The Open Dentistry Journal

2 See the PRISMA 2020 for Abstracts checklist.


Rationale
3 Describe the rationale for the review in the context of existing knowledge.

Initial introduction
Objectives 4 Provide an explicit statement of the objective(s) or question(s) the review addresses.

Eligibility criteria 5
Specify the inclusion and exclusion criteria for the review and how studies were grouped for the syntheses.

Dedicated section in M&M
Information sources 6 Specify all databases, registers, websites, organisations, reference lists and other sources searched or consulted to identify studies.Specify the date when each source was last searched or consulted.

Dedicated section in M&M
Search strategy 7 Present the full search strategies for all databases, registers and websites, including any filters and limits used.

Dedicated table
Selection process 8 Specify the methods used to decide whether a study met the inclusion criteria of the review, including how many reviewers screened each record and each report retrieved, whether they worked independently, and if applicable, details of automation tools used in the process.

Dedicated section in M&M
Data collection process 9 Specify the methods used to collect data from reports, including how many reviewers collected data from each report, whether they worked independently, any processes for obtaining or confirming data from study investigators, and if applicable, details of automation tools used in the process.

Data items 10a
List and define all outcomes for which data were sought.Specify whether all results that were compatible with each outcome domain in each study were sought (e.g. for all measures, time points, analyses), and if not, the methods used to decide which results to collect.

Dedicated section in M&M 10b
List and define all other variables for which data were sought (e.g.participant and intervention characteristics, funding sources).Describe any assumptions made about any missing or unclear information.Specify the methods used to assess risk of bias in the included studies, including details of the tool(s) used, how many reviewers assessed each study and whether they worked independently, and if applicable, details of automation tools used in the process.

Supplementary Material
2 reviewers assessed the risk of biasspecified in M&M Effect measures 12 Specify for each outcome the effect measure(s) (e.g.risk ratio, mean difference) used in the synthesis or presentation of results.

Mean difference (M&M)
Synthesis methods 13a Describe the processes used to decide which studies were eligible for each synthesis (e.g.tabulating the study intervention characteristics and comparing against the planned groups for each synthesis (item #5)).

Type of intervention 13b
Describe any methods required to prepare the data for presentation or synthesis, such as handling of missing summary statistics, or data conversions.

Procedure described M&M 13c
Describe any methods used to tabulate or visually display results of individual studies and syntheses.

Procedure described M&M 13d
Describe any methods used to synthesize results and provide a rationale for the choice(s).If meta-analysis was performed, describe the model(s), method(s) to identify the presence and extent of statistical heterogeneity, and software package(s) used.
Answer to PICO 13e Describe any methods used to explore possible causes of heterogeneity among study results (e.g.subgroup analysis, meta-regression).
N/A 13f Describe any sensitivity analyses conducted to assess robustness of the synthesized results.N/A Reporting bias assessment 14 Describe any methods used to assess risk of bias due to missing results in a synthesis (arising from reporting biases).

N/A
Certainty assessment 15 Describe any methods used to assess certainty (or confidence) in the body of evidence for an outcome.

Study selection 16a
Describe the results of the search and selection process, from the number of records identified in the search to the number of studies included in the review, ideally using a flow diagram.

Dedicated table 16b
Cite studies that might appear to meet the inclusion criteria, but which were excluded, and explain why they were excluded.

Study characteristics 17
Cite each included study and present its characteristics.

Dedicated table
Risk of bias in studies 18 Present assessments of risk of bias for each included study.Dedicated table

Results of individual studies 19
For all outcomes, present, for each study: (a) summary statistics for each group (where appropriate) and (b) an effect estimate and its precision (e.g.confidence/credible interval), ideally using structured tables or plots.

Results of syntheses 20a
For each synthesis, briefly summarise the characteristics and risk of bias among contributing studies.

Dedicated table 20b
Present results of all statistical syntheses conducted.If meta-analysis was done, present for each the summary estimate and its precision (e.g.confidence/credible interval) and measures of statistical heterogeneity.If comparing groups, describe the direction of the effect.

N/A 20c
Present results of all investigations of possible causes of heterogeneity among study results.Dedicated table 20d Present results of all sensitivity analyses conducted to assess the robustness of the synthesized results.

Dedicated table
Reporting biases 21 Present assessments of risk of bias due to missing results (arising from reporting biases) for each synthesis assessed.

Dedicated table
Certainty of evidence 22 Present assessments of certainty (or confidence) in the body of evidence for each outcome assessed.

Discussion 23a
Provide a general interpretation of the results in the context of other evidence.Followed 23b Discuss any limitations of the evidence included in the review.Followed 23c Discuss any limitations of the review processes used.Followed 23d Discuss implications of the results for practice, policy, and future research.Followed

Registration and protocol 24a
Provide registration information for the review, including register name and registration number, or state that the review was not registered.

The review was not registered 24b
Indicate where the review protocol can be accessed, or state that a protocol was not prepared.Hu et al., 2021 [13] Case Report Maurer et al., 2002 [14] Case Report Table S4.Criteria for judging risk of bias in the "Risk of bias" assessment tool.

Random Sequence Generation
Criteria for a judgement of 'Low risk' of bias.
The investigators describe a random component in the sequence generation process.
Criteria for the judgement of 'High risk' of bias.
The investigators describe a non-random component in the sequence generation process.Usually, the description would involve some systematic, non-random approach.Other non-random approaches happen much less frequently than the systematic approaches mentioned above and tend to be obvious.They usually involve judgement or some method of non-random categorization of participants.

Allocation Concealment
Criteria for a judgement of 'Low risk' of bias.
Participants and investigators enrolling participants could not foresee assignment because one of the following, or an equivalent method, was used to conceal allocation.
Criteria for the judgement of 'High risk' of bias.
Participants or investigators enrolling participants could possibly foresee assignments and thus introduce selection bias.

Blinding
Criteria for a judgement of 'Low risk' of bias.
Any one of the following: -No blinding or incomplete blinding, but the review authors judge that the outcome is not likely to be influenced by lack of blinding; -Blinding of participants and key study personnel ensured, and unlikely that the blinding could have been broken; -No blinding of outcome assessment, but the review authors judge that the outcome measurement is not likely to be influenced by lack of blinding; -Blinding of outcome assessment ensured, and unlikely that the blinding could have been broken.
Criteria for the judgement of 'High risk' of bias.
Any one of the following: -No blinding or incomplete blinding, and the outcome is likely to be influenced by lack of blinding; -Blinding of key study participants and personnel attempted, but likely that the blinding could have been broken, and the outcome is likely to be influenced by lack of blinding; -No blinding of outcome assessment, and the outcome measurement is likely to be influenced by lack of blinding; -Blinding of outcome assessment, but likely that the blinding could have been broken, and the outcome measurement is likely to be influenced by lack of blinding.

Incomplete Outcome Data
Criteria for a judgement of 'Low risk' of bias.
Any one of the following: -No missing outcome data; -Reasons for missing outcome data unlikely to be related to true outcome (for survival data, censoring unlikely to be introducing bias); -Missing outcome data balanced in numbers across intervention groups, with similar reasons for missing data across groups; -For dichotomous outcome data, the proportion of missing outcomes compared with observed event risk not enough to have a clinically relevant impact on the intervention effect estimate; -For continuous outcome data, plausible effect size (difference in means or standardized difference in means) among missing outcomes not enough to have a clinically relevant impact on observed effect size; -Missing data have been imputed using appropriate methods.

Random Sequence Generation
Criteria for the judgement of 'High risk' of bias.
Any one of the following: -Reason for missing outcome data likely to be related to true outcome, with either imbalance in numbers or reasons for missing data across intervention groups; -For dichotomous outcome data, the proportion of missing outcomes compared with observed event risk enough to induce clinically relevant bias in intervention effect estimate; -For continuous outcome data, plausible effect size (difference in means or standardized difference in means) among missing outcomes enough to induce clinically relevant bias in observed effect size; -'As-treated' analysis done with substantial departure of the intervention received from that assigned at randomization; -Potentially inappropriate application of simple imputation.

Selective Reporting
Criteria for a judgement of 'Low risk' of bias.
Any one of the following: -The study protocol is available and all of the study's pre-specified (primary and secondary) outcomes that are of interest in the review have been reported in the pre-specified way; -The study protocol is not available but it is clear that the published reports include all expected outcomes, including those that were pre-specified (convincing text of this nature may be uncommon).
Criteria for the judgement of 'High risk' of bias.
Any one of the following: -Not all of the study's pre-specified primary outcomes have been reported; -One or more primary outcomes is reported using measurements, analysis methods or subsets of the data (e.g., subscales) that were not pre-specified; -One or more reported primary outcomes were not pre-specified (unless clear justification for their reporting is provided, such as an unexpected adverse effect); -One or more outcomes of interest in the review are reported incompletely so that they cannot be entered in a meta-analysis; -The study report fails to include results for a key outcome that would be expected to have been reported for such a study.Results: increase in the alar base width in both groups, with a significant difference between the means (P<0.001).It was observed that the external technique (Group 2) better-controlled alar base width after Le Fort I osteotomy.
Conclusions: the external technique was more effective when compared to the internal technique in controlling the enlargement of the alar base width Ruf et al., 2004 [17] A

Camacho et al., 2020 [33]
A 2-week single-blind randomized controlled clinical trial with 56 participants affected by dentofacial deformities with mandibular orthognathic surgery indication and divided into three groups: post-mandibular orthognathic surgery who will be treated after the procedure with 250 mg naproxen sodium every 8 hours and 6 doses of low-level laser therapy with an energy density of 85.71 J/cm 2 , starting two days after the procedure and every other day until the 13th day (Group 1, 19 patients), postmandibular orthognathic surgery who will be treated after the procedure with 250 mg naproxen sodium every 8 hours and 6 doses of PBMT with an energy density of 68.33 J/cm 2 , starting two days after the procedure and every other day until the 13th day (Group 2, 18 patients), postmandibular orthognathic surgery who will be treated after the procedure with 250 mg naproxen sodium every 8 hours for 6 days (Control Group, 19 patients) Results: there were no significant differences between the SARME and isolated maxillary/mandibular surgery groups.In the bimaxillary groups, average mouth opening was increased in all patients who received PBMT, significantly so in male patients Conclusions: PBMT with a GaAlAs diode laser (780 nm) did not affect postoperative mouth opening after SARME, isolated maxillary surgery, or isolated mandibular surgery.However, it improved mouth opening in men who had undergone bimaxillary orthognathic surgery (Table 5) contd.....

Authors Study Design Inclusion and Exclusion Criteria
Aim Results and Conclusions Bevilacqua et al., 2016 [35] A 2-week double-blind prospective randomized controlled clinical trial with 60 participants scheduled for periodontal flap surgery and divided into three groups: alcohol-free 0.12% CHX (20 patients), alcohol-free 0.2% CHX (20 patients), and alcoholfree 0.2% CHX with ADS (20 patients).Before surgery (T0), 7 days (T1) and 14 days (T2) after surgery, following variables were recorded: gingival parameters at the surgically treated sites (Full- To present preliminary results and experiences using an ultrasonic bonecutting device in BSSRO with particular attention to possible damages to the IAN Results: Subjective neurosensory disturbances of the IAN showed a continuous decrease from 57.1% (eight sides) 2 months after the surgical procedure to 14.3% (2 sides) after 5 months and to 7.1% 7 months after BSSRO Conclusions: this preliminary clinical evaluation suggests that ultrasonic bone cutting is possible in orthognathic surgery at a high level of safety and precision.
Long-term benefits regarding protection of neurosensory functions remain to be shown Baan et al., 2016 [37] A 3-weeks clinical trial with 10 participants requiring a bimaxillary surgery to correct skeletal II class discrepancy, which underwent CBCT scans 4 weeks before surgery and 1-3 weeks after surgery To evaluate specific parameters: intra-operative time, facial swelling, degree of pain (VAS scale), recovery time and neurosensory disturbance in patients who underwent orthognathic surgery either using piezo or saw devices.
Results: intra-operative time is unchanged, but patients operated with the Piezo devices requested fewer painkilling medication and were dismissed on the second day after the surgery.Neurosensory recovery was statistically significant in the Piezo group (P<0.05)Conclusions: far less post-op swelling and the reduction in the use of painkillers lead to a speedier recovery in patients who underwent orthognathic surgery using Piezosurgery.These patients also recovered more sensitivity in the lower lip area Kee et al., 2022 [40] Retrospective clinical study with 64 participants affected by skeletal class III malocclusion and divided into two groups: 32 patients treated with orthognathic surgery and postsurgical orthodontic treatment (Group 1), and 32 patients treated with presurgical orthodontic treatment, orthognathic surgery, and postsurgical orthodontic treatment (Group 2).Cone-beam computed tomography scans were obtained before treatment, after presurgical orthodontic treatment, and after treatment for the COS group and were obtained before and after treatment for the SFA group.The measurements of vertical alveolar bone height and horizontal bone thickness at 4 levels and the alveolar bone area surrounding the mandibular incisors were compared according to the treatment progress and groups Results: six complexes were formed for the baseline samples.Similar complexes were formed for the samples taken 3-24 months post-therapy.However, distinct changes were observed in microbial communities in samples taken during the 7 days of plaque redevelopment.The complexes related to clinical parameters of periodontal disease Conclusions: there were specific microbial complexes in supragingival plaque that were like those found in subgingival plaque samples with a few minor differences Farronato et al., 2014 [45] Prospective clinical study with 300 participants affected by dental-skeletal facial deformities and edentulism, whose 100 pediatric patients assessed first visit (T1), third stage of the preorthodontic oral prevention scheme (T2), fourth stage of the preorthodontic oral prevention scheme; 100 patients undergoing orthodontic therapy assessed at the first visit (T1), at the positioning of the appliance (T2), at the intermediate stage of the fixed appliance therapy (T3), before removal of the fixed applicance (T4); 75 patients undergoing combined orthodontic-surgical treatment assessed at the first visit (T1), day after surgery (T2), intermaxillary fixation (T3), removal of the fixed appliance (T4); 25 patients undergoing implant-prosthetic rehabilitation assessed at the first visit (T1), before positioning of the implant/s (T2), at the insertion of the crown/s (T3), one month after implant loading (T4)

Inclusion criteria: NR Exclusion criteria: NR
To describe the qualitative and quantitative changes occurring within the oral bacterial flora of several groups of patients following oral prevention protocols during the stages of the dental treatment they required Results: Mean Plaque Index Score of most patients generally decreased during the various treatment phases and hence the overall bacterial count.However, there was slight increase in the plaque index in patients undergoing orthodontic surgery after placement of the orthodontic appliance and patients undergoing combined orthodontic-surgical treatment during the intermaxillary fixation phase.
There was found that the coccoidal bacterial form was the most prevalent Conclusions: patients who were adequately instructed and motivated through oral hygiene prevention strategies, showed a significant decrease in the plaque levels and in the overall bacterial components between the first visit and the successive sample taking.The slight increase in the plaque index in patients undergoing the intermaxillary fixation phase decreased immediately once the phase ended, and the patients managed to return to the routine oral hygiene care.This highlights the importance of constant motivation and oral hygiene instruction reinforcement  Note: Q1: Was the study described as randomized, a randomized trial, a randomized clinical trial, or an RCT?, Q2: Was the method of randomization adequate (i.e., use of randomly generated assignment)?, Q3: Was the treatment allocation concealed (so that assignments could not be predicted)?, Q4: Were study participants and providers blinded to treatment group assignment?, Q5: Were the people assessing the outcomes blinded to the participants' group assignments?, Q6: Were the groups similar at baseline on important characteristics that could affect outcomes (e.g., demographics, risk factors, co-morbid conditions)?, Q7: Was the overall drop-out rate from the study at endpoint 20% or lower of the number allocated to treatment?, Q8: Was the differential drop-out rate (between treatment groups) at endpoint 15 percentage points or lower?, Q9: Was there high adherence to the intervention protocols for each treatment group?, Q10: Were other interventions avoided or similar in the groups (e.g., similar background treatments)?, Q11: Were outcomes assessed using valid and reliable measures, implemented consistently across all study participants?, Q12: Did the authors report that the sample size was sufficiently large to be able to detect a difference in the main outcome between groups with at least 80% power?, Q13: Were outcomes reported or subgroups analyzed prespecified (i.e., identified before analyses were conducted)?, Q14: Were all randomized participants analyzed in the group to which they were originally assigned, i.e., did they use an intention-to-treat analysis?;Total Score: Number of yes; CD: cannot be determined; NA: not applicable; NR: not reported; N: no; Y: yes.Quality Rating: Poor <50%, Fair 50-75%, Good ≥75%.Note: Q1: Was the study question or objective clearly stated?, Q2: Were eligibility/selection criteria for the study population prespecified and clearly described?, Q3: Were the participants in the study representative of those who would be eligible for the test/service/intervention in the general or clinical population of interest?, Q4: Were all eligible participants that met the prespecified entry criteria enrolled?, Q5: Was the sample size sufficiently large to provide confidence in the findings?, Q6: Was the test/service/intervention clearly described and delivered consistently across the study population?, Q7: Were the outcome measures prespecified, clearly defined, valid, reliable, and assessed consistently across all study participants?, Q8: Were the people assessing the outcomes blinded to the participants' exposures/interventions?, Q9: Was the loss to follow-up after baseline 20% or less?Were those lost to follow-up accounted for in the analysis?, Q10: Did the statistical methods examine changes in outcome measures from before to after the intervention?Were statistical tests done that provided p values for the pre-to-post changes?, Q11: Were outcome measures of interest taken multiple times before the intervention and multiple times after the intervention (i.e., did they use an interrupted time-series design)?, Q12: If the intervention was conducted at a group level (e.g., a whole hospital, a community, etc.) did the statistical analysis take into account the use of individual-level data to determine effects at the group level?;Total Score: Number of yes; CD: cannot be determined; NA: not applicable; NR: not reported; N: no; Y: yes.Quality Rating: Poor <50%, Fair 50-75%, Good ≥75%.Note: Q1: Was the research question or objective in this paper clearly stated?, Q2: Was the study population clearly specified and defined?, Q3: Was the participation rate of eligible persons at least 50%?, Q4: Were all the subjects selected or recruited from the same or similar populations (including the same time period)?Were inclusion and exclusion criteria for being in the study prespecified and applied uniformly to all participants?, Q5: Was a sample size justification, power description, or variance and effect estimates provided?, Q6: For the analyses in this paper, were the exposure(s) of interest measured prior to the outcome(s) being measured?, Q7: Was the timeframe sufficient so that one could reasonably expect to see an association between exposure and outcome if it existed?, Q8: For exposures that can vary in amount or level, did the study examine different levels of the exposure as related to the outcome (e.g., categories of exposure, or exposure measured as continuous variable)?, Q9: Were the exposure measures (independent variables) clearly defined, valid, reliable, and implemented consistently across all study participants?, Q10: Was the exposure(s) assessed more than once over time?, Q11: Were the outcome measures (dependent variables) clearly defined, valid, reliable, and implemented consistently across all study participants?, Q12: Were the outcome assessors blinded to the exposure status of participants?, Q13: Was loss to follow-up after baseline 20% or less?, Q14: Were key potential confounding variables measured and adjusted statistically for their impact on the relationship between exposure(s) and outcome(s)?; Total Score: Number of yes; CD: cannot be determined; NA: not applicable; NR: not reported; N: no; Y: yes.Quality Rating: Poor <50%, Fair 50-75%, Good ≥75%.

Table S2 . Search strategies for electronic databases.
Protocol was not prepared 24cDescribe and explain any amendments to information provided at registration or in the protocol.N/A Support 25 Describe sources of financial or non-financial support for the review, and the role of the funders or sponsors in the review.