DOI":"10.1038\/srep39731","volume":"7","author":"YZ Foo","year":"2017","unstructured":"Foo YZ, Simmons LW, Rhodes G. 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