Major clinical findings of ortho-surgical procedures in Class II patients: a concise systematic review

Introduction: In the ortho-surgery treatment, the AOB is an easily recognized malocclusion and presents only aesthetic and functional problems. Its etiology is multifactorial, including heredity, oral habits, unfavorable growth patterns, and increased lymphatic tissue along with mouth breathing and functional oral matrices. The prevalence of anterior open bite in the early mixed dentition is approximately 17.0-25%. Objective: the present study aimed to list the major clinical findings of ortho-surgical procedures in class II patients, as well as to analyze the risks of bias between the selected clinical studies. Methods: The present study was followed by a systematic literature review model, according to the PRISMA rules. The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The present study was carried out from February to June of 2022. The quality of the studies was based on the GRADE instrument, with randomized controlled clinical studies, prospective controlled clinical studies, and studies of systematic review and meta-analysis listed as the studies with the greatest scientific evidence, and the Risk of Bias was analyzed according to the Cochrane instrument (Funnel Plot Analysis). Results and Conclusion: A total of 111 articles were found. After this process, the abstracts were evaluated and a new exclusion was performed based on the GRADE Instrument and Risk of Bias. A total of 57 articles were fully evaluated and 13 clinical studies were included and discussed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 27 studies that were excluded with a Major Risk of Bias (studies with small sample size), and 44 studies that were excluded with a Minor Risk of Bias. Also, 7 studies were excluded because they did not meet the GRADE. Significant improvement in anterior occlusion can be expected in most patients when maxillary or mandibular surgery is used for Class II open bite correction. However, there will be individual patients in whom there will be considerable post-treatment changes in the anteroposterior and vertical dimensions. Although individual morphology needs to be taken into account, it appears that both short-term and long-term stability are likely to be greater after Le Fort I surgery compared to bilateral sagittal split osteotomy