Evidence map›Paper›PMID 41923072›Full record

SynthesisBMC oral health2026

Comparative efficacy of clear aligner mandibular advancement versus traditional functional appliances for skeletal Class II malocclusion: a systematic review and meta-analysis.

Xinqi Huang, Yun Tao, Zhimao Huang, Zhihe Zhao, Xiao Cen

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Xinqi HuangState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
Yun TaoState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
Zhimao HuangSchool of Biomedical Engineering, University of New South Wales, Sydney, New South Wales, 2052, Australia.
Zhihe ZhaoState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
Xiao CenState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China. cenx@scu.edu.cn.

Funding

National Natural Science Foundation of China 32271416National Natural Science Foundation of China 81900981Research and Development Foundation of West China Hospital of Stomatology RD-02-202507Research and Develop Program, West China Hospital of Stomatology Sichuan University LCYJ-MS-202501Sichuan Science and Technology Program 2025ZNSFSC0751
6 · The paper itself

Abstract

introductionClear Aligner Mandibular Advancement (CAMA) has emerged as an esthetic alternative for correcting Class II malocclusion, yet its efficacy compared to traditional functional appliances remains debated. The aim of this systematic review was to systematically evaluate the therapeutic efficacy of CAMA features compared to traditional functional appliances in growing patients with skeletal Class II malocclusion. MATERIALS AND

methodsA systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library up to December 31, 2025. Randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) comparing clear aligners with mandibular advancement against traditional appliances or untreated controls were included. Risk of bias was assessed using RoB 2 and ROBINS-I tools. Treatment effects were synthesized as weighted mean differences (WMDs) with 95% confidence intervals using random- or fixed-effects models based on heterogeneity (I2).

resultsNine studies (1 RCT, 8 NRSIs) comprising 465 participants were included. Meta-analysis revealed no statistically significant differences between CAMA and traditional Twin Block (TB) regarding skeletal angular changes (SNA, SNB, ANB) or vertical dimensions. However, the CAMA group demonstrated a statistically significant, though clinically minimal, greater overjet reduction compared to TB (MD = -0.46 mm, P = 0.03). Notably, CAMA exhibited significantly less lower incisor proclination compared to TB (MD = -0.90°, P = 0.0002). Comparisons with the Herbst appliance showed similar skeletal effects across all dimensions.

conclusionsBased on the currently available evidence, which is predominantly retrospective, CAMA appears to achieve skeletal orthopedic effects comparable to traditional functional appliances in growing Class II patients. The data suggest that CAMA offers superior sagittal dental control, specifically by minimizing unwanted lower incisor proclination. However, given the limited number of high-quality primary studies, these findings should be interpreted with caution and confirmed by future rigorous randomized controlled trials.

trial registrationRegistration number: CRD420251050592.

Indexed as

Malocclusion, Angle Class IIMandibular AdvancementOrthodontic Appliances, FunctionalOrthodontic Appliances, RemovableHumansOrthodontic Appliance DesignTreatment OutcomeClass II malocclusionClear alignerLower incisor inclinationMandibular advancementMeta-analysisTwin block

Identifiers

PMID41923072
PMCPMC13169927

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.