Meta-analysis was performed on RCTs reporting on anchorage loss at the first molar.

Based on seven studies [1, 4, 11, 28, 49, 50, 52], the weighted mean differences (WMD) [95% CI, p] in horizontal anchorage loss between test and control groups amounted up to − 2.79 mm [− 3.56 to − 2.03 mm, p < 0.0001] favoring skeletal anchorage over conventional anchorage devices (Fig. 3). The heterogeneity among the analyzed studies was high (τ² = 0.89, I² = 89%).

Based on six studies [1, 11, 28, 48,49,50, 52], the WMD [95% CI, p] in vertical anchorage loss between test and control groups amounted to − 1.76 [−.56 to − 0.97 mm, p < 0.0001] favoring skeletal anchorage over control measures. The heterogeneity among the studies was high (τ² = 0.82, I² = 92%) (Fig. 4).

Funnel plots of the intervention effect estimates (presented as mean differences) plotted against standard errors are presented in Figs. 5 and 6. Their symmetricity suggests the absence of publication bias.