Department of Oral and Maxillofacial surgery, Erasmus University Medical Centre Rotterdam, 's Gravendijkwal 230, Rotterdam, The Netherlands.
J Craniomaxillofac Surg. 2012 Apr;40(3):248-60. doi: 10.1016/j.jcms.2011.04.016. Epub 2011 Jun 29.
A systematic review of mandibular midline distraction (MMD) was carried out to assess effectiveness, treatment related difficulties, complications and biomechanical effects of this treatment modality objectively.
MATERIAL & METHODS: Randomized controlled trials (RCT), controlled clinical trials (CCT) and case series concerning MMD with a sample size of >5 were searched electronically in Pubmed/Medline, Embase, Cochrane and CENTRAL up to September 6th 2010.
85 unique articles were found of which 22 met our inclusion criteria. The study designs of the articles found were prospective (9), retrospective (9) or uncertain (2). One clinical trial and no randomized clinical trials were found. The methodological quality was considered low in most articles.
Generally MMD is a safe and effective treatment modality to treat transverse mandibular discrepancies, however controversies still exist: choice of distractor, surgical setting, distraction rate, start of orthodontic treatment and relapse. In addition, little is known about patient experience and quality of life after treatment. Further prospective trials are necessary to address these controversies and questions.
为了客观评估下颌正中牵引（MMD）的疗效、治疗相关困难、并发症和生物力学影响，我们对其进行了系统评价。
我们在 2010 年 9 月 6 日之前，在 Pubmed/Medline、Embase、Cochrane 和 CENTRAL 中，以电子方式搜索了关于 MMD 的随机对照试验（RCT）、对照临床试验（CCT）和样本量>5 的病例系列研究。
共发现 85 篇独特的文章，其中 22 篇符合我们的纳入标准。所发现的文章的研究设计为前瞻性（9 篇）、回顾性（9 篇）或不确定（2 篇）。只发现了 1 项临床试验，没有随机临床试验。大多数文章的方法学质量被认为较低。
一般来说，MMD 是治疗横向下颌骨差异的一种安全有效的治疗方法，但仍存在争议：牵引器的选择、手术环境、牵引速度、正畸治疗的开始时间和复发。此外，人们对治疗后的患者体验和生活质量知之甚少。需要进一步的前瞻性试验来解决这些争议和问题。
