Comparative Evaluation of Microimplant and Traditional Anchorage in Class II Malocclusion Therapy: A Systematic Review and Meta-Analysis

Class II malocclusion affects aesthetics and function. Traditional anchorage methods have limitations, and microimplant anchorage (MIA) requires thorough comparison. The objective of this study was to compare the efficacy of MIA with traditional anchorage in treating patients with Class II malocclusion through meta-analysis. This study used a systematic review and meta-analysis, searching 5 English-language and 4 Chinese-language databases. The research question was structured using the PICO framework: Population (Class II malocclusion patients), Intervention (MIA), Comparison (traditional anchorage), and Outcome (cephalometric angle changes). A search formula was created using subject terms and Boolean logic. The Cochrane tool assessed bias risk in randomized controlled trials (RCTs), and the Newcastle-Ottawa scale evaluated the quality of nonrandomized studies. Evidence levels were assessed with GRADE. This study focused on indicators with clinical significance such as the sella-nasion (SN)-A point angle (SNA°). RevMan 5.4 software calculated the standardized mean difference (SMD) and odds ratio, with heterogeneity assessed using I2 and publication bias evaluated using funnel plots and Egger test, along with subgroup and sensitivity analyses. A total of 11 studies were included in the systematic review, of which 2 were RCTs and 9 were retrospective or controlled studies. Meta-analysis incorporated the data from all 11 studies, revealing that the MIA group showed a greater change in nasolabial angle than the traditional anchorage group (SMD = 0.58, P < .001) but no significant differences in SNA°, SN-B point angle, upper incisor to SN plane angle, A point-nasion-B point angle or SN plane to mandibular plane angle. The change in nasolabial angle before and after treatment was less minor in the MIA group for patients with Class II malocclusion. This provides evidence-based guidance on selecting treatment methods for patients with Angle's Class II malocclusion in clinical practice. Previous studies have shown that the choice of anchorage affects the orthodontic effect of Class II malocclusion. This meta-analysis found that the microimplant anchorage technique has certain advantages in treating patients with Angle's Class II malocclusion compared with the traditional anchorage approach; however, the degree of maxillary alveolar bone remodeling warrants further discussion.