Department of Prosthodontics, Dental School Ruprecht-Karls-University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
J Dent. 2011 Feb;39(2):108-16. doi: 10.1016/j.jdent.2010.11.002. Epub 2010 Nov 17.
It is unclear whether or not untreated bounded edentulous spaces (BES) can cause patients problems because of migration of unopposed and adjacent teeth.
To quantitatively assess BES-related occlusal changes and the level of evidence available.
A systematic search of the literature was conducted in triplicate in the PubMed and Cochrane Register of Controlled Trials (CENTRAL) databases up to and including February 2010 to assess studies related to the topic. The LILACS database also was searched by one of the authors (CMF). Quantitative mesio-distal changes and overeruption were the outcome measures. Manual searching of the reference lists of studies retrieved from the electronic databases was also conducted. Google Scholar in English, French, German, Greek, Italian, Portuguese, and Spanish was also searched to retrieve potential studies. Grey literature was searched in OpenSIGLE (System for Information on Grey Literature in Europe) for more potential papers. The quality of the retrieved literature and the strength of recommendations were assessed by use of the GRADE system. A decision-tree-like scheme was produced to depict treatment options.
The available evidence demonstrated that for most cases occlusal changes in BES after tooth loss might be limited (on average up to 2mm). The quality of evidence was regarded as very low, however.
Tooth replacement should not necessarily be regarded as the mainstay of therapy for posterior BES, although more robust studies are necessary to clarify the long-term effects of non-treatment. The GRADE approach may be useful for enhancing the transparency of the decision-making process in dentistry, especially when evidence of only limited quality is available.
由于未受治疗的无牙颌间隙（BES）中无牙颌牙齿的移动，是否会导致患者出现问题仍不清楚。
定量评估 BES 相关的咬合变化和现有证据的水平。
在 PubMed 和 Cochrane 对照试验注册中心（CENTRAL）数据库中进行了三次系统搜索，以评估与该主题相关的研究，截止日期为 2010 年 2 月。其中一位作者（CMF）还在 LILACS 数据库中进行了搜索。测量指标为近远中向变化和过度萌出。还对从电子数据库中检索到的研究的参考文献列表进行了手动搜索。还在 Google Scholar 中用英语、法语、德语、希腊语、意大利语、葡萄牙语和西班牙语进行了搜索，以检索潜在的研究。在 OpenSIGLE（欧洲灰色文献信息系统）中也检索了灰色文献，以获取更多潜在的论文。使用 GRADE 系统评估检索文献的质量和建议的强度。生成了一个决策树状图来描述治疗方案。
现有证据表明，大多数情况下，缺牙后 BES 的咬合变化可能有限（平均最多 2mm）。然而，证据质量被认为非常低。
对于后牙 BES，牙齿置换不一定被视为治疗的主要方法，尽管需要更有力的研究来阐明非治疗的长期效果。GRADE 方法可能有助于提高牙科决策过程的透明度，尤其是在只有有限质量证据可用的情况下。
