What is an underbite? When the lower front teeth bite in front, when should it be assessed?｜證據鏈

What is an underbite? When the lower front teeth bite in front, when should it be assessed?｜證據鏈

F-Units (fact-unit record)

• F1｜Topic-selection basis: reconciliation of the full GSC data from 14 clinic sites. The underbite query has 3,383 total impressions on(622 rows, 3 clicks, CTR 0.09%, average position 6.8); the same site also has 336 impressions for the companion query asking for the term's meaning. On 2026-08-06, an awk rerun against the raw TSV matched the clinic-topic-additions table in the production queue.｜Source #24｜confidence=high｜basis=internal_dataset｜period=GSC retention window (from 2025-03-22)｜geo: TW｜caveat: impressions are property-level figures, not deduplicated traffic; this is internal data, not a medical claim, and is excluded from the published visible layer.
• F2 [structural editorial organisation]｜This card's three-way sorting, its canonical boundaries with KM-DENTAL-08 / C03 / C07, and the editorial decision to point fee composition, clear-aligner comparison, and general orthodontic risks to their respective cards are site-defined structure, not factual claims or any institution's classification definition.｜Source #25｜confidence=n/a｜basis=editorial｜geo: universal｜caveat: must not be labelled pending verification, to avoid creating false verification work.
• F3 [structural editorial organisation]｜The decisions not to put self-matchable clinical cut-offs in the body, not to equate population averages with individual expectations, to use a question checklist rather than self-checking, and not to make individual or legal opinions are this site's editorial decisions, not literature-derived thresholds.｜Source #25｜confidence=n/a｜basis=editorial｜geo: universal｜caveat: as above, must not be labelled pending verification; this section is not diagnosis or treatment advice. The fact-unit record retains source numbers for traceability and audit, not as a basis for self-judgment.
• F4｜Cochrane 2024 update background breakdown of causes.｜Source #1｜confidence=high｜basis=peer_reviewed (Cochrane systematic review, CD003451.pub3)｜period=published 2024-04-10; searched to 2023-01-16｜geo: universal｜PMID 38597341｜span: 「Prominent lower front teeth (Class III malocclusion) may be due to jaw or tooth position or both. The upper jaw (maxilla) can be too far back or the lower jaw (mandible) too far forward; the upper front teeth (incisors) may be tipped back or the lower front teeth tipped forwards.」｜caveat: this is background text in the review, used to define the study population, not a pooled result. The version chain was checked: pub2 (2013, PMID 24085611) is the preceding version; pub3 is the current latest version; PubMed had no pub4 on 2026-08-06; pubtype had no Retracted Publication marker.
• F5｜Source definition of pseudo Class III and the study's eligibility criteria.｜Source #4｜confidence=moderate｜basis=peer_reviewed (doctoral thesis using randomised controlled trial methods, Swed Dent J Suppl)｜period=2015｜geo: universal｜PMID 26939312｜span (definition): “Anterior crossbite with functional shift also called pseudo Class III is a malocclusion in which the incisal edges of one or more maxillary incisors occlude with the incisal edges of the mandibular incisors in centric relationship: the mandible and mandibular incisors are then guided anteriorly in central occlusion resulting in an anterior crossbite.” span (eligibility criteria): “early to late mixed dentition, anterior crossbite affecting one or more incisors with functional shift, moderate space deficiency in the maxilla, no inherent skeletal Class III discrepancy, ANB angle > 0 degrees, and no previous orthodontic treatment” span (background statement): “Early correction, at the mixed dentition stage, is recommended, in order to avoid a compromising dentofacial condition which could result in the development of a true Class III malocclusion and temporomandibular symptoms.”｜caveat: the third span is in the thesis background and cites a prior claim; it is not a result measured in this study. The card states this in the FAQ. Eligibility criteria are for research, not reader self-matching (ANB requires cephalometric imaging).
• F6｜2011 review definition of the dental-anterior-crossbite group, defined by excluding skeletal discrepancy.｜Source #5｜confidence=moderate｜basis=peer_reviewed (systematic review)｜period=2011｜geo: universal｜PMID 21875991｜span: 「Children in the primary or mixed dentition with an anterior crossbite affecting one or more incisors, and no underlying skeletal class III discrepancy.」 Additional span: 「This review has highlighted the lack of high quality evidence for the management of anterior crossbites in children.」｜caveat: a 2026-08-06 search confirmed newer reviews of the same topic from 2020 (F7) and 2026 (F8/F9/F41). This card cites the present paper only for population definition and the evidence-gap statement, not its treatment-time data.
• F7｜2020 review wording for the same group; it is nearly the same as F6 but uses “pattern” rather than “discrepancy.”｜Source #6｜confidence=moderate｜basis=peer_reviewed (systematic review)｜period=2020-03; search stated in the original article｜geo: universal｜PMID 31509048｜span: 「Children in the early or late mixed dentition with an anterior crossbite affecting one or more incisors, and no underlying skeletal class III pattern.」 Additional span: 「Only 7 reports of 3 RCTs met the inclusion criteria and thus were included in the final analysis. All but one of the 3 RCTs were judged to be of very low quality.」｜caveat: the two sources use discrepancy versus pattern; this card lists them separately and does not merge them. Because of heterogeneity, the review did not perform meta-analysis.
• F8｜The 2026 meta-analysis composition, showing the three causes are classified separately in the literature.｜Source #3｜confidence=moderate｜basis=peer_reviewed (systematic review and meta-analysis, RCTs only)｜period=published 2026-06; searched to 2025-09｜geo: universal｜PMID 42256824｜span: 「A total of 21 RCTs involving 854 participants were included, comprising 18 studies on skeletal, two on functional, and one on dental anterior crossbite.」｜caveat: the journal is Cureus, whose peer-review strength is lower than that of the preceding journals. This card takes only its included-study composition and authors' stated limitations, not comparative recommendation wording.
• F9｜Conclusion of the same paper: underlying cause and appliance type influence outcomes; range of evidence certainty.｜Source #3｜confidence=moderate｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 42256824｜span: 「early orthodontic treatment of anterior crossbite in growing children is effective, with outcomes largely influenced by the underlying etiology and the type of appliance used」 Additional span: 「The overall certainty of evidence ranged from very low to moderate.」 Additional span: 「Considerable variability existed across trials in terms of appliance design, treatment protocols, follow-up duration, and outcome assessment methods.」｜caveat: the authors use “effective”; this card retains it as source wording and does not translate it into this site's judgment on effectiveness. The conclusion is population-level and must not be inferred as any individual's result.
• F10｜Malocclusion prevalence and the authors' own unreliability statement.｜Source #7｜confidence=moderate｜basis=peer_reviewed (systematic review)｜period=published 2022-06; searched to 2021-11｜geo: universal｜PMID 35742703｜span: 「The range of prevalence of Angle Class I, Class II, and Class III malocclusion was very large, with a mean prevalence of 51.9% (SD 20.7), 23.8% (SD 14.6), and 6.5% (SD 6.5), respectively.」 Additional span: 「The prevalence of anterior crossbite, posterior crossbite, and crossbite with functional shift were 7.8% (SD 6.5), 9.0% (SD 7.34), and 12.2% (SD 7.8), respectively.」 Additional span: 「The large variety in methodological approaches found in the literature makes the data regarding prevalence of malocclusion unreliable.」「A total of 415 full-text articles were assessed, and 123 articles were finally included for qualitative analysis.」｜caveat: the review's own conclusion is that the data are unreliable; this sentence must always accompany these figures. The three crossbite entries are parallel items and must not be made inclusive of one another or converted. This paper did not study a Taiwan population; it must not be used to state Taiwan prevalence.
• F11｜Number of skeletal-Class-III phenotype clusters and differences by ethnicity.｜Source #8｜confidence=moderate｜basis=peer_reviewed (systematic review)｜period=published 2019-03; searched to 2018-03｜geo: universal｜PMID 30926101｜span: 「All studies identified at least 3 different types of class III clusters (ranging from 3 to 14 clusters; the total variation of the prevalence of each cluster ranged from 0.2% to 36.0%).」 Additional span: 「With regard to ethnicity, a mean number of 8.5 and 3.5 clusters of class III were retrieved for Asian and Caucasian population, respectively.」｜caveat: this study evaluates the efficiency of clustering methods as a diagnostic tool. Its figures are the numbers of clusters studies identified, not prevalence and not an individual's assignment; only 7 studies were included.
• F12｜AAO public-education advice on age at first assessment, including the same page's explicit statement that an abnormality noticed before age 7 does not require waiting.｜Source #18｜confidence=verified｜basis=official_statement (professional-association public-education page)｜period=2026-08-06 curl check HTTP 200; after CX adversarial review, rechecked the same day by loading it in ego-browser (page innerText 6,640 characters; all four spans below matched verbatim, including U+201C/U+201D quotation marks and U+2019 apostrophe)｜geo: universal｜span: 「AAO experts recommend children complete their first check-up with an orthodontist by age 7.」 Additional span: 「AAO recommends that children first visit an orthodontist no later than age 7.」 Additional span: 「The mix of baby and permanent teeth present at this age allows the orthodontist to recognize orthodontic problems」 span (no waiting; added on 2026-08-06 recheck): “If your child is younger than 7 and you notice something that appears “off,” you don’t need to wait until your child turns 7 to see an orthodontist. Regardless of age, you should take your child to an orthodontist the moment you notice an issue.”｜caveat: advice to the public from a US professional association; not a Taiwan clinical guideline and not evidence for treatment timing. Completing an assessment does not mean starting treatment. This is a consumer-education page, not a guideline, and is not used for effectiveness claims. Age 7 is the latest time by which the first assessment should be complete, not a waiting threshold. Because its source says in the same section that noticed abnormalities before 7 do not need to wait, the body and FAQ both put that sentence before the age figure, to prevent isolated extraction from becoming a “wait until 7” rule.
• F13｜Cochrane explanation of ANB and enrolled-study size and ages.｜Source #1｜confidence=high｜basis=peer_reviewed｜period=2024; searched to 2023-01-16｜geo: universal｜PMID 38597341｜span: 「our secondary outcomes included ANB (A point, nasion, B point) angle (which measures the relative position of the maxilla to the mandible)」 Additional span: 「We identified 29 RCTs that randomised 1169 children (1102 analysed). The children were five to 13 years old at the start of treatment.」｜caveat: ages are the study's enrolment range, not a recommended treatment age.
• F14｜Cochrane statement of follow-up and risk-of-bias limitations.｜Source #1｜confidence=high｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 38597341｜span: 「Most studies measured outcomes directly after treatment; only one study provided long-term follow-up. All studies were at high risk of bias as participant and personnel blinding was not possible.」｜caveat: this limitation applies to all Cochrane figures cited in this card.
• F15｜Cochrane immediate effects, non-surgical orthodontics versus no treatment.｜Source #1｜confidence=high｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 38597341｜span: 「We found moderate-certainty evidence that non-surgical orthodontic treatments provided a substantial improvement in overjet (mean difference (MD) 5.03 mm, 95% confidence interval (CI) 3.81 to 6.25; 4 studies, 184 participants) and ANB (MD 3.05°, 95% CI 2.40 to 3.71; 8 studies, 345 participants), compared to an untreated control group, when measured immediately after treatment.」｜caveat: a population-level mean difference, not an individual expected value; measurement was immediately after treatment and includes no follow-up.
• F16｜Cochrane statement of heterogeneity and list of appliances studied.｜Source #1｜confidence=high｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 38597341｜span: 「There was high heterogeneity in the analyses, but the effects were consistently in favour of the orthodontic treatment groups rather than the untreated control groups (studies tested facemask (with or without RME), chin cup, orthodontic removable traction appliance, tandem traction bow appliance, reverse Twin Block with lip pads and RME, Reverse Forsus and mandibular headgear).」｜caveat: the appliance list is what studies tested. It is included only to describe the synthesis scope and is not any appliance recommendation or comparison.
• F17｜Cochrane longer-term follow-up at 3 and 6 years.｜Source #1｜confidence=high｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 38597341｜span: 「It presented low-certainty evidence that improvements in overjet and ANB were smaller at 3-year follow-up than just after treatment (overjet MD 2.5 mm, 95% CI 1.21 to 3.79; ANB MD 1.4°, 95% CI 0.43 to 2.37; 63 participants), and were not found at 6-year follow-up (overjet MD 1.30 mm, 95% CI -0.16 to 2.76; ANB MD 0.7°, 95% CI -0.74 to 2.14; 65 participants).」｜caveat: both 6-year confidence intervals cross 0 and do not rule out no difference. Do not write “still effective” or “proven ineffective”; always use the source wording “not found.” Six years is this single study's follow-up window, not an effect expiry date; only one study, 65 participants, low certainty.
• F18｜Cochrane report of clinicians' assessment at 6 years of future surgery need.｜Source #1｜confidence=high｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 38597341｜span: 「In the same study, at the 6-year follow-up, clinicians made an assessment of whether surgical correction of participants' jaw position was likely to be needed in the future. A perceived need for surgical correction was observed more often in participants who had not received facemask treatment (odds ratio (OR) 3.34, 95% CI 1.21 to 9.24; 65 participants; low-certainty evidence).」｜caveat: the outcome is clinicians' subjective perceived need, not the number who actually underwent surgery; one study, 65 people, low certainty.
• F19｜Cochrane authors' conclusion, including confidence and the unresolved question.｜Source #1｜confidence=high｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 38597341｜span: 「One study measured longer-term outcomes and found that the benefit from facemask was reduced three years after treatment, and appeared to be lost by six years. However, participants receiving facemask treatment were judged by clinicians to be less likely to need jaw surgery in adulthood. We have low confidence in these findings and more studies are required to reach reliable conclusions.」 Additional span: 「should last long enough to evaluate whether orthodontic treatment in childhood avoids the need for jaw surgery in adulthood」｜caveat: the authors report low confidence; the final sentence shows that whether childhood treatment avoids adult surgery remained unresolved when the review was completed.
• F20｜Direct comparison of maxillary protraction at different dentition stages.｜Source #10｜confidence=moderate｜basis=peer_reviewed (systematic review and meta-analysis, cohort studies included)｜period=published 2022-11; searched to 2022-01-15｜geo: universal｜PMID 35303382｜span: 「Patients in the early treatment group (ETG) were mainly in the early-mixed dentition stage, while patients in the late treatment group (LTG) were in the late-mixed and early-permanent dentition stage.」 Additional span: 「Our analysis showed that maxillary protraction applied in the late-mixed or early-permanent dentition stage did not cause different effects on the maxillary growth, the correction of the intermaxillary relationship, the inhibition of mandibular growth and dental tipping of skeletal class III patients when compared to that in the early-mixed dentition stage.」 Additional span: 「Six studies were finally included.」｜caveat: no detected difference does not mean equivalence; 6 cohort studies, not RCTs. The authors position this as theoretical basis for choosing timing after complete assessment; it must not be read as “a reader may delay it themselves.”
• F21｜Stability and relapse of maxillary-protraction treatment.｜Source #9｜confidence=moderate｜basis=peer_reviewed (systematic review and meta-analysis)｜period=published 2018-09; searched 1996-01 to 2016-10; included studies with more than 2 years of follow-up｜geo: universal｜PMID 29429068｜span: 「Compared with the control group, after treatment, the treated group showed significant changes: SNA +1.79° (95% CI: 1.23, 2.34), SNB -1.16° (95% CI -2.08, -0.24), ANB +2.92° (95% CI 2.40, 3.44), mandibular plane angle +1.41° (95% CI 0.63, 2.20), overjet +3.94 mm (95% CI 2.17, 5.71) and lower incisor angle -3.07° (95% CI -4.92, -1.22).」 Additional span: 「During follow-up, the changes in five variables reflected significant relapse. Overall, the treated group showed significant changes only in ANB +1.66° (95% CI 0.97, 2.35) and overjet +2.41 mm (95% CI 1.60, 3.23).」 Additional span: 「Maxillary protraction can be a short-term effective therapy and might improve sagittal skeletal and dental relationships in the medium term.」｜caveat: the authors use “can be” and “might”; this card preserves that tone and does not turn it into an effectiveness promise. Only 4 studies entered quantitative analysis; estimates are population level.
• F22｜Cochrane result on alternating rapid maxillary expansion and constriction.｜Source #1｜confidence=high｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 38597341｜span: 「There may be no benefit in terms of effect on ANB of alternating rapid maxillary expansion and constriction compared to using expansion alone (MD -0.46°, 95% CI -1.03 to 0.10; 4 studies, 131 participants; low-certainty evidence).」｜caveat: low certainty; interval crosses 0.
• F23｜A 2025 review reached the opposite direction for the same comparison.｜Source #11｜confidence=low｜basis=peer_reviewed (systematic review and meta-analysis)｜period=published 2025-01-30; searched to 2024-02｜geo: universal｜PMID 40003279｜span: 「A total of 61 articles were identified, and eight were included in the meta-analysis, which examined three parameters: Sella-Nasion-A (SNA), Sella-Nasion-B (SNB), and A Point-Nasion-B (ANB) values.」 Additional span: 「There were statistically significant differences between traditional maxillary disjunction and traction and the different types of Alt-RAMEC protocols, with the latter allowing greater skeletal corrections.」｜caveat: direction differs from Cochrane result F22; this review included non-randomised and retrospective studies, and only 8 entered meta-analysis. This card cites the inconsistency itself as a reason appliance selection belongs to clinical judgment; it makes no protocol recommendation.
• F24｜Soft-tissue changes from early Class III treatment: pooled values and age range.｜Source #12｜confidence=moderate｜basis=peer_reviewed (systematic review and meta-analysis)｜period=published 2025-03-17; searched to 2024-07｜geo: universal｜PMID 40091133｜span: 「The age range fell between 6.6 and 12.3 years.」 Additional span: 「The FM/RME protocol resulted in a 1.58 mm increase in upper lip protrusion and a 4.73-degree decrease in the nasolabial angle compared to the control group.」 Additional span: 「Chincup treatment led to a 2.13 mm increase in upper lip protrusion and a 2.63 mm decrease in lower lip protrusion compared to the control group.」｜caveat: population-level averages, not individual expectations; measurements in millimetres and angles are not necessarily visible appearance changes. The card does not cite the paper's miniplate-anchorage pooled values, to avoid confusion with F27/F28.
• F25｜Conclusion and methodological limitation of the same paper.｜Source #12｜confidence=moderate｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 40091133｜span: 「There is low to moderate evidence suggesting that early treatment positively influences the soft tissues in Class III patients.」 Additional span: 「However, these conclusions are based on a two-dimensional analysis of cephalometric images, which may not provide complete or accurate information.」｜caveat: the authors use “positively influences”; this card retains source wording and does not translate it into a promise of appearance improvement. The limitation is disclosed by the authors themselves.
• F26｜Cochrane background statement on surgery in adulthood.｜Source #1｜confidence=high｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 38597341｜span: 「In severe cases, or if orthodontic treatment is unsuccessful, people may need jaw (orthognathic) surgery as adults.」｜caveat: background statement, not pooled review result; wording is “may need” and must not be rewritten as certainty.
• F27｜Cochrane result on surgical orthodontic correction using miniplates.｜Source #1｜confidence=high｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 38597341｜span: 「One study of 30 participants evaluated surgical miniplates, with facemask or Class III elastics, against no treatment, and found a substantial improvement in overjet (MD 7.96 mm, 95% CI 6.99 to 8.40) and ANB (MD 5.20°, 95% CI 4.48 to 5.92; 30 participants). However, the evidence was of low certainty, and there was no follow-up beyond the end of treatment.」｜caveat: one study, 30 people, low certainty, no follow-up. Here surgery means implantation of orthodontic miniplates, not orthognathic surgery (jaw osteotomy).
• F28｜Cochrane comparison of facemask with added surgical anchorage.｜Source #1｜confidence=high｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 38597341｜span: 「There may be no advantage of adding surgical anchorage to facemasks for ANB (MD -0.35, 95% CI -0.78 to 0.07; 4 studies, 143 participants; low-certainty evidence).」｜caveat: interval crosses 0; low certainty.
• F29｜Published terminology in the difficulty classification of the Orthodontics section of Taipei's approved dental fee schedule.｜Sources #22, #23｜confidence=verified｜basis=official_statement (local-authority-approved document)｜period=approval date 109-01-17, approval number 北市衛醫字第 1093010058 號; independent recheck for this card on 2026-08-06: Department of Health fee-schedule page retrieved by curl, HTTP 200; PDF attachment downloaded by curl, HTTP 200, 411,466 bytes, SHA256 33588b87…f98183 (matching the same-day record for KM-DENTAL-44/C03); verbatim comparison then extracted with pdftotext -layout｜geo: TW｜span (difficult level): 「門牙水平覆咬大於 3mm 或垂直覆咬大於 3mm，或有顎骨間差異，或牙齒排列中度擁擠，或錯咬。」 span (high-difficulty level): 「嚴重下顎前凸，門牙水平覆咬大於 7mm 或垂直覆咬大於 7mm，或有嚴重顎骨間差異，或牙齒排列嚴重擁擠，或骨性開咬、骨性錯咬。」｜caveat: these are difficulty-classification conditions for fee approval, not clinical diagnostic criteria. A dentist classifies an individual from examination results; this is a Taipei-only approved document, with other counties and cities issuing their own notices; this card cites no amount from the schedule.
• F30｜Pooled 1-year incidence of persistent neurosensory disturbance after sagittal split osteotomy.｜Source #13｜confidence=high｜basis=peer_reviewed (systematic review and meta-analysis)｜period=published 2026-01; searched 1998 to 2025-02｜geo: universal｜PMID 40983111｜span: 「The final sample comprised 47 studies (5,406 patients). The pooled 1-year incidence of persistent NSD was 21% (95% CI, 13%-32%).」 Additional span: 「was defined as any NSD reported or assessed at 12 months postoperatively」｜caveat: population is people undergoing sagittal split osteotomy, including both mandibular advancement and setback; this is a population-level pooled estimate, not a probability for a person or institution.
• F31｜Risk factors and items without significant association in the same review.｜Source #13｜confidence=high｜basis=peer_reviewed｜period=as above｜geo: universal｜PMID 40983111｜span: 「Older age (statistically significant in 5 out of 9 studies), greater mandibular advancement (significant in 2 out of 2 studies), and intraoperative nerve exposure/manipulation (significant in 2 out of 3 studies) were statistically significantly associated with a higher risk of persistent NSD across contributing adequately powered studies.」 Additional span: 「Across the available evidence, persistent NSD was not significantly associated with sex (8/9 studies), skeletal class (4/5), fixation method (1/2), third molar presence (1/1), or concomitant genioplasty (3/5).」｜caveat: greater mandibular advancement is a risk factor in the advancement direction, unlike the setback direction commonly associated with skeletal Class III; the body states this. “No significant association with skeletal class” is a result in 4 of 5 studies, not a final conclusion.
• F32｜Range of condylar-resorption rates after orthognathic surgery.｜Source #14｜confidence=moderate｜basis=peer_reviewed (systematic review)｜period=published 2018-04｜geo: universal｜PMID 29534912｜span: 「Five studies had data regarding the rate of condylar resorption, varying from 0.0% to 4.2%. In conclusion, condylar resorption and relapses were present in a small percentage of patients studied.」 Additional span: 「individuals with skeletal dentofacial deformities (class II or III facial patterns), without asymmetry」｜caveat: range of rates separately reported by studies, not a pooled estimate; only 6 studies entered qualitative analysis; population included Class II and III and excluded asymmetry.
• F33｜Stability comparison of one-jaw and two-jaw surgery for skeletal Class III correction.｜Source #15｜confidence=moderate｜basis=peer_reviewed (systematic review and meta-analysis)｜period=published 2021-08; searched to 2020-10｜geo: universal｜PMID 33305502｜span: 「No significant difference in sagittal stability at the ANB angle, A-point or B-point on a short-term was detected. However, a statistically significant difference, indicating a greater short-term relapse in overjet with mandibular setbacks alone, was found (MD: -0.40 mm; 95% CI -0.77 to -0.04; I2 : 0%; P = .03).」 Additional span: 「Long-term follow-up (≥5 years) revealed a statistically non-significant difference in stability of sagittal skeletal and overjet corrections.」 Additional span: 「Within the limitations of this review, both procedures seem to offer comparable skeletal and overjet stability outcomes; however, further high-quality research is required to confirm these findings.」｜caveat: this compares two procedures, not an overall incidence of whether surgery relapses; 9 studies included, 8 quantitative; this card makes no procedure recommendation.
• F34 [structural editorial organisation]｜Editorial decision that this site provides no self-treatment method and explicitly discourages it, and the conservative care wording that people who have used an appliance themselves and develop loose teeth, red swollen or bleeding gums, pain, or bite change should stop and seek care promptly.｜Source #25｜confidence=n/a｜basis=editorial｜geo: universal｜caveat: must not be labelled pending verification. This search obtained no reliable quantitative source for incidence of harm from self-orthodontics, so this section makes no incidence claim. The discouragement is based on the need for clinical cause differentiation in F5/F8/F9 and insufficient adverse-effect evidence in F39; this inference is this site's editorial decision.
• F35 [structural editorial organisation]｜Terminology-governance decisions including “mapping colloquial and clinical terms is this site's editorial organisation,” “classification terms from different sources are not swapped or merged,” and “no causal sentence is written.”｜Source #25｜confidence=n/a｜basis=editorial｜geo: universal｜caveat: must not be labelled pending verification. No official institution's formal clinical translation for the source-language colloquial terms was found, so the mapping is disclosed as editorial organisation rather than claimed as an official definition.
• F36｜Published content for orthognathic consultation and treatment-plan items in the Oral and Maxillofacial Surgery section of Taipei's approved dental fee schedule.｜Source #22｜confidence=verified｜basis=official_statement｜period=same as F29; 2026-08-06 practical check and verbatim comparison｜geo: TW｜span (orthognathic consultation fee): 「由牙醫師提供患者正顎手術的諮詢(或再諮詢)，內容包括正顎手術目的、可能手術方式與風險、住院與麻醉相關問題，約略以 30 分鐘為單位、不足 30 分鐘以 30 分鐘計，不包含檢查與分析或治療計畫擬定。」 span (treatment-plan preparation): 「依病人主述擬定具可能性的治療計畫。」｜caveat: description of fee-item content; it does not mean any institution necessarily provides it or necessarily charges in that way. This card cites no amount from the schedule; it is a Taipei-only approved document.
• F37｜Duty to inform under Article 81 of Taiwan's Medical Care Act.｜Source #20｜confidence=verified｜basis=law｜period=current text; on 2026-08-06, curl retrieved HTTP 200 and the article text was extracted and compared verbatim｜geo: TW｜span: 「醫療機構診治病人時，應向病人或其法定代理人、配偶、親屬或關係人告知其病情、治療方針、處置、用藥、預後情形及可能之不良反應。」｜caveat: this article sets an institutional duty. This card makes no legal-applicability judgment. The official English translation is Taiwan's Medical Care Act: https://law.moj.gov.tw/ENG/LawClass/LawAll.aspx?pcode=L0020021
• F38｜Coverage exclusion in Article 51, Paragraph 3 of Taiwan's National Health Insurance Act.｜Source #19｜confidence=verified｜basis=law｜period=current text; on 2026-08-06, curl retrieved HTTP 200 and the article text was extracted and compared verbatim｜geo: TW｜span: 「藥癮治療、美容外科手術、非外傷治療性齒列矯正、預防性手術、人工協助生殖技術、變性手術。」｜caveat: the items in this article are excluded from coverage. Individual determination of trauma-related therapeutic orthodontics, and whether other care during a course—including surgery, hospitalisation, and anaesthesia—is covered, depends on current Taiwan National Health Insurance Administration rules and review. This card makes no individual determination and gives no legal opinion on insurance claims or contract terms. The same anchor is used by KM-DENTAL-08 and KM-DENTAL-C03.
• F39｜Amount of evidence on adverse effects of 2×4 fixed orthodontic appliances in mixed dentition.｜Source #16｜confidence=moderate｜basis=peer_reviewed (systematic review)｜period=published 2025-01｜geo: universal｜PMID 40439212｜span: 「82 patients with mean-age of 10-year, mostly with pseudo class-III malocclusion, anterior cross-bite and crowding treated using 2 x 4 appliance were found.」 Additional span: 「The literature-based evidence related to the adverse effects of 2 × 4 orthodontic appliances was found to be inadequate in quantity, but majority was of high quality (low risk of bias).」｜caveat: insufficient evidence quantity does not mean no risk. The abstract did not list specific adverse effects, so this card lists none; few studies and a sample of 82 people.
• F40｜Association and evidence certainty for malocclusion and pain-related temporomandibular disorders in children and adolescents.｜Source #17｜confidence=moderate｜basis=peer_reviewed (systematic review)｜period=published 2025-04-03｜geo: universal｜PMID 40248012｜span: 「Most of the studies showed that malocclusion may be associated with TMD-pain signs/symptoms in children and adolescents. The most frequent relationship was found between the prevalence of pain-related TMD and posterior crossbite, Class II malocclusion, Class III malocclusion, and anterior open bite.」 Additional span: 「The certainty of evidence was assessed as low, according to the GRADE approach.」 Additional span: 「However, given the limited reliability of existing research and the inconsistencies observed across studies, additional well-structured, long-term investigations are necessary.」｜caveat: association is not causation; GRADE certainty is low. This card therefore does not state that an underbite causes temporomandibular disorder.
• F41｜Pooled effects of different appliance categories in the 2026 meta-analysis.｜Source #3｜confidence=moderate｜basis=peer_reviewed｜period=published 2026-06; searched to 2025-09｜geo: universal｜PMID 42256824｜span: 「Intraoral non-skeletally anchored appliances demonstrated modest improvements in sagittal skeletal relationships (ANB mean difference (MD) = 0.29°-3.12°) and clinically meaningful overjet correction (MD = 1.4-5.9 mm), primarily through dentoalveolar mechanisms rather than true skeletal modification.」 Additional span: 「facemask therapy combined with rapid maxillary expansion (FM-RME) produced the most pronounced skeletal effects, with pooled estimates showing significant increases in ANB (MD = 3.54°) and SNA (MD = 1.37°), along with a reduction in SNB (MD = -2.14°), although substantial heterogeneity was observed across studies」｜caveat: the authors use comparative terms such as “most pronounced” and “most reliable”; this card does not translate them or make any appliance recommendation, and cites only pooled figures and authors' stated heterogeneity. The journal is Cureus; figures are population-level averages, not individual expectations.
• F44｜Oral-health-related quality of life before, during, and after orthodontic-orthognathic treatment.｜Source #26｜confidence=moderate｜basis=peer_reviewed (systematic review and meta-analysis)｜period=published 2022-03; searched to 2020-02-03｜geo: universal｜PMID 35194682｜span: 「Two studies (87 participants) were included in a meta-analysis showing improvement of OHRQoL when comparing before and after treatment were compared (mean 14.85 scale points, 95% confidence interval 10.36;19.35).」 Additional span: 「Studies indicate a decrease in OHRQoL during the pre-surgical orthodontic treatment phase but improvement after orthodontic-orthognathic treatment. Data substantiating these results are limited, and the quality of evidence is low.」 Additional span: 「All six studies had a serious risk of bias.」 Additional span: 「Patients should be well informed about the effect facial/esthetic changes may have on their OHRQoL during sequential phases of orthodontic-orthognathic treatment.」｜caveat: the direction of scale points depends on the questionnaire used (OHIP-14/OQLQ-22). This card records improvement in the source's wording and does not calculate or interpret direction itself. All 6 included studies had serious risk of bias; only 2 studies with 87 people entered meta-analysis; evidence quality is low. It is a population-level estimate and must not be used to infer any individual's treatment experience.
• F42｜Health-education status under Article 87 of Taiwan's Medical Care Act.｜Source #21｜confidence=verified｜basis=law｜period=current text; on 2026-08-06, curl retrieved HTTP 200 and the article text was extracted and compared verbatim｜geo: TW｜span: 「廣告內容暗示或影射醫療業務者，視為醫療廣告。醫學新知或研究報告之發表、病人衛生教育、學術性刊物，未涉及招徠醫療業務者，不視為醫療廣告。」｜caveat: this card uses the article to position itself as patient health education, without solicitation; it makes no legal-applicability judgment. Official English translation: Taiwan's Medical Care Act, https://law.moj.gov.tw/ENG/LawClass/LawAll.aspx?pcode=L0020021
• F43｜Literature currency-check record: the preceding independent review on the early-treatment question.｜Source #2｜confidence=moderate｜basis=peer_reviewed (systematic review and meta-analysis)｜period=published 2017-01; searched to 2016-06｜geo: universal｜PMID 28024779｜span: 「There is a moderate amount of evidence to show that early treatment with a facemask results in positive improvement for both skeletal and dental effects in the short term. However, there was lack of evidence on long-term benefits.」｜caveat: this card does not use any pooled value from this paper; it records only that its conclusion direction agrees with Cochrane 2024 (insufficient evidence of long-term benefit). Two reasons: (1) its search only reaches 2016-06 and is superseded in currency by the Cochrane update searched to 2023-01; (2) its facemask-versus-untreated reverse-overjet pooled value is numerically identical to the Cochrane 2024 3-year overjet value (both 2.5 mm, 95% CI 1.21 to 3.79). This site's cause check is incomplete and the overlap may come from the same original trials. To avoid readers or AI treating them as independent corroboration, this card uses Cochrane 2024 values only.

How to find a clinic that provides this service

This site lists no clinics and does not recommend, rate or compare any medical institution.

To find a clinic that provides this service, use the following official lookup channels yourself —

they are maintained by the competent authorities and are more current than any list:

>

- The Ministry of Health and Welfare's medical-institution lookup: search by city or county,

township and specialty (dentistry) for institutions that have completed practice registration.

The results show the institution's name, address and registered specialty. This is the first place

to confirm whether a clinic is lawfully registered.

- The National Health Insurance Administration's contracted-institution lookup: check whether a

clinic is under contract with National Health Insurance. This determines which items are covered

and which are self-paid, and therefore what kind of fee explanation you will be given.

>

Both systems are on the respective authorities' official websites; searching for the

medical-institution lookup or the contracted-institution lookup will find them. This site does not

reproduce the URLs, because they change; use whichever entry point the authority currently publishes.

>

In an emergency, do not spend time looking up lists. If your breathing, swallowing or speech is

affected, or swelling is spreading, go to the nearest emergency department.

Chinese labels to look for on the official pages

These official systems, datasets and files are published in Chinese only. The English names above are this site's renderings; on the page itself you will see the following strings, so search for these:

>

- 「醫事機構查詢」

- 「特約醫事機構查詢」

- 「特約院所查詢」

Compliance note

This is patient health-education information under Article 87 of Taiwan's Medical Care Act [F42], not medical advertising. It recommends no particular institution and neither recommends nor compares any appliance, procedure, or brand, and it gives no amount or price range. Orthodontics and orthognathic surgery have risks and contraindications, including treatment effects shrinking over time and relapse, postoperative neurosensory disturbance, condylar resorption, and hospitalisation- and anaesthesia-related risks. Actual treatment method and effects vary by person and require a dentist's assessment. This card gives no self-orthodontics or home-treatment method and no legal opinion on insurance claims or contract terms; related questions depend on the policy and contract terms.

Sources

All sources accessed on 2026-08-06. PubMed entries were retrieved through E-utilities efetch (rettype=abstract) and compared verbatim; pubtype was checked item by item through esummary for retraction status (all 18 had no Retracted Publication marker and no WITHDRAWN title). For the Cochrane item, the CD-number version chain was separately checked to confirm pub3 is the current version. Statutes were retrieved from Taiwan's Laws & Regulations Database by curl (HTTP 200), then the article blocks were extracted and compared verbatim. The Taipei fee-schedule page and PDF attachment were both retrieved by curl (HTTP 200) and compared verbatim after pdftotext extraction. The AAO public-education page was retrieved by curl (HTTP 200) and its text extracted and compared verbatim.

• S1 Owens D, Watkinson S, Harrison JE, Turner S, Worthington HV. Orthodontic treatment for prominent lower front teeth (Class III malocclusion) in children. Cochrane Database Syst Rev. 2024;4(4):CD003451. PMID 38597341. pubmed.ncbi.nlm.nih.gov/38597341
• S2 Woon SC, Thiruvenkatachari B. Early orthodontic treatment for Class III malocclusion: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2017;151(1):28-52. PMID 28024779. pubmed.ncbi.nlm.nih.gov/28024779
• S3 Kourbaj YM, Hajeer MY, Burhan AS, Alam MK, Abutayyem H. Effectiveness of Treatment Modalities for the Correction of Anterior Crossbite in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cureus. 2026;18(6):e110226. PMID 42256824. pubmed.ncbi.nlm.nih.gov/42256824
• S4 Wiedel AP. Fixed or removable appliance for early orthodontic treatment of functional anterior crossbite. Swed Dent J Suppl. 2015;(238):10-72. PMID 26939312. pubmed.ncbi.nlm.nih.gov/26939312
• S5 Borrie F, Bearn D. Early correction of anterior crossbites: a systematic review. J Orthod. 2011;38(3):175-84. PMID 21875991. pubmed.ncbi.nlm.nih.gov/21875991
• S6 Khalaf K, Mando M. Removable appliances to correct anterior crossbites in the mixed dentition: a systematic review. Acta Odontol Scand. 2020;78(2):118-125. PMID 31509048. pubmed.ncbi.nlm.nih.gov/31509048
• S7 De Ridder L, Aleksieva A, Willems G, Declerck D, Cadenas de Llano-Pérula M. Prevalence of Orthodontic Malocclusions in Healthy Children and Adolescents: A Systematic Review. Int J Environ Res Public Health. 2022;19(12):7446. PMID 35742703. pubmed.ncbi.nlm.nih.gov/35742703
• S8 de Frutos-Valle L, Martin C, Alarcon JA, Palma-Fernandez JC, Iglesias-Linares A. Subclustering in Skeletal Class III Phenotypes of Different Ethnic Origins: A Systematic Review. J Evid Based Dent Pract. 2019;19(1):34-52. PMID 30926101. pubmed.ncbi.nlm.nih.gov/30926101
• S9 Lin Y, Guo R, Hou L, Fu Z, Li W. Stability of maxillary protraction therapy in children with Class III malocclusion: a systematic review and meta-analysis. Clin Oral Investig. 2018;22(7):2639-2652. PMID 29429068. pubmed.ncbi.nlm.nih.gov/29429068
• S10 Wang J, Wang Y, Yang Y, et al. Clinical effects of maxillary protraction in different stages of dentition in skeletal class III children: A systematic review and meta-analysis. Orthod Craniofac Res. 2022;25(4):549-561. PMID 35303382. pubmed.ncbi.nlm.nih.gov/35303382
• S11 Otel A, Montiel-Company JM, Zubizarreta-Macho Á. Comparative Analysis of Early Class III Malocclusion Treatments-A Systematic Review and Meta-Analysis. Children (Basel). 2025;12(2):177. PMID 40003279. pubmed.ncbi.nlm.nih.gov/40003279
• S12 Alhamwi AM, Burhan AS, Nawaya FR, Sultan K. Soft tissue changes associated with Class III orthopaedic treatment in growing patients: a systematic review and meta-analysis. Prog Orthod. 2025;26(1):10. PMID 40091133. pubmed.ncbi.nlm.nih.gov/40091133
• S13 Bertagna AE, Van der Cruyssen F, Miloro M. Persistent Neurosensory Disturbance Following Sagittal Split Osteotomy: A Systematic Review and Meta-Analysis of One-Year Outcomes and Risk Factors. J Oral Maxillofac Surg. 2026;84(1):25-44. PMID 40983111. pubmed.ncbi.nlm.nih.gov/40983111
• S14 Nunes de Lima V, Faverani LP, Santiago JF Jr, Palmieri C Jr, Magro Filho O, Pellizzer EP. Evaluation of condylar resorption rates after orthognathic surgery in class II and III dentofacial deformities: A systematic review. J Craniomaxillofac Surg. 2018;46(4):668-673. PMID 29534912. pubmed.ncbi.nlm.nih.gov/29534912
• S15 Rizk MZ, Torgersbråten N, Mohammed H, Franzen TJ, Vandevska-Radunovic V. Stability of single-jaw vs two-jaw surgery following the correction of skeletal class III malocclusion: A systematic review and meta-analysis. Orthod Craniofac Res. 2021;24(3):314-327. PMID 33305502. pubmed.ncbi.nlm.nih.gov/33305502
• S16 Khan MK, Pandiyan R, Rather SH. Adverse Effects of 'Two-by-Four Fixed Orthodontic Appliance' in Mixed Dentition Period - A Systematic Review. Indian J Dent Res. 2025;36(1):94-102. PMID 40439212. pubmed.ncbi.nlm.nih.gov/40439212
• S17 Szyszka-Sommerfeld L, Sycińska-Dziarnowska M, Gerreth K, Spagnuolo G, Woźniak K, Czajka-Jakubowska A. The impact of malocclusion on the prevalence of pain-related temporomandibular disorders in children and adolescents: a systematic review. Front Neurol. 2025;16:1550110. PMID 40248012. pubmed.ncbi.nlm.nih.gov/40248012
• S18 American Association of Orthodontists. Child Orthodontics (public-education page). aaoinfo.org/child-orthodontics
• S19 Taiwan National Health Insurance Act, Article 51 (Taiwan Laws & Regulations Database). law.moj.gov.tw pcode=L0060001 flno=51
• S20 Taiwan Medical Care Act, Article 81 (Taiwan Laws & Regulations Database; official English translation). law.moj.gov.tw ENG pcode=L0020021
• S21 Taiwan Medical Care Act, Article 87 (Taiwan Laws & Regulations Database; official English translation). Verbatim Chinese: 「廣告內容暗示或影射醫療業務者，視為醫療廣告。醫學新知或研究報告之發表、病人衛生教育、學術性刊物，未涉及招徠醫療業務者，不視為醫療廣告。」 law.moj.gov.tw ENG pcode=L0020021
• S22 Taipei City Dental Fee Schedule for Medical Institutions (approved version 1090117), PDF attachment linked from Taipei City Government Department of Health. www-ws.gov.taipei download
• S23 Taipei City Government Department of Health—Fee schedule: “Taipei City Dental Fee Schedule for Medical Institutions” (approved 1090117). health.gov.taipei fee-schedule page　[On the official page the label appears in Chinese only: 「臺北市醫療機構牙科收費標準表」]
• S24 Internal data (the eight-digit number in the path is the data-export date, not a PMID): this topic's row in the clinic-topic additions table in `km-production-queue.html`, and `gsc-full-20260804/__web__full.tsv` (full GSC data for one site, data window 2025-03 to 2026-08), reconcilable item by item. It is not medical evidence and is only a basis for topic selection and mounting.
• S26 Brouns VEHW, de Waal AML, Bronkhorst EM, Kuijpers-Jagtman AM, Ongkosuwito EM. Oral health-related quality of life before, during, and after orthodontic-orthognathic treatment: a systematic review and meta-analysis. Clin Oral Investig. 2022;26(3):2223-2235. PMID 35194682. pubmed.ncbi.nlm.nih.gov/35194682
• S25 Editorial framework (no external source): the card's three-way sorting, terminology-governance rules, editorial decision to discourage self-treatment, and checklist design; see F2, F3, F34, F35.

Internal citation chain

• Canonical card for fees (not repeated here): How much do “braces” cost? First distinguish orthodontic braces from a prosthetic crown (KM-DENTAL-08, draft) and How much does clear-aligner treatment cost? How is that price calculated? (KM-DENTAL-C03, draft). Boundary: orthodontic fee components, how to read the approved fee schedule, and the full explanation of why National Health Insurance does not cover them belong to those two cards. This card only briefly points to them when needed. Where the cards cite the same Taipei schedule, they use different sections: this card uses the Oral and Maxillofacial Surgery notice on orthognathic consultation and the Orthodontics Chinese terminology; C03 uses orthodontics item structure and the fee meaning of difficulty classes. The Article 51, Paragraph 3 span in the three cards is verbatim identical.
• Canonical card for appliance-indication limits: What are the disadvantages of clear aligners? (KM-DENTAL-C07, draft). Boundary: predictability of clear aligners for different tooth movements, the gap in extraction cases, and evidence for skeletal Class II in children belong to C07. This card covers the Class III / anterior-crossbite branch. Their populations and skeletal classifications differ and must not be applied to one another.
• General method for choosing a clinic and questions for a first visit: How do I choose a Shulin dentist? First use the official system to verify them, then see how the first consultation is explained (KM-DENTAL-49, draft). This card's checklist contains topic-specific questions; the general verification method is in that card.