Can lingual spurs alter the oral health-related quality of life during anterior open bite interceptive treatment? A systematic review

Table 5:
Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) instrument.¹⁴14 Balshem H, Helfand M, Schunemann HJ, Oxman AD, Kunz R, Brozek G, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64(4):401-6.

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Database Keywords Results Pubmed ((((((((((((((((((((((((((((((((((((((((((((((((((((((((Infant[MeSH Terms]) OR (Infant[Title/Abstract])) OR (Toddler[Title/Abstract])) OR (Pediatrics[MeSH Terms])) OR (Pediatrics[Title/Abstract])) OR (Pediatric[Title/Abstract])) OR (Paediatric[Title/Abstract])) OR (Child[MeSH Terms])) OR (Child[Title/Abstract])) OR (Children[Title/Abstract])) OR (Minors[MeSH Terms])) OR (Minors[Title/Abstract])) OR (Minor[Title/Abstract])) OR (Adolescent[MeSH Terms])) OR (Adolescent[Title/Abstract])) OR (Adolescents[Title/Abstract])) OR (Adolescence[Title/Abstract])) OR (Teens[Title/Abstract])) OR (Teen[Title/Abstract])) OR (Teenagers[Title/Abstract])) OR (Teenager[Title/Abstract])) OR (Youth[Title/Abstract])) OR (Youths[Title/Abstract])) OR (Adolescents, Female[Title/Abstract])) OR (Adolescent, Female[Title/Abstract])) OR (Female Adolescent[Title/Abstract])) OR (Female Adolescents[Title/Abstract])) OR (Adolescents, Male[Title/Abstract])) OR (Adolescent, Male[Title/Abstract])) OR (Male Adolescent[Title/Abstract])) OR (Male Adolescents[Title/Abstract])) OR (Boy[Title/Abstract])) OR (Boys[Title/Abstract])) OR (Girl[Title/Abstract])) OR (Girls[Title/Abstract])) OR (Schools, Nursery[MeSH Terms])) OR (Schools, Nursery[Title/Abstract])) OR (Nursery schools[Title/Abstract])) OR (Nursery school[Title/Abstract])) OR (School, Nursery[Title/Abstract])) OR (Child, Preschool[MeSH Terms])) OR (Child, Preschool[Title/Abstract])) OR (Preschool Child[Title/Abstract])) OR (Children, Preschool[Title/Abstract])) OR (Preschool Children[Title/Abstract])) OR (Day care[Title/Abstract])) OR (Kindergarten[Title/Abstract])) OR (Kindergarden[Title/Abstract])) OR (Elementary school[Title/Abstract])) OR (Schoolchild[Title/Abstract])) OR (Middle school[Title/Abstract])) OR (High school[Title/Abstract]))) AND ((((((((((Open bite[MeSH Terms]) OR (Open bite[Title/Abstract])) OR (Bite, Open[Title/Abstract])) OR (Nonoclusion[Title/Abstract])) OR (Openbite[Title/Abstract])) OR (Apertognathia[Title/Abstract])) OR (Anterior open bite[Title/Abstract])) OR (Anterior open-bite[Title/Abstract])) OR (Open-bite[Title/Abstract]))))) AND (((((((((((((((((((((((((((((((((((((((((((((((((((((Orthodontics, Interceptive[MeSH Terms]) OR (Orthodontics, Interceptive[Title/Abstract])) OR (Interceptive orthodontics[Title/Abstract])) OR (Orthodontic Appliances, Functional[MeSH Terms])) OR (Orthodontic Appliances, Functional[Title/Abstract])) OR (Appliance, Functional Orthodontic[Title/Abstract])) OR (Appliances, Functional Orthodontic[Title/Abstract])) OR (Functional Orthodontic Appliance[Title/Abstract])) OR (Functional Orthodontic Appliance[Title/Abstract])) OR (Orthodontic Appliance, Functional[Title/Abstract])) OR (Early orthodontic treatment[Title/Abstract])) OR (Early open bite treatment[Title/Abstract])) OR (Anterior open bite treatment[Title/Abstract])) OR (Orthopaedic treatment[Title/Abstract])) OR (Habit appliances[Title/Abstract])) OR (Fixed intraoral habit appliance[Title/Abstract])) OR (Spur[Title/Abstract])) OR (Spurs[Title/Abstract])) OR (Spur therapy[Title/Abstract])) OR (Spur appliance[Title/Abstract])) OR (Sharp spur[Title/Abstract])) OR (Sharp spurs[Title/Abstract])) OR (Tongue spur[Title/Abstract])) OR (Tongue spurs[Title/Abstract])) OR (Lingual spurs[Title/Abstract])) OR (Lingual spur[Title/Abstract])) OR (Palatal spur[Title/Abstract])) OR (Palatal spurs[Title/Abstract])) OR (Spike[Title/Abstract])) OR (Spikes[Title/Abstract])) OR (Lingual spike[Title/Abstract])) OR (Lingual spikes[Title/Abstract])) OR (Bonded spur[Title/Abstract])) OR (Bonded spurs[Title/Abstract])) OR (Spur bonded[Title/Abstract])) OR (Spurs bonded[Title/Abstract])) OR (Bonded lingual spur[Title/Abstract])) OR (Bonded lingual spurs[Title/Abstract])) OR (Bonded palatal spur[Title/Abstract])) OR (Bonded palatal spurs[Title/Abstract])) OR (Bondable lingual spur[Title/Abstract])) OR (Bondable lingual spurs[Title/Abstract])) OR (Bondable lingual tongue spur[Title/Abstract])) OR (Bondable lingual tongue spurs[Title/Abstract])) OR (Conventional spur[Title/Abstract])) OR (Conventional spurs[Title/Abstract])) OR (Conventional orthodontic spur[Title/Abstract])) OR (Conventional orthodontic spurs[Title/Abstract])) OR (Conventional lingual spur[Title/Abstract])) OR (Conventional lingual spurs[Title/Abstract])) OR (Banded spur[Title/Abstract])) OR (Banded spurs[Title/Abstract])))) 195 Scopus (((TITLE-ABS-KEY(Infant*) OR TITLE-ABS-KEY(“Toddler”) OR TITLE-ABS-KEY(Pediatrics*) OR TITLE-ABS-KEY(“Pediatric”) OR TITLE-ABS-KEY(“Paediatric”) OR TITLE-ABS-KEY(Child*) OR TITLE-ABS-KEY(“Children”) OR TITLE-ABS-KEY(Minors*) OR TITLE-ABS-KEY(“Minor”) OR TITLE-ABS-KEY(Adolescent*) OR TITLE-ABS-KEY(“Adolescents”) OR TITLE-ABS-KEY(“Adolescence”) OR TITLE-ABS-KEY(“Teens”) OR TITLE-ABS-KEY(“Teen”) OR TITLE-ABS-KEY(“Teenagers”) OR TITLE-ABS-KEY(“Teenager”) OR TITLE-ABS-KEY(“Youth”) OR TITLE-ABS-KEY(“Youths”) OR TITLE-ABS-KEY(“Female Adolescent”) OR TITLE-ABS-KEY(“Female Adolescents”) OR TITLE-ABS-KEY(“Male Adolescent”) OR TITLE-ABS-KEY(“Male Adolescents”) OR TITLE-ABS-KEY(“Boy”) OR TITLE-ABS-KEY(“Boys”) OR TITLE-ABS-KEY(“Girl”) OR TITLE-ABS-KEY(“Girls”) OR TITLE-ABS-KEY(Schools Nursery*) OR TITLE-ABS-KEY(“Nursery schools”) OR TITLE-ABS-KEY(“Nursery school”) OR TITLE-ABS-KEY(Child Preschool*) OR TITLE-ABS-KEY(“Preschool Child”) OR TITLE-ABS-KEY(“Preschool Children”) OR TITLE-ABS-KEY(“Day care”) OR TITLE-ABS-KEY(“Kindergarten”) OR TITLE-ABS-KEY(“Kindergarden”) OR TITLE-ABS-KEY(“Elementary school”) OR TITLE-ABS-KEY(“Schoolchild”) OR TITLE-ABS-KEY(“Middle school”) OR TITLE-ABS-KEY(“High school”))) AND ((TITLE-ABS-KEY(Open bite*) OR TITLE-ABS-KEY(“Nonoclusion”) OR TITLE-ABS-KEY(“Openbite”) OR TITLE-ABS-KEY(“Apertognathia”) OR TITLE-ABS-KEY(“Anterior open bite”) OR TITLE-ABS-KEY(“Anterior open-bite”) OR TITLE-ABS-KEY(“Open-bite”)))) AND ((TITLE-ABS-KEY(Orthodontics Interceptive*) OR TITLE-ABS-KEY(“Interceptive orthodontics”) OR TITLE-ABS-KEY(Orthodontic Appliances Functional*) OR TITLE-ABS-KEY(“Functional Orthodontic Appliance”) OR TITLE-ABS-KEY(“Functional Orthodontic Appliance”) OR TITLE-ABS-KEY(“Early orthodontic treatment”) OR TITLE-ABS-KEY(“Early open bite treatment”) OR TITLE-ABS-KEY(“Anterior open bite treatment”) OR TITLE-ABS-KEY(“Orthopaedic treatment”) OR TITLE-ABS-KEY(“Habit appliances”) OR TITLE-ABS-KEY(“Fixed intraoral habit appliance”) OR TITLE-ABS-KEY(“Spur”) OR TITLE-ABS-KEY(“Spurs”) OR TITLE-ABS-KEY(“Spur therapy”) OR TITLE-ABS-KEY(“Spur appliance”) OR TITLE-ABS-KEY(“Sharp spur”) OR TITLE-ABS-KEY(“Sharp spurs”) OR TITLE-ABS-KEY(“Tongue spur”) OR TITLE-ABS-KEY(“Tongue spurs”) OR TITLE-ABS-KEY(“Tongue spur”) OR TITLE-ABS-KEY(“Lingual spurs”) OR TITLE-ABS-KEY(“Lingual spur”) OR TITLE-ABS-KEY(“Palatal spur”) OR TITLE-ABS-KEY(“Palatal spurs”) OR TITLE-ABS-KEY(“Spike”) OR TITLE-ABS-KEY(“Spikes”) OR TITLE-ABS-KEY(“Lingual spike”) OR TITLE-ABS-KEY(“Lingual spikes”) OR TITLE-ABS-KEY(“Bonded spur”) OR TITLE-ABS-KEY(“Bonded spurs”) OR TITLE-ABS-KEY(“Spur bonded”) OR TITLE-ABS-KEY(“Spurs bonded”) OR TITLE-ABS-KEY(“Bonded lingual spur”) OR TITLE-ABS-KEY(“Bonded lingual spurs”) OR TITLE-ABS-KEY(“Bonded palatal spur”) OR TITLE-ABS-KEY(“Bonded palatal spurs”) OR TITLE-ABS-KEY(“Bondable lingual spur”) OR TITLE-ABS-KEY(“Bondable lingual spurs”) OR TITLE-ABS-KEY(“Bondable lingual tongue spur”) OR TITLE-ABS-KEY(“Bondable lingual tongue spurs”) OR TITLE-ABS-KEY(“Conventional spur”) OR TITLE-ABS-KEY(“Conventional spurs”) OR TITLE-ABS-KEY(“Conventional orthodontic spur”) OR TITLE-ABS-KEY(“Conventional orthodontic spurs”) OR TITLE-ABS-KEY(“Conventional lingual spur”) OR TITLE-ABS-KEY(“Conventional lingual spurs”) OR TITLE-ABS-KEY(“Banded spur”) OR TITLE-ABS-KEY(“Banded spurs”))) 198 Web of Science TÓPICO: (Infant*) OR TÓPICO: (“Toddler”) OR TÓPICO: (Pediatrics*) OR TÓPICO: (“Pediatric”) OR TÓPICO: (“Paediatric”) OR TÓPICO: (Child*) OR TÓPICO: (“Children”) OR TÓPICO: (Minors*) OR TÓPICO: (“Minor”) OR TÓPICO: (Adolescent*) OR TÓPICO: (“Adolescents”) OR TÓPICO: (“Adolescence”) OR TÓPICO: (“Teens”) OR TÓPICO: (“Teen”) OR TÓPICO: (“Teenagers”) OR TÓPICO: (“Teenager”) OR TÓPICO: (“Youth”) OR TÓPICO: (“Youths”) OR TÓPICO: (“Female Adolescent”) OR TÓPICO: (“Female Adolescents”) OR TÓPICO: (“Male Adolescent”) OR TÓPICO: (“Male Adolescents”) OR TÓPICO: (“Boy”) OR TÓPICO: (“Boys”) OR TÓPICO: (“Girl”) OR TÓPICO: (“Girls”) OR TÓPICO: (Schools Nursery*) OR TÓPICO: (“Nursery schools”) OR TÓPICO: (“Nursery school”) OR TÓPICO: (Child Preschool*) OR TÓPICO: (“Preschool Child”) OR TÓPICO: (“Preschool Children”) OR TÓPICO: (“Day care”) OR TÓPICO: (“Kindergarten”) OR TÓPICO: (“Kindergarden”) OR TÓPICO: (“Elementary school”) OR TÓPICO: (“Schoolchild”) OR TÓPICO: (“Middle school”) OR TÓPICO: (“High school”) AND TÓPICO: (Open bite*) OR TÓPICO: (“Nonoclusion”) OR TÓPICO: (“Openbite”) OR TÓPICO: (“Apertognathia”) OR TÓPICO: (“Anterior open bite”) OR TÓPICO: (“Anterior open-bite”) OR TÓPICO: (“Open-bite”) AND TÓPICO: (Orthodontics Interceptive*) OR TÓPICO: (“Interceptive orthodontics”) OR TÓPICO: (Orthodontic Appliances Functional*) OR TÓPICO: (“Functional Orthodontic Appliance”) OR TÓPICO: (“Functional Orthodontic Appliance”) OR TÓPICO: (“Early orthodontic treatment”) OR TÓPICO: (“Early open bite treatment”) OR TÓPICO: (“Anterior open bite treatment”) OR TÓPICO: (“Orthopaedic treatment”) OR TÓPICO: (“Habit appliances”) OR TÓPICO: (“Fixed intraoral habit appliance”) OR TÓPICO: (“Spur”) OR TÓPICO: (“Spurs”) OR TÓPICO: (“Spur therapy”) OR TÓPICO: (“Spur appliance”) OR TÓPICO: (“Sharp spur”) OR TÓPICO: (“Sharp spurs”) OR TÓPICO: (“Tongue spur”) OR TÓPICO: (“Tongue spurs”) OR TÓPICO: (“Lingual spurs”) OR TÓPICO: (“Lingual spur”) OR TÓPICO: (“Palatal spur”) OR TÓPICO: (“Palatal spurs”) OR TÓPICO: (“Spike”) OR TÓPICO: (“Spikes”) OR TÓPICO: (“Lingual spike”) OR TÓPICO: (“Lingual spikes”) OR TÓPICO: (“Bonded spur”) OR TÓPICO: (“Bonded spurs”) OR TÓPICO: (“Spur bonded”) OR TÓPICO: (“Spurs bonded”) OR TÓPICO: (“Bonded lingual spur”) OR TÓPICO: (“Bonded lingual spurs”) OR TÓPICO: (“Bonded palatal spur”) OR TÓPICO: (“Bonded palatal spurs”) OR TÓPICO: (“Bondable lingual spur”) OR TÓPICO: (“Bondable lingual spurs”) OR TÓPICO: (“Bondable lingual tongue spur”) OR TÓPICO: (“Bondable lingual tongue spurs”) OR TÓPICO: (“Conventional spur”) OR TÓPICO: (“Conventional spurs”) OR TÓPICO: (“Conventional orthodontic spur”) OR TÓPICO: (“Conventional orthodontic spurs”) OR TÓPICO: (“Conventional lingual spur”) OR TÓPICO: (“Conventional lingual spurs”) OR TÓPICO: (“Banded spur”) OR TÓPICO: (“Banded spurs”) 47 Cochrane #1 MeSH descriptor: [Infant] explode all trees 16427 #2 MeSH descriptor: [Pediatrics] explode all trees 659 #3 MeSH descriptor: [Child] explode all trees 3254 #4 MeSH descriptor: [Minors] explode all trees 8 #5 MeSH descriptor: [Adolescent] explode all trees 101695 #6 (“Pubescen”):ti,ab,kw OR (“Juvenile”):ti,ab,kw OR (“Pre-pubescen”):ti,ab,kw OR (“Boy”):ti,ab,kw OR (“Girl”):ti,ab,kw 5197 #7 MeSH descriptor: [Schools, Nursery] explode all trees 37 #8 MeSH descriptor: [Child, Preschool] explode all trees 1509 #9 MeSH descriptor: [Open Bite] explode all trees 33 #10 (“Anterior open bite”):ti,ab,kw OR (“Anterior open-bite”):ti,ab,kw OR (“Open-bite”):ti,ab,kw 41 #11 MeSH descriptor: [Orthodontics, Interceptive] explode all trees 70 #12 MeSH descriptor: [Orthodontic Appliances, Functional] explode all trees 184 #13 (“Early orthodontic treatment”):ti,ab,kw OR (“Early open bite treatment”):ti,ab,kw OR (“Anterior open bite treatment”):ti,ab,kw OR (“Habit appliances”):ti,ab,kw OR (“Fixed intraoral habit appliance”):ti,ab,kw 27 #14 (“Spurs”):ti,ab,kw OR (“Spur”):ti,ab,kw OR (“Spur therapy”):ti,ab,kw OR (“Spur appliance”):ti,ab,kw OR (“Sharp spurs”):ti,ab,kw 238 #15 (“Sharp spur”):ti,ab,kw OR (“Tongue spur”):ti,ab,kw OR (“Tongue spurs”):ti,ab,kw OR (“Lingual spurs”):ti,ab,kw OR (“Lingual spur”):ti,ab,kw 3 #16 (“Palatal spur”):ti,ab,kw OR (“Palatal spurs”):ti,ab,kw OR (“Spike”):ti,ab,kw OR (“Spikes”):ti,ab,kw OR (“Lingual spike”):ti,ab,kw 772 #17 (“Lingual spikes”):ti,ab,kw OR (“Bonded spur”):ti,ab,kw OR (“Bonded spurs”):ti,ab,kw OR (“Spur bonded”):ti,ab,kw OR (“Spurs bonded”):ti,ab,kw 4 #18 (“Bonded lingual spur”):ti,ab,kw OR (“Bonded lingual spurs”):ti,ab,kw OR (“Bonded palatal spur”):ti,ab,kw OR (“Bonded palatal spurs”):ti,ab,kw OR (“Bondable lingual spur”):ti,ab,kw 3 #19 (“Bondable lingual spurs”):ti,ab,kw OR (“Bondable lingual tongue spur”):ti,ab,kw OR (“Bondable lingual tongue spurs”):ti,ab,kw OR (“Conventional spur”):ti,ab,kw OR (“Conventional spurs”):ti,ab,kw 1 #20 (“Conventional orthodontic spur”):ti,ab,kw OR (“Conventional orthodontic spurs”):ti,ab,kw OR (“Conventional lingual spur”):ti,ab,kw OR (“Conventional lingual spurs”):ti,ab,kw OR (“Banded spur”):ti,ab,kw 1 #21 #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 122097 #22 #9 OR #10 53 #23 #11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR #20 1251 #24 #21 AND #22 AND #23 4 4 Lilacs (tw:((Infant$) OR (Toddler) OR (Pediatrics$) OR (Pediatric) OR (Paediatric) OR (Child$) OR (Children) OR (Minors$) OR (Minor) OR (Adolescent$) OR (Adolescents) OR (Adolescence) OR (Teens) OR (Teen) OR (Teenagers) OR (Teenager) OR (Youth) OR (Youths) OR (Female Adolescent) OR (Female Adolescents) OR (Male Adolescent) OR (Male Adolescents) OR (Pubescen) OR (Juvenile) OR (Pre-pubescen) OR (Boy) OR (Boys) OR (Girl) OR (Girls) OR (Schools Nursery$) OR (Nursery schools) OR (Nursery school) OR (Child Preschool$) OR (Preschool Child) OR (Preschool Children) OR (Day care) OR (Kindergarten) OR (Kindergarden) OR (Elementary school) OR (Schoolchild) OR (Middle school) OR (High school))) AND (tw:((Open bite$) OR (Nonoclusion) OR (Openbite) OR (Apertognathia) OR (Anterior open bite) OR (Anterior open-bite) OR (Open-bite))) AND (tw:((Interceptive orthodontics$) OR (Functional Orthodontic Appliance$) OR (Functional Orthodontic Appliance) OR (Early orthodontic treatment) OR (Early open bite treatment) OR (Anterior open bite treatment) OR (Orthopaedic treatment) OR (Habit appliances) OR (Fixed intraoral habit appliance) OR (Spur) OR (Spurs) OR (Spur therapy) OR (Spur appliance) OR (Sharp spur) OR (Sharp spurs) OR (Tongue spur) OR (Tongue spurs) OR (Lingual spurs) OR (Lingual spur) OR (Palatal spur) OR (Palatal spurs) OR (Spike) OR (Spikes) OR (Lingual spike) OR (Lingual spikes) OR (Bonded spur) OR (Bonded spurs) OR (Spur bonded) OR (Spurs bonded) OR (Bonded lingual spur) OR (Bonded lingual spurs) OR (Bonded palatal spur) OR (Bonded palatal spurs) OR (Bondable lingual spur) OR (Bondable lingual spurs) OR (Bondable lingual tongue spurs) OR (Bondable lingual tongue spur) OR (Conventional spur) OR (Conventional spurs) OR (Conventional orthodontic spur) OR (Conventional orthodontic spurs) OR (Conventional lingual spur) OR (Conventional lingual spurs) OR (Banded spur) OR (Banded spurs))) 132 ClinicalTrials Anterior Open Bite 6 OpenGrey Anterior Open Bite 3 Google Scholar Anterior open bite+(Child OR Adolescent)+Lingual spurs 422

Author, year (study design)	Participants (n)	Age (years)	Follow-up	Statistics Analysis	Methods of Evaluation	Results
Canuto et al.¹⁵15 Canuto LF, Janson G, de Lima NS, de Almeida RR, Cançado RH. Anterior open-bite treatment with bonded vs conventional lingual spurs: A comparative study. Am J Orthod Dentofacial Orthop. 2016;149(6):847-55. 2016 (NRCT* - Prospective)	Bonded lingual spurs: 20 Conventional spurs: 21 Untreated subjects: 27	7.6 - 10.8	12 months	x²2 Pithon M, Magno M, Coqueiro R, Paiva S, Marques L, Paranhus L, et al. Oral health-related quality of life of children before, during, and after anterior open bite correction: A single-blinded randomized controlled trial. Am J Orthod Dentofacial Orthop. 2019;156(3):303-11. test	Questionnaire, similar to that proposed by McRae¹⁷17 McRae EJ. Bondable lingual spur therapy to treat anterior open bite. Thesis [Master in Science]. Wisconsin: Faculty of the Graduate School, Marquete University; 2010., 2010	Comparative acceptance evaluation showed both appliances were well tolerated: p=0.30 Discomfort time was at most 7 days with both appliances: p=0.37 Bonded lingual spurs had better acceptance than conventional spurs during chewing and eating: p=0.015
Haryett et al.¹⁶16 Harryet RD, Hansen FC, Davidson PO. Chronic thumb-sucking. A second report on treatment and its psychological effects. Am J Orthod. 1970;57(2):164-78. 1970 (NRCT* - Retrospective)	Untreated subjects: 8 Palatal crib with spurs: 11 Palatal cribs with spurs and psychological treatment:10 Crib without spurs: 27 Crib without spurs and psychological treatment: 10	≥ 4	20 months	x²2 Pithon M, Magno M, Coqueiro R, Paiva S, Marques L, Paranhus L, et al. Oral health-related quality of life of children before, during, and after anterior open bite correction: A single-blinded randomized controlled trial. Am J Orthod Dentofacial Orthop. 2019;156(3):303-11. test	Interviews with parents and rating scales	Irritability with spurs: 25% Irritation of the palate with spurs: 31%; Some speech difficulty with spurs: 66% Some difficulty in eating with spurs: 50% Sleep disturbance with spurs: 50%; Restlessness: 81%
McRae¹⁷17 McRae EJ. Bondable lingual spur therapy to treat anterior open bite. Thesis [Master in Science]. Wisconsin: Faculty of the Graduate School, Marquete University; 2010. 2010 (Case-series)	Bonded lingual spurs n=12 9 females and 3 males	7.1 - 17.2	6 months	paired-sample Sign Test	Questionnaire developed by authors	Some minimal initial discomfort and this observation did not change substantially over time (p=0.969) After only one month of therapy, the spurs were rated as either easy or neutral to tolerate in all categories except eating and tongue pain (p<0.05) Two droup-out in follow up
Araújo et al.¹⁸18 Araújo E, Jr Andrade I, Brito GM, Guerra L, Horta MCR. Perception of discomfort during orthodontic treatment with tongue spurs. Orthodontics (Chic). 2011;12(3):260-7. 2011 (Case-series)	Conventional spurs ≤ 14 years: 33 Conventional spurs ≥ 15 years: 39	10.4 - 16.8	8.1 months	x²2 Pithon M, Magno M, Coqueiro R, Paiva S, Marques L, Paranhus L, et al. Oral health-related quality of life of children before, during, and after anterior open bite correction: A single-blinded randomized controlled trial. Am J Orthod Dentofacial Orthop. 2019;156(3):303-11. test and Fisher’s exact test	Questionnaire developed by orthodontists, physiologists and psychologists	Accepted the treatment: 98.6% Aggressive: 58.2% Felt some degree of pain: 86.1% Discomfort and pain may continue up as 10 days: 92.0% Female group demonstrated a higher tolerance (p<0.05) Speech and chewing impairments were the most frequent functional problem: 79.2% Sleep disturbances: 8.3%
Moda¹⁹19 Moda LB. Preliminary study of oral, functional and pain perpception when using lingual spurs in children. Thesis [Master in Orthodontics] Rio de Janeiro (RJ): Rio de Janeiro State University, 2020. 2020 (Case-series)	Bonded lingual spurs (8-10 years): 9 Bonded lingual spurs (11-14 years): 7	8.5 - 12.8	3 months	Friedman’s test and Wilcoxon Signed Rank test	**CPQ_8-10, CPQ_11-14 and Pain rating Scale Wong-Baker Faces	Greatest impact on oral symptoms before the placement of spurs: p=0.01 The scores had a decreasing trend for oral symptoms and functional limitations over time: p=0.04 No pain perception on the Wong-Baker faces pain scale: p>0.05 One droup-out in follow-up

Questions/Author	MacRae¹⁷17 McRae EJ. Bondable lingual spur therapy to treat anterior open bite. Thesis [Master in Science]. Wisconsin: Faculty of the Graduate School, Marquete University; 2010., 2010	Araújo et al.¹⁸18 Araújo E, Jr Andrade I, Brito GM, Guerra L, Horta MCR. Perception of discomfort during orthodontic treatment with tongue spurs. Orthodontics (Chic). 2011;12(3):260-7., 2011	Moda¹⁹19 Moda LB. Preliminary study of oral, functional and pain perpception when using lingual spurs in children. Thesis [Master in Orthodontics] Rio de Janeiro (RJ): Rio de Janeiro State University, 2020., 2020
Were there clear criteria for inclusion in the case series?	Yes	Unclear	Yes
Was the condition measured in a standard and reliable way for all participants included in the case series?	Yes	Yes	Yes
Were valid methods used for identification of the condition for all participants included in the case series?	Unclear	Yes	Yes
Did the case series have consecutive inclusion of participants?	Yes	Unclear	Yes
Did the case series have complete inclusion of participants?	Yes	Unclear	Yes
Was there clear reporting of the demographics of the participants in the study?	Yes	Yes	Yes
Was there clear reporting of clinical information of the participants?	Yes	Yes	Yes
Were the outcomes or follow-up results of cases clearly reported?	Unclear	Yes	Unclear
Was there clear reporting of the presenting site(s)/clinic(s) demographic information?	Yes	Unclear	Yes
Was statistical analysis appropriate?	No	No	Yes
Risk of bias	Low	Moderate	Low

Domains/ROBINS-I Tool
	Pre-intervention		Intervention		Post-intervention
Author	Bias due to confounding	Bias in selecting participants for study	Bias in classifying Interventions	Bias due to deviations from intended intervention	Bias due to missing data	Bias in measuring outcomes	Bias in selecting reported result	Overall risk of bias
Canuto¹⁵15 Canuto LF, Janson G, de Lima NS, de Almeida RR, Cançado RH. Anterior open-bite treatment with bonded vs conventional lingual spurs: A comparative study. Am J Orthod Dentofacial Orthop. 2016;149(6):847-55., 2016	Moderate	Serious	Low	Low	Low	Low	Moderate	Serious risk of bias
Harryet, 1970¹⁶16 Harryet RD, Hansen FC, Davidson PO. Chronic thumb-sucking. A second report on treatment and its psychological effects. Am J Orthod. 1970;57(2):164-78.	Moderate	Moderate	Low	Moderate	Low	Low	Serious	Serious risk of bias

Reference	Reasons for exclusion
Harryet (1967)	Over sample
Justus (2001)	Literature review
Meyer-Marcotty et al. (2007)	Lingual spurs not evaluated for oral health-related quality of life
Cassis et al. (2010)	Lingual spurs not evaluated for oral health-related quality of life
Cassis et al. (2012)	Lingual spurs not evaluated for oral health-related quality of life
Benjamin (2013)	Lingual spurs not evaluated for oral health-related quality of life
Meyer-Marcotty et al. (2013)	Lingual spurs not evaluated for oral health-related quality of life
Urnau (2014)	Lingual spurs not evaluated for oral health-related quality of life
Insabralde et al. (2016)	Lingual spurs not evaluated for oral health-related quality of life
Leite et al. (2016)	Lingual spurs not evaluated for oral health-related quality of life
Dias (2017)	Lingual spurs not evaluated for oral health-related quality of life
Rossato et al. (2018)	Lingual spurs not evaluated for oral health-related quality of life
Cassis et al. (2018)	Lingual spurs not evaluated for oral health-related quality of life
Dias et al. (2019)	Case report
Rossato (2019)	Lingual spurs not evaluated for oral health-related quality of life

Certainty assessment							Impact	Certainty	Importance
№ of studies	Study design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations
Oral health-related quality of life (rated with: questionnaires )
2	NRCT (1 prospective and 1 retrospective)	Serious^a	Serious^b	Not serious	Not serious	Highly suspicious publication bias^c	Both evaluated articles showed some negative impact on the quality of life related to the oral health of children and/or adolescents. Discomfort, speech and chewing problems were the most common changes, with transitory nature.	⨁◯◯◯ VERY LOW	CRITICAL
3	Case-series	Serious^d	Serious^b	Not serious	Not serious	Highly suspicious publication bias^e	Of the three studies, two showed an initial negative impact of a transitory nature. Except for one, who completed minimal initial discomfort with no changes over time. Discomfort, speech problems and chewing were the most reported oral symptoms.	⨁◯◯◯ VERY LOW	IMPORTANT

Database	Keywords	Results
Pubmed	((((((((((((((((((((((((((((((((((((((((((((((((((((((((Infant[MeSH Terms]) OR (Infant[Title/Abstract])) OR (Toddler[Title/Abstract])) OR (Pediatrics[MeSH Terms])) OR (Pediatrics[Title/Abstract])) OR (Pediatric[Title/Abstract])) OR (Paediatric[Title/Abstract])) OR (Child[MeSH Terms])) OR (Child[Title/Abstract])) OR (Children[Title/Abstract])) OR (Minors[MeSH Terms])) OR (Minors[Title/Abstract])) OR (Minor[Title/Abstract])) OR (Adolescent[MeSH Terms])) OR (Adolescent[Title/Abstract])) OR (Adolescents[Title/Abstract])) OR (Adolescence[Title/Abstract])) OR (Teens[Title/Abstract])) OR (Teen[Title/Abstract])) OR (Teenagers[Title/Abstract])) OR (Teenager[Title/Abstract])) OR (Youth[Title/Abstract])) OR (Youths[Title/Abstract])) OR (Adolescents, Female[Title/Abstract])) OR (Adolescent, Female[Title/Abstract])) OR (Female Adolescent[Title/Abstract])) OR (Female Adolescents[Title/Abstract])) OR (Adolescents, Male[Title/Abstract])) OR (Adolescent, Male[Title/Abstract])) OR (Male Adolescent[Title/Abstract])) OR (Male Adolescents[Title/Abstract])) OR (Boy[Title/Abstract])) OR (Boys[Title/Abstract])) OR (Girl[Title/Abstract])) OR (Girls[Title/Abstract])) OR (Schools, Nursery[MeSH Terms])) OR (Schools, Nursery[Title/Abstract])) OR (Nursery schools[Title/Abstract])) OR (Nursery school[Title/Abstract])) OR (School, Nursery[Title/Abstract])) OR (Child, Preschool[MeSH Terms])) OR (Child, Preschool[Title/Abstract])) OR (Preschool Child[Title/Abstract])) OR (Children, Preschool[Title/Abstract])) OR (Preschool Children[Title/Abstract])) OR (Day care[Title/Abstract])) OR (Kindergarten[Title/Abstract])) OR (Kindergarden[Title/Abstract])) OR (Elementary school[Title/Abstract])) OR (Schoolchild[Title/Abstract])) OR (Middle school[Title/Abstract])) OR (High school[Title/Abstract]))) AND ((((((((((Open bite[MeSH Terms]) OR (Open bite[Title/Abstract])) OR (Bite, Open[Title/Abstract])) OR (Nonoclusion[Title/Abstract])) OR (Openbite[Title/Abstract])) OR (Apertognathia[Title/Abstract])) OR (Anterior open bite[Title/Abstract])) OR (Anterior open-bite[Title/Abstract])) OR (Open-bite[Title/Abstract]))))) AND (((((((((((((((((((((((((((((((((((((((((((((((((((((Orthodontics, Interceptive[MeSH Terms]) OR (Orthodontics, Interceptive[Title/Abstract])) OR (Interceptive orthodontics[Title/Abstract])) OR (Orthodontic Appliances, Functional[MeSH Terms])) OR (Orthodontic Appliances, Functional[Title/Abstract])) OR (Appliance, Functional Orthodontic[Title/Abstract])) OR (Appliances, Functional Orthodontic[Title/Abstract])) OR (Functional Orthodontic Appliance[Title/Abstract])) OR (Functional Orthodontic Appliance[Title/Abstract])) OR (Orthodontic Appliance, Functional[Title/Abstract])) OR (Early orthodontic treatment[Title/Abstract])) OR (Early open bite treatment[Title/Abstract])) OR (Anterior open bite treatment[Title/Abstract])) OR (Orthopaedic treatment[Title/Abstract])) OR (Habit appliances[Title/Abstract])) OR (Fixed intraoral habit appliance[Title/Abstract])) OR (Spur[Title/Abstract])) OR (Spurs[Title/Abstract])) OR (Spur therapy[Title/Abstract])) OR (Spur appliance[Title/Abstract])) OR (Sharp spur[Title/Abstract])) OR (Sharp spurs[Title/Abstract])) OR (Tongue spur[Title/Abstract])) OR (Tongue spurs[Title/Abstract])) OR (Lingual spurs[Title/Abstract])) OR (Lingual spur[Title/Abstract])) OR (Palatal spur[Title/Abstract])) OR (Palatal spurs[Title/Abstract])) OR (Spike[Title/Abstract])) OR (Spikes[Title/Abstract])) OR (Lingual spike[Title/Abstract])) OR (Lingual spikes[Title/Abstract])) OR (Bonded spur[Title/Abstract])) OR (Bonded spurs[Title/Abstract])) OR (Spur bonded[Title/Abstract])) OR (Spurs bonded[Title/Abstract])) OR (Bonded lingual spur[Title/Abstract])) OR (Bonded lingual spurs[Title/Abstract])) OR (Bonded palatal spur[Title/Abstract])) OR (Bonded palatal spurs[Title/Abstract])) OR (Bondable lingual spur[Title/Abstract])) OR (Bondable lingual spurs[Title/Abstract])) OR (Bondable lingual tongue spur[Title/Abstract])) OR (Bondable lingual tongue spurs[Title/Abstract])) OR (Conventional spur[Title/Abstract])) OR (Conventional spurs[Title/Abstract])) OR (Conventional orthodontic spur[Title/Abstract])) OR (Conventional orthodontic spurs[Title/Abstract])) OR (Conventional lingual spur[Title/Abstract])) OR (Conventional lingual spurs[Title/Abstract])) OR (Banded spur[Title/Abstract])) OR (Banded spurs[Title/Abstract]))))	195
Scopus	(((TITLE-ABS-KEY(Infant) OR TITLE-ABS-KEY(“Toddler”) OR TITLE-ABS-KEY(Pediatrics) OR TITLE-ABS-KEY(“Pediatric”) OR TITLE-ABS-KEY(“Paediatric”) OR TITLE-ABS-KEY(Child) OR TITLE-ABS-KEY(“Children”) OR TITLE-ABS-KEY(Minors) OR TITLE-ABS-KEY(“Minor”) OR TITLE-ABS-KEY(Adolescent) OR TITLE-ABS-KEY(“Adolescents”) OR TITLE-ABS-KEY(“Adolescence”) OR TITLE-ABS-KEY(“Teens”) OR TITLE-ABS-KEY(“Teen”) OR TITLE-ABS-KEY(“Teenagers”) OR TITLE-ABS-KEY(“Teenager”) OR TITLE-ABS-KEY(“Youth”) OR TITLE-ABS-KEY(“Youths”) OR TITLE-ABS-KEY(“Female Adolescent”) OR TITLE-ABS-KEY(“Female Adolescents”) OR TITLE-ABS-KEY(“Male Adolescent”) OR TITLE-ABS-KEY(“Male Adolescents”) OR TITLE-ABS-KEY(“Boy”) OR TITLE-ABS-KEY(“Boys”) OR TITLE-ABS-KEY(“Girl”) OR TITLE-ABS-KEY(“Girls”) OR TITLE-ABS-KEY(Schools Nursery) OR TITLE-ABS-KEY(“Nursery schools”) OR TITLE-ABS-KEY(“Nursery school”) OR TITLE-ABS-KEY(Child Preschool) OR TITLE-ABS-KEY(“Preschool Child”) OR TITLE-ABS-KEY(“Preschool Children”) OR TITLE-ABS-KEY(“Day care”) OR TITLE-ABS-KEY(“Kindergarten”) OR TITLE-ABS-KEY(“Kindergarden”) OR TITLE-ABS-KEY(“Elementary school”) OR TITLE-ABS-KEY(“Schoolchild”) OR TITLE-ABS-KEY(“Middle school”) OR TITLE-ABS-KEY(“High school”))) AND ((TITLE-ABS-KEY(Open bite) OR TITLE-ABS-KEY(“Nonoclusion”) OR TITLE-ABS-KEY(“Openbite”) OR TITLE-ABS-KEY(“Apertognathia”) OR TITLE-ABS-KEY(“Anterior open bite”) OR TITLE-ABS-KEY(“Anterior open-bite”) OR TITLE-ABS-KEY(“Open-bite”)))) AND ((TITLE-ABS-KEY(Orthodontics Interceptive) OR TITLE-ABS-KEY(“Interceptive orthodontics”) OR TITLE-ABS-KEY(Orthodontic Appliances Functional) OR TITLE-ABS-KEY(“Functional Orthodontic Appliance”) OR TITLE-ABS-KEY(“Functional Orthodontic Appliance”) OR TITLE-ABS-KEY(“Early orthodontic treatment”) OR TITLE-ABS-KEY(“Early open bite treatment”) OR TITLE-ABS-KEY(“Anterior open bite treatment”) OR TITLE-ABS-KEY(“Orthopaedic treatment”) OR TITLE-ABS-KEY(“Habit appliances”) OR TITLE-ABS-KEY(“Fixed intraoral habit appliance”) OR TITLE-ABS-KEY(“Spur”) OR TITLE-ABS-KEY(“Spurs”) OR TITLE-ABS-KEY(“Spur therapy”) OR TITLE-ABS-KEY(“Spur appliance”) OR TITLE-ABS-KEY(“Sharp spur”) OR TITLE-ABS-KEY(“Sharp spurs”) OR TITLE-ABS-KEY(“Tongue spur”) OR TITLE-ABS-KEY(“Tongue spurs”) OR TITLE-ABS-KEY(“Tongue spur”) OR TITLE-ABS-KEY(“Lingual spurs”) OR TITLE-ABS-KEY(“Lingual spur”) OR TITLE-ABS-KEY(“Palatal spur”) OR TITLE-ABS-KEY(“Palatal spurs”) OR TITLE-ABS-KEY(“Spike”) OR TITLE-ABS-KEY(“Spikes”) OR TITLE-ABS-KEY(“Lingual spike”) OR TITLE-ABS-KEY(“Lingual spikes”) OR TITLE-ABS-KEY(“Bonded spur”) OR TITLE-ABS-KEY(“Bonded spurs”) OR TITLE-ABS-KEY(“Spur bonded”) OR TITLE-ABS-KEY(“Spurs bonded”) OR TITLE-ABS-KEY(“Bonded lingual spur”) OR TITLE-ABS-KEY(“Bonded lingual spurs”) OR TITLE-ABS-KEY(“Bonded palatal spur”) OR TITLE-ABS-KEY(“Bonded palatal spurs”) OR TITLE-ABS-KEY(“Bondable lingual spur”) OR TITLE-ABS-KEY(“Bondable lingual spurs”) OR TITLE-ABS-KEY(“Bondable lingual tongue spur”) OR TITLE-ABS-KEY(“Bondable lingual tongue spurs”) OR TITLE-ABS-KEY(“Conventional spur”) OR TITLE-ABS-KEY(“Conventional spurs”) OR TITLE-ABS-KEY(“Conventional orthodontic spur”) OR TITLE-ABS-KEY(“Conventional orthodontic spurs”) OR TITLE-ABS-KEY(“Conventional lingual spur”) OR TITLE-ABS-KEY(“Conventional lingual spurs”) OR TITLE-ABS-KEY(“Banded spur”) OR TITLE-ABS-KEY(“Banded spurs”)))	198
Web of Science	TÓPICO: (Infant) OR TÓPICO: (“Toddler”) OR TÓPICO: (Pediatrics) OR TÓPICO: (“Pediatric”) OR TÓPICO: (“Paediatric”) OR TÓPICO: (Child) OR TÓPICO: (“Children”) OR TÓPICO: (Minors) OR TÓPICO: (“Minor”) OR TÓPICO: (Adolescent) OR TÓPICO: (“Adolescents”) OR TÓPICO: (“Adolescence”) OR TÓPICO: (“Teens”) OR TÓPICO: (“Teen”) OR TÓPICO: (“Teenagers”) OR TÓPICO: (“Teenager”) OR TÓPICO: (“Youth”) OR TÓPICO: (“Youths”) OR TÓPICO: (“Female Adolescent”) OR TÓPICO: (“Female Adolescents”) OR TÓPICO: (“Male Adolescent”) OR TÓPICO: (“Male Adolescents”) OR TÓPICO: (“Boy”) OR TÓPICO: (“Boys”) OR TÓPICO: (“Girl”) OR TÓPICO: (“Girls”) OR TÓPICO: (Schools Nursery) OR TÓPICO: (“Nursery schools”) OR TÓPICO: (“Nursery school”) OR TÓPICO: (Child Preschool) OR TÓPICO: (“Preschool Child”) OR TÓPICO: (“Preschool Children”) OR TÓPICO: (“Day care”) OR TÓPICO: (“Kindergarten”) OR TÓPICO: (“Kindergarden”) OR TÓPICO: (“Elementary school”) OR TÓPICO: (“Schoolchild”) OR TÓPICO: (“Middle school”) OR TÓPICO: (“High school”) AND TÓPICO: (Open bite) OR TÓPICO: (“Nonoclusion”) OR TÓPICO: (“Openbite”) OR TÓPICO: (“Apertognathia”) OR TÓPICO: (“Anterior open bite”) OR TÓPICO: (“Anterior open-bite”) OR TÓPICO: (“Open-bite”) AND TÓPICO: (Orthodontics Interceptive) OR TÓPICO: (“Interceptive orthodontics”) OR TÓPICO: (Orthodontic Appliances Functional) OR TÓPICO: (“Functional Orthodontic Appliance”) OR TÓPICO: (“Functional Orthodontic Appliance”) OR TÓPICO: (“Early orthodontic treatment”) OR TÓPICO: (“Early open bite treatment”) OR TÓPICO: (“Anterior open bite treatment”) OR TÓPICO: (“Orthopaedic treatment”) OR TÓPICO: (“Habit appliances”) OR TÓPICO: (“Fixed intraoral habit appliance”) OR TÓPICO: (“Spur”) OR TÓPICO: (“Spurs”) OR TÓPICO: (“Spur therapy”) OR TÓPICO: (“Spur appliance”) OR TÓPICO: (“Sharp spur”) OR TÓPICO: (“Sharp spurs”) OR TÓPICO: (“Tongue spur”) OR TÓPICO: (“Tongue spurs”) OR TÓPICO: (“Lingual spurs”) OR TÓPICO: (“Lingual spur”) OR TÓPICO: (“Palatal spur”) OR TÓPICO: (“Palatal spurs”) OR TÓPICO: (“Spike”) OR TÓPICO: (“Spikes”) OR TÓPICO: (“Lingual spike”) OR TÓPICO: (“Lingual spikes”) OR TÓPICO: (“Bonded spur”) OR TÓPICO: (“Bonded spurs”) OR TÓPICO: (“Spur bonded”) OR TÓPICO: (“Spurs bonded”) OR TÓPICO: (“Bonded lingual spur”) OR TÓPICO: (“Bonded lingual spurs”) OR TÓPICO: (“Bonded palatal spur”) OR TÓPICO: (“Bonded palatal spurs”) OR TÓPICO: (“Bondable lingual spur”) OR TÓPICO: (“Bondable lingual spurs”) OR TÓPICO: (“Bondable lingual tongue spur”) OR TÓPICO: (“Bondable lingual tongue spurs”) OR TÓPICO: (“Conventional spur”) OR TÓPICO: (“Conventional spurs”) OR TÓPICO: (“Conventional orthodontic spur”) OR TÓPICO: (“Conventional orthodontic spurs”) OR TÓPICO: (“Conventional lingual spur”) OR TÓPICO: (“Conventional lingual spurs”) OR TÓPICO: (“Banded spur”) OR TÓPICO: (“Banded spurs”)	47
Cochrane	#1 MeSH descriptor: [Infant] explode all trees 16427 #2 MeSH descriptor: [Pediatrics] explode all trees 659 #3 MeSH descriptor: [Child] explode all trees 3254 #4 MeSH descriptor: [Minors] explode all trees 8 #5 MeSH descriptor: [Adolescent] explode all trees 101695 #6 (“Pubescen”):ti,ab,kw OR (“Juvenile”):ti,ab,kw OR (“Pre-pubescen”):ti,ab,kw OR (“Boy”):ti,ab,kw OR (“Girl”):ti,ab,kw 5197 #7 MeSH descriptor: [Schools, Nursery] explode all trees 37 #8 MeSH descriptor: [Child, Preschool] explode all trees 1509 #9 MeSH descriptor: [Open Bite] explode all trees 33 #10 (“Anterior open bite”):ti,ab,kw OR (“Anterior open-bite”):ti,ab,kw OR (“Open-bite”):ti,ab,kw 41 #11 MeSH descriptor: [Orthodontics, Interceptive] explode all trees 70 #12 MeSH descriptor: [Orthodontic Appliances, Functional] explode all trees 184 #13 (“Early orthodontic treatment”):ti,ab,kw OR (“Early open bite treatment”):ti,ab,kw OR (“Anterior open bite treatment”):ti,ab,kw OR (“Habit appliances”):ti,ab,kw OR (“Fixed intraoral habit appliance”):ti,ab,kw 27 #14 (“Spurs”):ti,ab,kw OR (“Spur”):ti,ab,kw OR (“Spur therapy”):ti,ab,kw OR (“Spur appliance”):ti,ab,kw OR (“Sharp spurs”):ti,ab,kw 238 #15 (“Sharp spur”):ti,ab,kw OR (“Tongue spur”):ti,ab,kw OR (“Tongue spurs”):ti,ab,kw OR (“Lingual spurs”):ti,ab,kw OR (“Lingual spur”):ti,ab,kw 3 #16 (“Palatal spur”):ti,ab,kw OR (“Palatal spurs”):ti,ab,kw OR (“Spike”):ti,ab,kw OR (“Spikes”):ti,ab,kw OR (“Lingual spike”):ti,ab,kw 772 #17 (“Lingual spikes”):ti,ab,kw OR (“Bonded spur”):ti,ab,kw OR (“Bonded spurs”):ti,ab,kw OR (“Spur bonded”):ti,ab,kw OR (“Spurs bonded”):ti,ab,kw 4 #18 (“Bonded lingual spur”):ti,ab,kw OR (“Bonded lingual spurs”):ti,ab,kw OR (“Bonded palatal spur”):ti,ab,kw OR (“Bonded palatal spurs”):ti,ab,kw OR (“Bondable lingual spur”):ti,ab,kw 3 #19 (“Bondable lingual spurs”):ti,ab,kw OR (“Bondable lingual tongue spur”):ti,ab,kw OR (“Bondable lingual tongue spurs”):ti,ab,kw OR (“Conventional spur”):ti,ab,kw OR (“Conventional spurs”):ti,ab,kw 1 #20 (“Conventional orthodontic spur”):ti,ab,kw OR (“Conventional orthodontic spurs”):ti,ab,kw OR (“Conventional lingual spur”):ti,ab,kw OR (“Conventional lingual spurs”):ti,ab,kw OR (“Banded spur”):ti,ab,kw 1 #21 #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 122097 #22 #9 OR #10 53 #23 #11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR #20 1251 #24 #21 AND #22 AND #23 4	4
Lilacs	(tw:((Infant$) OR (Toddler) OR (Pediatrics$) OR (Pediatric) OR (Paediatric) OR (Child$) OR (Children) OR (Minors$) OR (Minor) OR (Adolescent$) OR (Adolescents) OR (Adolescence) OR (Teens) OR (Teen) OR (Teenagers) OR (Teenager) OR (Youth) OR (Youths) OR (Female Adolescent) OR (Female Adolescents) OR (Male Adolescent) OR (Male Adolescents) OR (Pubescen) OR (Juvenile) OR (Pre-pubescen) OR (Boy) OR (Boys) OR (Girl) OR (Girls) OR (Schools Nursery$) OR (Nursery schools) OR (Nursery school) OR (Child Preschool$) OR (Preschool Child) OR (Preschool Children) OR (Day care) OR (Kindergarten) OR (Kindergarden) OR (Elementary school) OR (Schoolchild) OR (Middle school) OR (High school))) AND (tw:((Open bite$) OR (Nonoclusion) OR (Openbite) OR (Apertognathia) OR (Anterior open bite) OR (Anterior open-bite) OR (Open-bite))) AND (tw:((Interceptive orthodontics$) OR (Functional Orthodontic Appliance$) OR (Functional Orthodontic Appliance) OR (Early orthodontic treatment) OR (Early open bite treatment) OR (Anterior open bite treatment) OR (Orthopaedic treatment) OR (Habit appliances) OR (Fixed intraoral habit appliance) OR (Spur) OR (Spurs) OR (Spur therapy) OR (Spur appliance) OR (Sharp spur) OR (Sharp spurs) OR (Tongue spur) OR (Tongue spurs) OR (Lingual spurs) OR (Lingual spur) OR (Palatal spur) OR (Palatal spurs) OR (Spike) OR (Spikes) OR (Lingual spike) OR (Lingual spikes) OR (Bonded spur) OR (Bonded spurs) OR (Spur bonded) OR (Spurs bonded) OR (Bonded lingual spur) OR (Bonded lingual spurs) OR (Bonded palatal spur) OR (Bonded palatal spurs) OR (Bondable lingual spur) OR (Bondable lingual spurs) OR (Bondable lingual tongue spurs) OR (Bondable lingual tongue spur) OR (Conventional spur) OR (Conventional spurs) OR (Conventional orthodontic spur) OR (Conventional orthodontic spurs) OR (Conventional lingual spur) OR (Conventional lingual spurs) OR (Banded spur) OR (Banded spurs)))	132
ClinicalTrials	Anterior Open Bite	6
OpenGrey	Anterior Open Bite	3
Google Scholar	Anterior open bite+(Child OR Adolescent)+Lingual spurs	422

[1] modablarissa@gmail.com

Brasil

Brasil

Can lingual spurs alter the oral health-related quality of life during anterior open bite interceptive treatment? A systematic review

ABSTRACT

Introduction:

Objective:

Methods:

Results:

Conclusion: