Millett D T, Glenny A M, Mattick C R, Hickman J, Mandall N A
University Dental School and Hospital, Department of Oral Health and Development, Wilton, Cork, Ireland.
Cochrane Database Syst Rev. 2007 Apr 18(2):CD004485. doi: 10.1002/14651858.CD004485.pub3.
Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. It has been shown that the quality of treatment result obtained with fixed appliances is much better than with removable appliances. Fixed appliances are, therefore, favoured by most orthodontists for treatment. The success of a fixed orthodontic appliance depends on the metal attachments (brackets and bands) being attached securely to the teeth so that they do not become loose during treatment. Brackets are usually attached to the front and side teeth, whereas bands (metal rings that go round the teeth) are more commonly used on the back teeth (molars). A number of adhesives are available to attach bands to teeth and it is important to understand which group of adhesives bond most reliably, as well as reducing or preventing dental decay during the treatment period.
To evaluate the effectiveness of the adhesives used to attach bands to teeth during fixed appliance treatment, in terms of:(1) how often the bands come off during treatment; and(2) whether they protect the banded teeth against decay during fixed appliance treatment.
Electronic databases were searched: the Cochrane Oral Health Group's Trials Register (29th January 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 1), MEDLINE (1966 to 29th January 2007) and EMBASE (1980 to 29th January 2007). A search of the internet was also undertaken. There was no restriction with regard to publication status or language of publication.
Randomised and controlled clinical trials (RCTs and CCTs) (including split-mouth studies) of adhesives used to attach orthodontic bands to molar teeth were selected. Patients with full arch fixed orthodontic appliance(s) who had bands attached to molars were included.
All review authors were involved in study selection, validity assessment and data extraction without blinding to the authors, adhesives used or results obtained. All disagreements were resolved by discussion.
Five RCTs and three CCTs were identified as meeting the review's inclusion criteria. All the included trials were of split-mouth design. Four trials compared chemically cured zinc phosphate and chemically cured glass ionomer; three trials compared chemically cured glass ionomer cement with light cured compomer; one trial compared chemically cured glass ionomer with a chemically cured glass phosphonate. Data analysis was often inappropriate within the studies meeting the inclusion criteria.
AUTHORS' CONCLUSIONS: There is insufficient high quality evidence with regard to the most effective adhesive for attaching orthodontic bands to molar teeth. Further RCTs are required.
正畸治疗是指使用固定或可摘矫治器（牙套）来矫正牙齿位置。研究表明，使用固定矫治器获得的治疗效果质量要比可摘矫治器好得多。因此，大多数正畸医生更倾向于使用固定矫治器进行治疗。固定正畸矫治器的成功取决于金属附件（托槽和带环）牢固地附着在牙齿上，以便在治疗过程中不会松动。托槽通常附着在前牙和侧牙上，而带环（环绕牙齿的金属环）更常用于后牙（磨牙）。有多种粘合剂可用于将带环附着在牙齿上，了解哪类粘合剂粘结最可靠，以及在治疗期间减少或预防龋齿非常重要。
评估在固定矫治器治疗期间用于将带环附着在牙齿上的粘合剂的有效性，具体涉及：（1）治疗期间带环脱落的频率；（2）在固定矫治器治疗期间它们是否能保护带环牙齿预防龋齿。
检索了电子数据库：Cochrane口腔健康组试验注册库（2007年1月29日）、Cochrane对照试验中央注册库（CENTRAL）（Cochrane图书馆2007年第1期）、MEDLINE（1966年至2007年1月29日）和EMBASE（1980年至2007年1月29日）。还进行了互联网搜索。对发表状态或发表语言没有限制。
选择用于将正畸带环附着到磨牙上的粘合剂的随机对照临床试验（RCT和CCT）（包括半口研究）。纳入全牙弓固定正畸矫治器且磨牙上附着有带环的患者。
所有综述作者都参与了研究选择、有效性评估和数据提取，对作者、使用的粘合剂或获得的结果不设盲。所有分歧都通过讨论解决。
确定有5项RCT和3项CCT符合综述的纳入标准。所有纳入试验均为半口设计。4项试验比较了化学固化磷酸锌和化学固化玻璃离子水门汀；3项试验比较了化学固化玻璃离子水门汀与光固化复合树脂；1项试验比较了化学固化玻璃离子水门汀与化学固化玻璃膦酸盐。在符合纳入标准的研究中，数据分析往往不恰当。
关于将正畸带环附着到磨牙上最有效的粘合剂，目前缺乏高质量证据。需要进一步的RCT。
