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低强度激光疗法在加速正畸牙齿移动中的有效性:一项荟萃分析。

The effectiveness of low-level laser therapy in accelerating orthodontic tooth movement: a meta-analysis.

作者信息

Long Hu, Zhou Yang, Xue Junjie, Liao Lina, Ye Niansong, Jian Fan, Wang Yan, Lai Wenli

机构信息

Department of Orthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min South Road, Chengdu, 610041, Sichuan, China.

出版信息

Lasers Med Sci. 2015 Apr;30(3):1161-70. doi: 10.1007/s10103-013-1507-y. Epub 2013 Dec 11.

Abstract

Low-level laser therapy is claimed to accelerate bone remodeling. The aim of this meta-analysis was to critically appraise current evidence and to determine the effectiveness of low-level laser therapy in accelerating orthodontic tooth movement. PubMed, Web of Knowledge, Embase, CENTRAL, ProQuest Dissertations &Theses, and SIGLE were electronically searched from Jan 1990 to Jun 2013. Article screening, data extraction, assessment of risk of bias and evaluation of evidence quality through GRADE were conducted independently and in duplicate by two reviewer authors. Outcome of interest in this meta-analysis was accumulative moved distance (AMD). Meta-analyses were performed in Comprehensive Meta-Analysis Version 2.2.064 (Biostat, Englewood, NJ, USA). Finally, five studies were included in this meta-analysis. The meta-analysis revealed that the pooled difference in mean (DM) was 0.33 [95 % CI: (0.03-0.64)], 0.76 [95 % CI: (-0.14, 1.65)] and 0.43 [95 % CI: (-0.05, 0.91)] for AMD within 1 month, AMD within 2 months and AMD within 3 months, respectively. However, significant heterogeneities and instability of the pooled results were detected. Moreover, publication bias was found for AMD within 3 months. The subgroup analysis on the wavelength of 780 nm revealed that the pooled DM of AMD were 0.54 (95 % CI = 0.18-0.91), 1.11 (95 % CI = 0.91-1.31) and 1.25 (95 % CI = 0.68-1.82) for 1, 2, and 3 months, respectively. For the output power of 20 mW, the subgroup analysis showed that the pooled DM of AMD was 0.45 (95 % CI = 0.26-0.64), 1.11 (95 % CI = 0.91-1.31), and 1.25 (95 % CI = 0.68-1.82) for 1, 2, and 3 months, respectively. Weak evidence suggests that low-level laser irradiations at the wavelength of 780 nm, at the fluence of 5 J/cm(2) and/or the output power of 20 mW could accelerate orthodontic tooth movement within 2 months and 3 months. However, we cannot determine its effectiveness within 1 month due to potential measurement errors.

摘要

低强度激光疗法据称可加速骨重塑。本荟萃分析的目的是严格评估现有证据,并确定低强度激光疗法在加速正畸牙齿移动方面的有效性。对1990年1月至2013年6月期间的PubMed、Web of Knowledge、Embase、CENTRAL、ProQuest Dissertations & Theses和SIGLE进行了电子检索。两名综述作者独立且重复地进行文章筛选、数据提取、偏倚风险评估以及通过GRADE对证据质量进行评估。本荟萃分析感兴趣的结果是累计移动距离(AMD)。在Comprehensive Meta-Analysis Version 2.2.064(美国新泽西州恩格尔伍德的Biostat公司)中进行荟萃分析。最后,本荟萃分析纳入了五项研究。荟萃分析显示,1个月内、2个月内和3个月内AMD的合并平均差异(DM)分别为0.33 [95%置信区间:(0.03 - 0.64)]、0.76 [95%置信区间:(-0.14, 1.65)]和0.43 [95%置信区间:(-0.05, 0.91)]。然而,检测到合并结果存在显著异质性和不稳定性。此外,发现3个月内AMD存在发表偏倚。对780 nm波长的亚组分析显示,1个月、2个月和3个月时AMD的合并DM分别为0.54(95%置信区间 = 0.18 - 0.91)、1.11(95%置信区间 = 0.91 - 1.31)和1.25(95%置信区间 = 0.68 - 1.82)。对于20 mW的输出功率,亚组分析表明,1个月、2个月和3个月时AMD的合并DM分别为0.45(95%置信区间 = 0.26 - 0.64)、1.11(95%置信区间 = 0.91 - 1.31)和1.25(95%置信区间 = 0.68 - 1.82)。证据薄弱表明,波长为780 nm、能量密度为5 J/cm²和/或输出功率为20 mW的低强度激光照射可在2个月和3个月内加速正畸牙齿移动。然而,由于潜在的测量误差,我们无法确定其在1个月内的有效性。

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