## 4 Discussion  
The intended focus of the present systematic review was on identifying high-quality, evidence-based clinical studies, such as randomized controlled trials that evaluated the post-operative outcomes (in terms of FS and occlusion) in patients who underwent CAT or fixed OT after OS. With particular regard to FS, it is challenging to label this manifestation as a complication of OS as \"post-operative swelling\" when it is a normal bodily response to surgical trauma and is part of the normal healing process. While post-surgical swelling is not a complication per se, it is essential for healthcare professionals to monitor the extent and duration of swelling, as excessive or prolonged swelling may indicate other underlying issues or complications such as an abscess [18]. It is crucial to highlight that none of the studies [10; 11; 12; 13] included in the investigation assessed both post-operative FS and occlusion simultaneously. Instead, out of the four clinical investigations [10; 11; 12; 13] two studies [11; 13] specifically addressed occlusion-related outcomes, while the remaining studies [10; 12] assessed post-operative FS. Due to the limited number of studies available on either of the two parameters, FS or dentoskeletal occlusion, it was challenging to dedicate the entire manuscript to either topic exclusively. Instead, authors of the present investigation decided to incorporate all four available studies [10; 11; 12; 13] to provide the most comprehensive and up-to-date review on the subject. The absence of studies assessing both aspects and potential post-surgical complications emphasize the need for further research to comprehensively and prospectively explore the effects of CAT and fixed OT in such a patient cohort. Nonetheless, by including all relevant studies [10; 11; 12; 13], the authors aimed to present a thorough analysis of the current state of research on the topic despite the scarcity of individual studies on each parameter. Based on a comprehensive review of the currently available literature, it is alluring to conclude that both CAT and fixed OT can produce satisfactory outcomes in relation to postoperative FS and occlusion following OS. However, it is crucial to exercise caution when interpreting such a conclusion. Prior sample-size estimation (SSE) or power analysis (PA) plays a pivotal role in ensuring the validity and reliability of study findings [19; 20]. In other words, it is critical to determine an appropriate sample size (number of participants as in the present scenario) before conducting a study to avoid underpowered or overpowered investigations, which can otherwise lead to publication bias and/or inaccurate conclusions [21; 22]. Amongst the studies [10; 11; 12; 13] assessed, the number of participants and their ages ranged between 22 and 29; however, a prior SSE was performed in none of them. It is worth mentioning that a small sample may not adequately represent the target population, leading to limited external validity or generalizability of the study findings, [23] and it can result in imprecise estimates of population parameters, such as means, proportions, or effect sizes [24]. From the design perspective, all studies [10; 11; 12; 13] were retrospective. Evaluation of retrospective studies comes with several limitations including selection bias (as the studies rely on pre-existing data), uncontrolled confounding factors, blinding of operators, allocation concealment of interventions and limited generalizability and validity [23; 25]. Furthermore, all studies had a moderate RoB and the GRADE analysis revealed that the importance of the included studies were either uncertain or limited. Therefore, the findings of the included studies [10; 11; 12; 13] should be interpreted with prudence, recognizing the potential for biases and uncertainties that could influence the results.