Department of Orthodontics, School of Dentistry, Medical University of Vienna, Vienna, Austria.
Am J Orthod Dentofacial Orthop. 2010 Jan;137(1):108-13. doi: 10.1016/j.ajodo.2008.01.027.
A systematic review of effects related to patient, screw, surgery, and loading on the stability of miniscrews was conducted.
Reports of clinical trials published before September 2007 with at least 30 miniscrews were reviewed. Parameters examined were patient sex and age, location and method of screw placement, screw length and diameter, time, and amount of loading.
Fourteen clinical trials included 452 patients and 1519 screws. The mean overall success rate was 83.8% + or - 7.4%. Patient sex showed no significant differences. In terms of age, 1 of 5 studies with patients over 30 years of age showed a significant difference (P <0.05). Screw diameters of 1 to 1.1 mm yielded significantly lower success rates than those of 1.5 to 2.3 mm. One study reported significantly lower success rates for 6-mm vs 8-mm long miniscrews (72% vs 90%). Screw placement with or without a surgical flap showed contradictory results between studies. Three studies showed significantly higher success rates for maxillary than for mandibular screws. Loading and healing period were not significant in the miniscrews' success rates.
All 14 articles described success rates sufficient for orthodontic treatment. Placement protocols varied markedly. Screws under 8 mm in length and 1.2 mm in diameter should be avoided. Immediate or early loading up to 200 cN was adequate and showed no significant influence on screw stability.
系统综述了与患者、螺钉、手术和加载相关的因素对微螺钉稳定性的影响。
对 2007 年 9 月前发表的至少包含 30 颗微螺钉的临床试验报告进行了回顾。检查的参数包括患者的性别和年龄、螺钉的位置和放置方法、螺钉的长度和直径、加载时间和加载量。
14 项临床试验共纳入 452 名患者和 1519 颗螺钉。总的成功率平均为 83.8%±7.4%。患者的性别没有显著差异。就年龄而言，5 项研究中有 1 项研究显示年龄超过 30 岁的患者有显著差异（P<0.05）。直径为 1 至 1.1 毫米的螺钉的成功率显著低于 1.5 至 2.3 毫米的螺钉。有一项研究报告称，6 毫米长的微螺钉与 8 毫米长的微螺钉相比，成功率显著降低（72%比 90%）。带或不带外科皮瓣的螺钉放置在不同的研究中结果相反。3 项研究表明，上颌骨的螺钉成功率明显高于下颌骨的螺钉。加载和愈合时间在微螺钉的成功率中没有显著影响。
所有 14 篇文章都描述了足以满足正畸治疗需要的成功率。放置方案差异很大。长度小于 8 毫米、直径小于 1.2 毫米的螺钉应避免使用。立即或早期加载至 200cN 是足够的，对螺钉稳定性没有显著影响。
