Bondemark L, Holm Anna-Karin, Hansen Ken, Axelsson Susanna, Mohlin Bengt, Brattstrom Viveka, Paulin Gunnar, Pietila Terttu
Faculty of Odontology, Malmoe University, Department of Orthodontics, Malmoe, Sweden.
Angle Orthod. 2007 Jan;77(1):181-91. doi: 10.2319/011006-16R.1.
To evaluate morphologic stability and patient satisfaction at least 5 years after orthodontic treatment.
Published literature was searched through the PubMed and Cochrane Library electronic databases from 1966 to January 2005. The search was performed by an information specialist at the Swedish Council on Technology Assessment in Health Care. The inclusion criteria consisted of a follow-up period of at least 5 years postretention; randomized clinical trials, prospective or retrospective clinical controlled studies, and cohort studies; and orthodontic treatment including fixed or removable appliances, selective grinding, or extractions. Two reviewers extracted the data independently and also assessed the quality of the studies.
The search strategy resulted in 1004 abstracts or full-text articles, of which 38 met the inclusion criteria. Treatment of crowding resulted in successful dental alignment. However, the mandibular arch length and width gradually decreased, and crowding of the lower anterior teeth reoccurred postretention. This condition was unpredictable at the individual level (limited evidence). Treatment of Angle Class II division 1 malocclusion with Herbst appliance normalized the occlusion. Relapse occurred but could not be predicted at the individual level (limited evidence). The scientific evidence was insufficient for conclusions on treatment of cross-bite, Angle Class III, open bite, and various other malocclusions as well as on patient satisfaction in a long-term perspective.
This review has exposed the difficulties in drawing meaningful evidence-based conclusions often because of the inherent problems of retrospective and uncontrolled study design.
评估正畸治疗后至少5年的形态稳定性和患者满意度。
通过检索1966年至2005年1月期间PubMed和Cochrane图书馆电子数据库中的已发表文献进行研究。检索由瑞典卫生保健技术评估委员会的一名信息专家进行。纳入标准包括保持期后至少5年的随访期；随机临床试验、前瞻性或回顾性临床对照研究以及队列研究；以及包括固定或可摘矫治器、选择性调磨或拔牙在内的正畸治疗。两名评审员独立提取数据并评估研究质量。
检索策略共获得1004篇摘要或全文文章，其中38篇符合纳入标准。牙列拥挤的治疗使牙齿排列成功。然而，下颌牙弓长度和宽度逐渐减小，且保持期后下前牙拥挤复发。这种情况在个体水平上无法预测（证据有限）。使用Herbst矫治器治疗安氏II类1分类错牙合可使咬合正常化。复发确实发生，但在个体水平上无法预测（证据有限）。从长期来看，关于反牙合、安氏III类、开牙合及其他各种错牙合的治疗以及患者满意度的科学证据不足，无法得出结论。
本综述揭示了得出有意义的循证结论存在困难，这通常是由于回顾性和非对照研究设计的固有问题所致。
