Aesthetic and functional aspects of incisal guidance: a systematic review

Abstract

This systematic review of the literature aims to assess the scientific evidence regarding incisal guidancefrom both aesthetic and functional perspectives. The ultimate aim was to provide the clinician with evidencebasedguidelines to assist in routine dental practice. The Medline database (PubMed) was searched for relevantarticles using the keywords “incisal guidance” and “anterior dental guidance” and no time constraints.Types of studies selected were randomised clinical trials (RTCs); prospective, retrospective and transversalstudies; controlled clinical trials; and comparative studies. This search furnished 252 articles, but only eightwere deemed suitable for review after application of the inclusion and exclusion criteria. The final samplecontained no RCTs, comprising only transversal clinical trials. No study included a previous sample sizeestimation, and none performed method error analysis. None of the subjects analysed dropped out. Onlyone article featured blind measurements, and only one a randomly selected sample. The description of thecharacteristics of the test subjects was judged to be adequate in five studies, intermediate in one, and poor intwo. The quality of the articles was deemed to be low in three cases, and intermediate in the remaining five.Given the heterogeneity of the articles deemed suitable for review and the poor statistical power of several, itwas not possible to formulate evidence-based guidelines. Nevertheless, several indications useful for clinicalpractice are suggested, particularly as regards combined orthodontic-restorative treatments.