Management of Malocclusion in Children Using Myobrace Appliance: A Systematic Review

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If these bad habits continue after the age of six years, it can cause malocclusion. In the world of pediatric dentistry, one of the treatments for malocclusion is Oral Myofunctional Therapy (OMT). One of the myofunctional tools that can be used to correct malocclusion as well as bad habits in children is the Myobrace Appliance - an intraoral device system used in interceptive orthodontics. The purpose of this systematic review is to explore the management of malocclusion in children using the Myobrace Appliance. Methods: The data was collected by a literature search on Google Scholar, including articles published from 2016 to 2020. The data search was carried out systematically using the keywords Malocclusion in Children and Myobrace Appliance. After eliminating duplicate articles, the titles and abstracts of each article were analyzed across 108 articles, resulting in 51 articles. There were 36 articles not in line with topic and 6 articles which could not be freely accessed, so that 42 articles were excluded. The full text articles in the other nine articles were reanalyzed; three articles were excluded with reason and six articles were produced which were then included in the analysis. Results: There are six articles that discuss the management of malocclusion in children using the Myobrace appliance. All of these explain that Myobrace appliance is effective in handling cases of malocclusion especially to correct class II malocclusion and class III malocclusion. Conclusion: Myobrace appliance can be used as an alternative treatment for malocclusion in children, especially to correct class II and III malocclusion (mandibular prognathy and maxillary retrognathy). Additionally, this tool is capable of correcting overbite, overjet, crowding of upper and lower anterior teeth, sagittal molar relationships, lip seals, and facial asymmetry." } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/13-53", "name": "Management of Malocclusion in Children Using Myobrace Appliance: A..." } } ] } Home Browse Management of Malocclusion in Children Using Myobrace Appliance: A... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Achmad H and Auliya N. Management of Malocclusion in Children Using Myobrace Appliance: A Systematic Review [version 1; peer review: 1 not approved] . F1000Research 2024, 13 :53 ( https://doi.org/10.12688/f1000research.51879.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Systematic Review Management of Malocclusion in Children Using Myobrace Appliance: A Systematic Review [version 1; peer review: 1 not approved] Harun Achmad https://orcid.org/0000-0003-3124-2064 1 , Nurul Auliya 2 Harun Achmad https://orcid.org/0000-0003-3124-2064 1 , Nurul Auliya 2 PUBLISHED 08 Jan 2024 Author details Author details 1 Department of Pediatric Dentistry, Hasanuddin University, Makassar, South Sulawesi, Indonesia 2 Faculty of Dentistry, Hasanuddin University, Makassar, South Sulawesi, 90245, Indonesia Harun Achmad Roles: Conceptualization, Methodology, Project Administration, Writing – Review & Editing Nurul Auliya Roles: Investigation, Project Administration, Software, Visualization, Writing – Original Draft Preparation OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background: Bad oral habits are common in children aged less than six years and can stop spontaneously. If these bad habits continue after the age of six years, it can cause malocclusion. In the world of pediatric dentistry, one of the treatments for malocclusion is Oral Myofunctional Therapy (OMT). One of the myofunctional tools that can be used to correct malocclusion as well as bad habits in children is the Myobrace Appliance - an intraoral device system used in interceptive orthodontics. The purpose of this systematic review is to explore the management of malocclusion in children using the Myobrace Appliance. Methods: The data was collected by a literature search on Google Scholar, including articles published from 2016 to 2020. The data search was carried out systematically using the keywords Malocclusion in Children and Myobrace Appliance . After eliminating duplicate articles, the titles and abstracts of each article were analyzed across 108 articles, resulting in 51 articles. There were 36 articles not in line with topic and 6 articles which could not be freely accessed, so that 42 articles were excluded. The full text articles in the other nine articles were reanalyzed; three articles were excluded with reason and six articles were produced which were then included in the analysis. Results: There are six articles that discuss the management of malocclusion in children using the Myobrace appliance. All of these explain that Myobrace appliance is effective in handling cases of malocclusion especially to correct class II malocclusion and class III malocclusion. Conclusion: Myobrace appliance can be used as an alternative treatment for malocclusion in children, especially to correct class II and III malocclusion (mandibular prognathy and maxillary retrognathy). Additionally, this tool is capable of correcting overbite, overjet, crowding of upper and lower anterior teeth, sagittal molar relationships, lip seals, and facial asymmetry. READ ALL READ LESS Keywords Malocclusion, Myobrace, Oral Myofunctional Therapy, Appliance, Children, Bad Habit, Management, Alternative treatment Corresponding Author(s) Harun Achmad ( [email protected] ) Close Corresponding author: Harun Achmad Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Achmad H and Auliya N. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Achmad H and Auliya N. Management of Malocclusion in Children Using Myobrace Appliance: A Systematic Review [version 1; peer review: 1 not approved] . F1000Research 2024, 13 :53 ( https://doi.org/10.12688/f1000research.51879.1 ) First published: 08 Jan 2024, 13 :53 ( https://doi.org/10.12688/f1000research.51879.1 ) Latest published: 08 Jan 2024, 13 :53 ( https://doi.org/10.12688/f1000research.51879.1 ) Introduction A habit is a pattern of behavior that is repeated and is generally a normal stage of development. Repetitive behavior is common in childhood and most of these behaviors start, and can stop, spontaneously. The mouth is a general and permanent location for emotional expression and is a source for releasing desire and anxiety in both children and adults. Stimulation can be through the tongue, fingers or nails which can be a palliative action (a state that can provide calm). Habits that occur in the oral cavity (Oral Habits) can be classified into two, namely physiological and non-physiological Oral Habits. Physiological oral habits are normal human habits such as nasal breathing, chewing, talking, and swallowing. Non-physiological oral habits are abnormal human habits that cause pressure and tendencies that persist and are repeated continuously so that they affect craniofacial growth and are usually called Bad Habits 1 – 4 . Bad habits are normal in children aged less than six years and can stop on their own (spontaneously). If these bad habits continue after the age of six years, it can cause malocclusion in children. Malocclusion is defined as an abnormal dentofacial condition which refers to an abnormal occlusion or impaired craniofacial relationship that can affect appearance (aesthetics), function, facial balance, and psychosocial states. Malocclusion is one of the most common dental problems with, a prevalence ranging from 20%–100% in different studies, and is a common study 5 – 7 . Examples of bad habits that can lead to malocclusion include thumb sucking, pacifier sucking, the tongue placing pressure on teeth, nail biting, mouth breathing, bruxism, and lip biting or sucking. The habit is carried out at least six hours a day, a high enough frequency with sufficient intensity to cause malocclusion. Of these three factors the most influential is the duration of the habit. Bad habits are often distributed as a cause or risk factor for various types of malocclusion. Malocclusion may include the occurrence of an open bite, with the maxillary incisors sloping to the face (protrusive), the mandibular to lingual (retrusive) incisors, and the eruption of some incisors being obstructed leading to increased overjet and reduced overbite 1 , 8 – 10 . In the world of pediatric dentistry, one of the treatments for malocclusion is Oral Myofunctional Therapy (OMT). OMT is defined as the treatment of dysfunction of the facial and mouth muscles, with the aim of correcting orofacial functions, such as chewing and swallowing, and improving nasal breathing 11 , 12 . The goal of myofunctional therapy is to strengthen the muscles necessary for normal breathing, chewing, and swallowing, with a focus on increasing the tone and mobility of the oral and cervical structures 13 – 15 . One myofunctional tool that can be used to correct malocclusion, as well as bad habits, in children is the Myobrace Appliance. Myobrace is an intraoral appliance system used in interceptive orthodontics, designed for the treatment of malocclusion in mixed dentition patients (ages 8–12 years). Myobrace can also be used in adult patients but only for non-extractive cases and for mild or moderate malocclusion. This tool works to improve the balance of facial muscles and chewing, and restore tongue posture. Myobrace has the following objectives: 1) to get a myofunctional effect, 2) to restore the position of the mandible, 3) to stimulate the muscles of the face, masseter and tongue, 4) to move the mandible forward, 5) and to stimulate horizontal growth 16 , 17 . Methods Data source Data collection was carried out by conducting a literature search on an article search site, namely Google Scholar, for papers published from 2016 to December 2020, to obtain the latest articles related to the topic. The data search was carried out systematically using the terms Malocclusion in Children , and Myobrace Appliance . Research criteria A. Inclusion Criteria: (1) articles published between 2016–2020, (2) articles in English, (3) scientific articles that are published and available online, (4) articles which study Myobrace Appliance use in children. B. Exclusion Criteria: (1) articles that cannot be freely accessed, (2) articles which do not talk about malocclusion treatment in children Data collection The data used in this research is secondary data. The data is obtained from articles that were searched for in the article database which were then reviewed according to the research criteria set by the researcher. Research procedure A literature search was conducted on the Google Scholar online database. A search for the list of references to articles that fall under the inclusion criteria was also carried out to determine whether there were other related studies that were relevant to this research. The keywords Malocclusion in Children and Myobrace Appliance were used in the literature search. Duplicated literature was eliminated, and articles were filtered on the basis of title, abstract, and the aforementioned keywords. The remaining 108 articles were read (completely or partially) to determine whether they met the eligibility criteria. The data collection was done manually by creating a research matrix containing: author's name, year, title, and conclusion. Limitations of the dataset The author is limited to articles available on the desired topic in the year from 2016 to 2020. This is influenced by the quality of the articles that have been obtained in full text but cannot be analyzed. Result After eliminating duplicate articles, the titles and abstracts of each article were analyzed across 108 articles. Then a Journal Search on Google Scholar took place using the keywords ' Malocclusion in children and Myobrace Appliance ', for articles published between 2016–2020. We then judged the titles and abstracts in correspondence with the topic, resulting in 51 articles. Of these, there were 36 articles not in line with the topic and six articles that could not be freely accessed, so that 42 articles were excluded. The full text articles in the other nine articles were reanalyzed and three articles were excluded with reason and six articles were produced which were then included in the analysis. Table 1. The characteristics of each article entered into the systematic review 35 – 40 . No Authors Years Titles Conclusion 1 Kee-Sang Hong, Youn-Soo Shim, So-Young Park, Ah- Hyeon Kim, So-Youn An 35 2016 Oropharyngeal Airway Dimensional Changes after Treatment with Trainer for Kids (T4K) in Class II Retrognathic Children The use of the Myobrace appliance is effective in correcting Class II malocclusion cases in which the protrusive maxillary anterior and mandibular teeth are retrognated from an excess axial angle to the labial of the maxillary anterior teeth to the palatal area. 2 Isha Aggarwal, Manu Wadhawan, Vishesh Dhir 36 2016 Myobraces: Say No to Traditional Braces: Review Article Myobrace appliance is a special tool designed to overcome bad habits and solve the developmental problems of the upper and lower jaw in children which will lead to malocclusion. Myobrace appliance provides a more stable, preventive, non-invasive treatment to address causes that hinder facial development and prevent malocclusion in children. 3 Kizi G, Ventura I, Barata R, Riba D, Castaño Seiquer A 37 2017 Early treatment of a class III malocclusion with the myobrace system clinical case Myobrace appliance is effective for treating malocclusion at an early stage with good results and stability. The case of anterior crossbite can also be corrected with the use of the Myobrace appliance. 4 Rohan Wijey 38 2017 Treatment for Class III Malocclusion: Surely we can do better? – Case report Significant results in cases of class III malocclusion with the Myobrace class III intercept device. The Myobrace appliance markedly retrained tongue posture and function, forward progression of the mandible, and improved maxillary sagittal movement. 5 Hisham Mohammed, Emina Čirgić, Mumen Z. Rizk, and Vaska Vandevska- Radunovic 39 2019 Effectiveness of prefabricated myofunctional appliances in the treatment of Class II division 1 malocclusion: a systematic review Class II division 1 malocclusion cases in children can be corrected using the myobrace appliance. Effective results are obtained by using this Myobrace appliance. 6 M Wishney, MA Darendeliler, O Dalci 40 2019 Myofunctional therapy and prefabricated functional appliances: an overview of the history and evidence Myobrace appliance is proven to be able to correct class II division 1 malocclusion at a relatively low cost so that it can be the choice of many people. Discussion The results of this systematic review show that the Myobrace appliance can be used as an alternative treatment for malocclusion in children, especially to correct class II malocclusion and class III malocclusion (mandibular prognathy and maxillary retrognathy). In addition, this tool is also capable of correcting overbite, overjet, crowding of upper and lower anterior teeth, sagittal molar relationships, lip seals, and facial asymmetry 18 – 21 . The Myobrace appliance is a prefabricated functional appliance with myofunctional training characteristics, which is used to correct malocclusion in children who are in the development stage 22 . The form of the Myobrace appliance can be seen in Figure 2 . Figure 1. Flowchart of the systematic review. Figure 2. Myobrace tool used during treatment. Source: Primary Data. Malocclusion is a form of maxillary and mandibular connection which deviates from the standard form which is accepted as the normal form. Malocclusion can be caused by the absence of dentofacial balance. It is a fairly large dental and oral health problem in Indonesia and its prevalence is still very high, around 80% of the population, and is in third place after dental caries and periodontal disease 23 – 25 . One of the causes of malocclusion is bad oral habits. Bad habits that are done repeatedly and continuously during the development of the jaw will result in malocclusion. Bad habits such as finger/nipple sucking, nail biting, lip biting, mouth breath, and tongue sticking have an impact on the prevalence of malocclusion, especially in children 26 – 28 . Examples of bad habits such as finger sucking are likely to interfere with the position of the teeth, this habit can lead to malocclusion, namely an anterior open bite due to disruption of the growth pattern of the cranofacial bones. There is a significant relationship between the development and prevalence of malocclusion and the prevalence of bad habits 29 – 32 . The results of the study on children aged seven to 15 years 33 who have bad oral habits show that around 80% of children suffer from malocclusion, such as class II and class III malocclusion. According to Singh 34 , children who have bad mouth habits, especially finger sucking, tend to experience class II malocclusion. This indicates that bad oral habits lead to malocclusion. Previous studies involving children aged eight to 10 years revealed that children with malocclusion were more likely to have a negative impact on their quality of life than individuals who were malocclusion free 41 . Some types of malocclusion also have a higher impact on quality of life 42 , 43 . The Myobrace appliance was introduced by Myofunctional Research Company, Australia, followed by other appliances of The Trainer System™ in 2004. It also contains various tools for different age groups and is available in various sizes. The Myobrace appliance is available for four stages of treatment, including habit correction, arch extension, tooth alignment and retention. The Myobrace appliance has a structural element similar to that of a trainer system, consisting of a tough nylon element, called the Inner-Core or Dynamicore. The manufacturer states that dynamicore helps withstand the forces developed on the teeth by the buccinator and orbicularis muscles allowing correction of misaligned teeth by providing better arch shape. The presence of additional channels in the area of the anterior teeth on the Myobrace appliances is claimed to increase its ability to align teeth because it can exert direct force on the teeth. They are available in a variety of sizes for primary, mixed and permanent teeth and for different treatment purposes 44 – 46 . The goals of treatment using the Myobrace appliance are: 1) Restoring nasal breathing from mouth breathing, 2) correcting correct tongue posture, 3) correcting correct swallowing, 4) Correcting alignment of teeth and jaw to the correct position, 5) There can be retention or no retention, 6) minimal or no use of braces, 7) achieve optimal health, 8) unhindered craniofacial development 47 – 49 . Use of Myobrace at least two hours every day and a maximum of overnight, aims to provide adequate expansion and arch strength of the jaws to align the anterior teeth 50 – 52 . The parts of the Myobrace appliance consist of 53 : a. Guides for teeth: a guide to aligning the teeth in the correct position. b. Labial and buccal shields: to prevent interposition of lips and cheeks, as well as to provide some strength to misaligned anterior teeth. c. Tongue tag: positioned on the retro-incisive papilla, acts as a proprioceptive stimulus to the tip of the tongue, and as a myofunctional trainer to improve tongue posture d. Tongue Guard: to prevent tongue jostling and interposition, forcing the tongue in its original position, stimulating nasal breathing, and preventing bad habits. e. Lip Bumper: prevents mentalist muscle hyperactivity. Things that need to be considered when using Myobrace appliance are: 1) the patient must wear the appliance for one to two hours every day and overnight while sleeping, and 2) it is necessary to use the appliance every day (if it is not used every day, then the treatment will not be successful), 3) at least one myofunctional function exercise must be completed every day, 4) the patient must learn how to swallow correctly and position the tongue in the correct place in the mouth, 5) the patient must guard their mouth closed when not talking or eating 36 . Based on the age group, Myobrace appliance is classified into four types, namely: a. Myobrace for Juniors (age three to six years); Myobrace for Juniors is a three-stage equipment system specially designed to correct bad oral habits while addressing developmental problems of the upper and lower jaw. Myobrace for Juniors is most effective on primary teeth from three to six years of age. This device is specially designed to correct mouth breathing problems, improve tongue position and swallowing pattern, train jaw muscles, change pacifiers, improve natural curve development, early treatment for open bites and cross bites 54 , 55 . b. Myobrace for Kids (Age 6–10 years) Myobrace for Kids is a three-stage equipment system specially designed to correct bad mouth breathing and oral habits, which helps to solve problems with the development of the upper and lower jaw. This allows the permanent teeth to adjust to their original position. Most effective in the early stages until the teeth are mixed, ages 6–10 years. It is specially designed to correct class II division 1 and 2 malocclusion, crowding of upper and lower anterior teeth, deep bite, and open bite 54 , 55 . c. Myobrace for Teens (10–15 years) Myobrace for Teens is a four-stage Myofunctional Orthodontic system designed to replace complex orthodontics with braces and extractions. Its main purpose is to correct oral breathing and poor myofunctional habits that can lead to malocclusion, while the stage three (T3) apparatus guides permanent teeth to grow in parallel positions that are in the developmental stage of the tooth. It is specially designed to treat class II malocclusion in the final stages of mixed teeth, class II division one and two, crowding of upper and lower anterior teeth, deep bite, and open bite 54 , 55 . d. Myobrace for Adults (>15 years) Myobrace for Adults is a three-stage equipment system for permanent teeth. For adult patients, all growth has occurred, and the tooth is in the most stable position. Improper mouth breathing and swallowing habits have developed over the years and are more difficult to correct. For this reason, outcomes in adults are not as predictable as in children. It is specially designed to treat most malocclusions in adult patients, crowding of upper and lower anterior teeth in mild to moderate cases, treatment of relapsed anterior teeth after fixed orthodontics, moderate cases of Class II division one and two malocclusion 54 – 59 , 60 . Conclusion Myobrace appliance can be used as an alternative treatment for malocclusion in children, especially to correct class II malocclusion and class III malocclusion (mandibular prognathy and maxillary retrognathy). In addition, this tool is also capable of correcting overbite, overjet, crowding of upper and lower anterior teeth, sagittal molar relationships, lip seals, and facial asymmetry. Data availability Underlying data No data are associated with this article. Reporting guidelines Figshare: PRISMA checklist for ‘Management of Malocclusion in children using Myobrace Appliance: A systematic review’. https://figshare.com/s/a5cf58a96fc2d3f9fb1f Faculty Opinions recommended References 1. Kolawole KA, Folayan MO, Agbaje HO, et al. : Oral habits and malocclusion in children resident in Ile-Ife Nigeria. Eur Arch Paediatr Dent. 2019; 20 (3): 257–265. PubMed Abstract | Publisher Full Text 2. Paolantonio EG, Ludovici N, Saccomanno S, et al. : Association between oral habits, mouth breathing and malocclusion in Italian preschoolers. Eur J Paediatr Dent. 2019; 20 (3): 204–208. PubMed Abstract | Publisher Full Text 3. Grippaudo C, Paolantonio EG, Antonini G, et al. : Association between oral habits, mouth breathing and malocclusion. Acta Otorhinolaryngol Ital. 2016; 36 (5): 386–394. PubMed Abstract | Publisher Full Text | Free Full Text 4. 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Reference Source Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 08 Jan 2024 ADD YOUR COMMENT Comment Author details Author details 1 Department of Pediatric Dentistry, Hasanuddin University, Makassar, South Sulawesi, Indonesia 2 Faculty of Dentistry, Hasanuddin University, Makassar, South Sulawesi, 90245, Indonesia Harun Achmad Roles: Conceptualization, Methodology, Project Administration, Writing – Review & Editing Nurul Auliya Roles: Investigation, Project Administration, Software, Visualization, Writing – Original Draft Preparation Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 08 Jan 2024, 13:53 https://doi.org/10.12688/f1000research.51879.1 Copyright © 2024 Achmad H and Auliya N. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Achmad H and Auliya N. Management of Malocclusion in Children Using Myobrace Appliance: A Systematic Review [version 1; peer review: 1 not approved] . F1000Research 2024, 13 :53 ( https://doi.org/10.12688/f1000research.51879.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 08 Jan 2024 Views 0 Cite How to cite this report: Elfouly D. Reviewer Report For: Management of Malocclusion in Children Using Myobrace Appliance: A Systematic Review [version 1; peer review: 1 not approved] . F1000Research 2024, 13 :53 ( https://doi.org/10.5256/f1000research.55089.r238908 ) The direct URL for this report is: https://f1000research.com/articles/13-53/v1#referee-response-238908 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 16 Feb 2024 Dina Elfouly , Alexandria University, Alexandria, Alexandria Governorate, Egypt Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.55089.r238908 The systematic review has a clear aim and organization. However, some critical points are missing that needs to be carried out. 1- Systematic review must follow PRISMA guidelines Check Ref1 2- Authors must mention the ... Continue reading READ ALL The systematic review has a clear aim and organization. However, some critical points are missing that needs to be carried out. 1- Systematic review must follow PRISMA guidelines Check Ref1 2- Authors must mention the electronic databases as (PubMed, Web of Science, Scopus...) and Journals where search was carried out. This has to be explained in the search strategy. 3- In the results: Need more explanation of the included articles (what is common and what is not) 4- No assessment of risk of bias of the studies, please check risk of bias for systematic reviews. 5- Discussion is written as a literature review not in a discussion format, explaining the studies included. 6- Study limitations missing and why no metanalysis was conducted. I believe it needs a lot of amendments. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? No Is the statistical analysis and its interpretation appropriate? No Are the conclusions drawn adequately supported by the results presented in the review? No References 1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, et al.: The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev . 2021; 10 (1): 89 PubMed Abstract | Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Digital orthoodntics I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Elfouly D. Reviewer Report For: Management of Malocclusion in Children Using Myobrace Appliance: A Systematic Review [version 1; peer review: 1 not approved] . F1000Research 2024, 13 :53 ( https://doi.org/10.5256/f1000research.55089.r238908 ) The direct URL for this report is: https://f1000research.com/articles/13-53/v1#referee-response-238908 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 08 Jan 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 1 08 Jan 24 read Dina Elfouly , Alexandria University, Alexandria, Egypt Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Elfouly D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 16 Feb 2024 | for Version 1 Dina Elfouly , Alexandria University, Alexandria, Alexandria Governorate, Egypt 0 Views copyright © 2024 Elfouly D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The systematic review has a clear aim and organization. However, some critical points are missing that needs to be carried out. 1- Systematic review must follow PRISMA guidelines Check Ref1 2- Authors must mention the electronic databases as (PubMed, Web of Science, Scopus...) and Journals where search was carried out. This has to be explained in the search strategy. 3- In the results: Need more explanation of the included articles (what is common and what is not) 4- No assessment of risk of bias of the studies, please check risk of bias for systematic reviews. 5- Discussion is written as a literature review not in a discussion format, explaining the studies included. 6- Study limitations missing and why no metanalysis was conducted. I believe it needs a lot of amendments. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? No Is the statistical analysis and its interpretation appropriate? No Are the conclusions drawn adequately supported by the results presented in the review? No References 1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, et al.: The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev . 2021; 10 (1): 89 PubMed Abstract | Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Digital orthoodntics I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Elfouly D. Peer Review Report For: Management of Malocclusion in Children Using Myobrace Appliance: A Systematic Review [version 1; peer review: 1 not approved] . F1000Research 2024, 13 :53 ( https://doi.org/10.5256/f1000research.55089.r238908) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-53/v1#referee-response-238908 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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