Background/Objectives: Skeletal Class III malocclusion in growing patients presents therapeutic challenges. While traditional tooth-anchored facemask (FM) therapy is widely used, it may induce undesired dental effects. Bone-anchored maxillary protraction (BAMP), using either miniscrews (MSs) or miniplates (MPs), has been proposed to enhance skeletal outcomes and minimize dental compensation. The objective is to compare the efficacy of MS and MP as skeletal anchorage in the orthopedic treatment of the Class III growing patients. Methods: This systematic review and meta-analysis followed PRISMA guidelines. Five databases and manual searches were conducted without restrictions. Inclusion criteria encompassed randomized and non-randomized controlled trials assessing cephalometric outcomes in growing patients treated with MS or MP. Risk of bias was assessed with RoB 2 and ROBINS-I tools, and evidence certainty was evaluated using GRADE. A meta-analysis was performed, collecting all the statistically significant results that emerged in the 11 articles between skeletal anchorage and controls, comparing the values of the MP group with the MS group. Results: Eleven studies (seven MP, four MS) met the inclusion criteria. Both MS and MP groups showed significant maxillary advancement and improved maxillo–mandibular relationships compared to controls. Regarding vertical values, studies have reported contrasting outcomes. Soft tissue improvements were consistent in both MS and MP devices. Statistical analysis has highlighted how MP devices demonstrated more pronounced skeletal effects, while MS systems were associated with more dental effects. Conclusions: MP may be preferable when the aim is to maximize skeletal correction with fewer dental side effects, while MS can be considered in cases favoring less invasive approaches; long-term follow-up and high-quality clinical studies are needed to confirm these clinical assessments.
(1) Introduction: Deciduous traumatic dental injuries pose a serious global health concern. Root fractures show an incidence rate of approximately 2%; however, the literature is limited regarding the appropriate treatment and prognosis of affected teeth. This retrospective study aims to analyze the long-term outcomes of orthodontic splinting using brackets compared with composite resin-only splinting in two homogeneous samples affected by root fractures. The study also examines the onset and patterns of root resorption. (2) Methods: The first group included 25 patients with 27 deciduous upper incisors affected by root fracture; Group 2 consisted of 35 patients with 38 root fractures of maxillary deciduous teeth. The categorical data for both groups were analyzed using the chi-squared homogeneity test. Age groups were compared using the Mann–Whitney U test; p < 0.005 was considered statistically significant. (3) Results: In both groups, the male gender predominated similarly. In Group 1, early decidual loss occurred in 16% of cases, whereas in Group 2 it occurred in 51% of cases. Pulp canal obliteration was observed in 68% of deciduous teeth in Group 1, compared with 30% in Group 2. No complications affecting permanent teeth were noted in Group 1; in Group 2, 29% developed enamel dysplasia and 26% experienced delayed eruption, with statistically significant differences in these proportions. Apical fragment resorption was observed in 92% of cases in Group 1 and 30% in Group 2. (4) Conclusions: The treatment of deciduous tooth root fractures using orthodontic splints can yield significant benefits, such as reduction of early tooth loss. Furthermore, the study confirms that early resorption of the distal fragment of fractured roots is a common physiological phenomenon in primary teeth and typically occurs within a year following trauma.