Abstract

Midline deviation is a prevalent orthodontic issue that affects both function and aesthetics, often resulting from factors such as premature loss of primary teeth and insufficient arch length. Various treatment strategies, including midline elastics, unilateral extractions, and dental expansion, are employed to correct these deviations. However, the effectiveness of these approaches can vary significantly, leading to on-going debates in clinical practice. By synthesizing findings from diverse studies, this review seeks to enhance understanding of midline deviation treatment mechanics, offering insights that may inform future clinical decision-making and improve patient outcomes. A systematic review was conducted, searching databases including PubMed, Gale, Research Gate, and AJODO for articles published between 2000 and 2021. Keywords focused on midline deviations and treatment mechanics. After screening 2,962 records, 89 articles were assessed for eligibility, resulting in 18 studies being included in the review. This systematic review identified 2,962 unique records related to midline deviation across four databases: PubMed (2,140), Gale (822), AJODO (2,038), and Science Direct (1,118). After removing duplicates, 1,408 records were screened, 89 full articles were assessed, and 18 studies were included in the qualitative synthesis. The findings from these studies highlight limitations in generalizability due to the varying number of articles and treatment categories. While elastics demonstrate the highest number of published articles, other methods such as miniscrews, headgear, combinations of elastics and jig springs, the Meaw technique, unilateral closing loops, expanders, and Forsus appliances also produce positive outcomes. However, further research with larger sample sizes and diverse clinical scenarios is needed to validate these results. Effective treatment of midline deviation requires a multifaceted approach, integrating various techniques tailored to individual cases. Understanding these complex mechanics enhances patient outcomes and reduces the number of patient appointments. On-going education and adherence to evidence-based practices are crucial for orthodontists to refine their skills, improve treatment strategies, and adapt to evolving methodologies in clinical practice.

Key words: Midline, midline deviation, treatment mechanics.