Orthodontic and Orthopedic Management of Deep Bite in Young Adolescents - Systematic Review and Meta Analysis

Abstract

Background

Deep bite, a prevalent vertical malocclusion in young adolescents, adversely affects esthetics, occlusal function, and long-term dental stability. Although various orthodontic and orthopedic treatments exist, comparative data on their effectiveness and biomechanics are inconsistent.

Objective

To systematically review and synthesize evidence on orthodontic and orthopedic interventions for deep-bite correction in young adolescents, while appraising the quality and consistency of clinical research.

Methods

We conducted a comprehensive search of Scopus, Cochrane Central, PubMed Central, Web of Science, Google Scholar, and Embase for randomized controlled trials (RCTs) and clinical studies on deep-bite correction in adolescents.

Search methods

Complete searches across all listed databases.

Selection criteria

Included randomized and non-randomized studies evaluating orthodontic and orthopedic deep-bite management in young adolescents.

Data collection and analysis

Risk of bias was assessed using ROBINS-I and Rob 2.0 tools, with forest and funnel plots for quantitative synthesis.

Results

Thirteen studies were included (7 RCTs, 6 non-RCTs), with 6 eligible for quantitative and 7 eligible for quantitative synthesis. Meta-analysis showed miniscrew-supported intrusion (MSI) yielded significantly greater overbite reduction (MD = −0.36 mm), maxillary incisor intrusion (MD = −0.77 mm), and incisor inclination control (MD = 0.63°) than Connecticut intrusion arch (CIA), though evidence quality was low to moderate.Moderate-quality evidence found no significant overbite reduction difference between anterior bite turbos (ABT; MD = −4.07 mm) and reverse curve of Spee (RCS; MD = −3.27 mm). Low-quality evidence indicated MSI and utility arch (UA) outperformed J-hook headgear (J-Hg) in overbite reduction (MDs: −2.33 mm, −2.00 mm, −0.80 mm, respectively), with MSI also superior in maxillary incisor intrusion (MDs: −2.08 mm vs. UA, −1.33 mm vs. J-Hg, −0.10 mm for J-Hg).

Conclusions:

This systematic review and meta-analysis demonstrate that deep-bite correction in young adolescents can be effectively achieved using a variety of orthodontic and orthopedic modalities, each characterized by distinct biomechanical mechanisms and clinical indications. Although the overall certainty of evidence ranges from moderate to low, findings underscore the importance of tailored, growth-sensitive, biomechanically driven treatment planning to achieve stable, aesthetics, and functionally optimal outcomes. Additional well-designed trials with standardized outcome reporting and longer follow-up are needed to enhance evidence strength and clinical decision-making.