Skeletal versus conventional anchorage in dentofacial orthopedics: an international modified Delphi consensus study

Authors

Lorenzo Franchi, Università degli Studi di Firenze, Facoltà di Medicina e Chirurgia
Maria Denisa Statie, Università degli Studi di Firenze, Facoltà di Medicina e Chirurgia
Tommaso Clauser, Università degli Studi di Firenze, Facoltà di Medicina e Chirurgia
Marco Migliorati, Università degli Studi di Genova
Alessandro Ugolini, Università degli Studi di Genova
Rosaria Bucci, Università degli Studi di Napoli Federico II
Roberto Rongo, Università degli Studi di Napoli Federico II
Riccardo Nucera, Università degli Studi di Messina
Marco Portelli, Università degli Studi di Messina
James A. McNamara, University of Michigan, Ann Arbor
Michele Nieri, Università degli Studi di Firenze, Facoltà di Medicina e Chirurgia
Sercan Akyalcin, Harvard School of Dental Medicine
Fernanda Angelieri
Daniele Cantarella, Arizona School of Dentistry and Oral Health
Paolo Cattaneo, Faculty of Medicine, Dentistry and Health Sciences
Lucia Cevidanes, University of Michigan, Ann Arbor
Luca Contardo, Università degli Studi di Trieste
Marie Cornelis, Faculty of Medicine, Dentistry and Health Sciences
Renzo De Gabriele, Private Practice
Carlos Flores Mir, University of Alberta, Faculty of Medicine and Dentistry
Daniela Garib, Universidade de São Paulo
Giorgio Iodice, Università degli Studi di Napoli Federico II
Antonino Lo Giudice, Università degli Studi di Catania
Luca Lombardo, University of Ferrara
Björn Ludwig, Universität des Saarlandes
Cesare Luzi, Private practice
Maria Costanza Meazzini, L'Ospedale San Gerardo
Peter Ngan, West Virginia University School of Dentistry
Tung Nguyen, UNC-CH Adams School of Dentistry
Alexandra Papadopoulou, Université de Genève Faculté de Médecine
Spyridon Papageorgiou, Universität Zürich
Jae Hyun Park, Arizona School of Dentistry and Oral Health
Sabine Ruf, Justus-Liebig-Universität Gießen

Document Type

Article

Publication Title

Progress in Orthodontics

Abstract

Background: To establish consensus of skeletal anchorage versus conventional anchorage in treating: 1. Maxillary transverse deficiency in growing and adult patients, 2. Class II skeletal disharmony due to mandibular retrusion in growing patients, 3. Class III skeletal disharmony in growing patients. Methods: A four-rounds modified Delphi method was conducted. A steering committee performed a literature selection and compiled a list of 33 statements. An international panel of 25 experts in orthodontics agreed to participate. In each round, panelists were asked to rate their level of agreement with each statement using a 5-point Likert scale and provide comments. Statements that reached consensus were either accepted or rephrased. Statements that did not reach consensus were either rephrased, rejected, or split into two statements or merged with another. Results: After the four rounds, 24 statements achieved consensus while 9 were rejected. The distribution of consensus statements was as follows: Maxillary transverse deficiency: 4 statements; Class II skeletal disharmony: 10 statements; Class III skeletal disharmony: 10 statements. Conclusions: This modified Delphi consensus study aimed to provide guidance for orthodontists in choosing between skeletal and conventional anchorage for various treatment conditions. The study generated 24 consensus statements across three key domains. While the Delphi method provides valuable expert opinions, future studies, including randomized controlled trials, are needed to confirm these findings and address remaining uncertainties. Such efforts will aid in refining orthodontic treatment protocols and enhancing patient outcomes.

DOI

10.1186/s40510-025-00556-4

Publication Date

12-1-2025

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