Clinic for Orthodontics and Pediatric Dentistry, Center for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, University of Zurich, Zurich, Switzerland.
Clin Oral Implants Res. 2009 Dec;20(12):1351-9. doi: 10.1111/j.1600-0501.2009.01754.x. Epub 2009 Sep 30.
The purpose of this study was to systematically review the literature on the survival rates of palatal implants, Onplants((R)), miniplates and mini screws.
An electronic MEDLINE search supplemented by manual searching was conducted to identify randomized clinical trials, prospective and retrospective cohort studies on palatal implants, Onplants((R)), miniplates and miniscrews with a mean follow-up time of at least 12 weeks and of at least 10 units per modality having been examined clinically at a follow-up visit. Assessment of studies and data abstraction was performed independently by two reviewers. Reported failures of used devices were analyzed using random-effects Poisson regression models to obtain summary estimates and 95% confidence intervals (CI) of failure and survival proportions.
The search up to January 2009 provided 390 titles and 71 abstracts with full-text analysis of 34 articles, yielding 27 studies that met the inclusion criteria. In meta-analysis, the failure rate for Onplants((R)) was 17.2% (95% CI: 5.9-35.8%), 10.5% for palatal implants (95% CI: 6.1-18.1%), 16.4% for miniscrews (95% CI: 13.4-20.1%) and 7.3% for miniplates (95% CI: 5.4-9.9%). Miniplates and palatal implants, representing torque-resisting temporary anchorage devices (TADs), when grouped together, showed a 1.92-fold (95% CI: 1.06-2.78) lower clinical failure rate than miniscrews.
Based on the available evidence in the literature, palatal implants and miniplates showed comparable survival rates of >or=90% over a period of at least 12 weeks, and yielded superior survival than miniscrews. Palatal implants and miniplates for temporary anchorage provide reliable absolute orthodontic anchorage. If the intended orthodontic treatment would require multiple miniscrew placement to provide adequate anchorage, the reliability of such systems is questionable. For patients who are undergoing extensive orthodontic treatment, force vectors may need to be varied or the roots of the teeth to be moved may need to slide past the anchors. In this context, palatal implants or miniplates should be the TADs of choice.
本研究旨在系统地回顾有关腭部种植体、Onplants((R))、微型板和微型螺钉的存活率的文献。
通过电子 MEDLINE 搜索，并辅以手动搜索，确定了随机临床试验、前瞻性和回顾性队列研究，研究对象为腭部种植体、Onplants((R))、微型板和微型螺钉，平均随访时间至少 12 周，每种治疗模式至少检查 10 个单位。由两名独立的评审员进行研究评估和数据提取。使用随机效应泊松回归模型分析报告的器械失败情况，以获得失败和存活率的汇总估计值和 95%置信区间（CI）。
截至 2009 年 1 月的检索提供了 390 个标题和 71 个摘要，对 34 篇全文进行了分析，共纳入 27 项符合纳入标准的研究。在荟萃分析中，Onplants((R))的失败率为 17.2%（95%CI：5.9-35.8%），腭部种植体为 10.5%（95%CI：6.1-18.1%），微型螺钉为 16.4%（95%CI：13.4-20.1%），微型板为 7.3%（95%CI：5.4-9.9%）。微型板和腭部种植体，代表抗扭临时锚固装置（TAD），当分组在一起时，其临床失败率比微型螺钉低 1.92 倍（95%CI：1.06-2.78）。
根据文献中的现有证据，腭部种植体和微型板在至少 12 周的时间内显示出>或=90%的存活率，并且比微型螺钉具有更高的存活率。腭部种植体和微型板作为临时锚固装置可提供可靠的绝对正畸锚固。如果预期的正畸治疗需要放置多个微型螺钉以提供足够的锚固，则此类系统的可靠性值得怀疑。对于接受广泛正畸治疗的患者，力矢量可能需要改变，或者需要移动牙齿的根部以使其滑过锚固器。在这种情况下，腭部种植体或微型板应该是首选的 TAD。
