Treatment Effects of Miniscrew Anchored Forsus: A Meta-Analysis of Randomized Clinical Trials

Objectives: To evaluate the skeletal and dental treatment effects of Forsus Fatigue Resistant Device (FFRD) when used with miniscrews and compare them with its conventional use in Class II malocclusions.
Methods: Unrestricted electronic search of six databases and additional manual searches were performed up to September 2017. Randomized controlled trials in Class II malocclusion individuals having one treatment arm with miniscrew anchored FFRD and another matched treatment group treated with conventional FFRD were included in this review. Risk of bias assessment was performed using Cochrane’s Risk of Bias Tool. Skeletal and dentoalveolar outcomes data were extracted by two authors independently. Random effects meta-analysis including subgroup analysis were presented.
Results: Three studies were finally included and qualified for meta-analysis. The review included data from 93 Class II malocclusion patients (46 treated with miniscrew anchored Forsus and 47 treated with conventional Forsus). Meta-analysis showed a statistically significant reduction in SNA angle in favor of miniscrew anchored Forsus (MD: -0.26, CI: -0.50 to -0.02), a non-significant difference in SNB (MD: 0.17, CI: -0.06 to 0.39), a statistically significant increase in SN-MP angle in favor of miniscrew anchored Forsus FRD (MD: 0.53, CI: 0.06 to 1.00), a statistically significant reduction in the L1-MP angle in favor of miniscrew anchored Forsus FRD (MD: -3.54, CI: -4.96 to -2.12)
Conclusions: With high level of certainty(GRADE), the use of miniscrews as a means of anchorage with Forsus FRD could not enhance forward mandibular growth. However, miniscrew anchored Forsus FRD could minimize mandibular incisors protrusion.