Forst Darren, Nijjar Simrit, Khaled Yasser, Lagravere Manuel, Flores-Mir Carlos
*Orthodontic Graduate Program, Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta.
**Private Practice.
Eur J Orthod. 2014 Oct;36(5):576-85. doi: 10.1093/ejo/cjt090. Epub 2013 Dec 19.
To evaluate in adolescents and young adults if jackscrew-based maxillary expansion therapies result in external root resorption as measured in vivo via any radiological method.
The authors conducted a systematic search of several electronic databases (MEDLINE, EMBASE, PubMed, Scopus, CINAHL, Evidence Based Medicine Reviews, LILACS) with the assistance of a senior librarian specialized in Health Sciences database searches through 25 August 2013, as well as a limited grey-literature search (Google Scholar). Human, in vivo studies of adolescents or young adults with transverse maxillary deficiency undergoing non-surgical maxillary expansion therapy through the use of a jackscrew-based maxillary expander with a radiographical assessment of root resorption were selected for full article review. Additionally, manual searches of reference lists of relevant articles were completed to identify additional publications not identified by electronic searches. The lowest levels of evidence accepted for inclusion were case-control studies or consecutively treated series of cases. Two authors independently reviewed and extracted data from selected studies.
A total of 83 original articles were identified from the electronic database and limited grey-literature searches. Once selection criteria were applied, only three articles satisfied all inclusion criteria, and individual analysis of the selected articles was undertaken.
Two-dimensional periapical radiographs do not fully reveal the amount of external root resorption associated with maxillary expansion therapy, except for frank apical root resorption. Three-dimensional cone-beam computed tomography radiography displays statistically significant root volume loss associated with maxillary expansion therapy. However, when considering volume-loss percentages, no statistical significance was found.
评估在青少年和青年中，基于扩弓螺旋器的上颌扩弓治疗是否会导致通过任何放射学方法在体内测量到的牙根外部吸收。
作者在一位专门从事健康科学数据库搜索的高级图书馆员的协助下，对几个电子数据库（MEDLINE、EMBASE、PubMed、Scopus、CINAHL、循证医学综述、LILACS）进行了系统检索，检索截至2013年8月25日，同时进行了有限的灰色文献检索（谷歌学术）。选择对患有上颌横向发育不足的青少年或青年进行非手术上颌扩弓治疗，并使用基于扩弓螺旋器的上颌扩弓器且对牙根吸收进行影像学评估的人体体内研究进行全文综述。此外，还手动检索了相关文章的参考文献列表，以识别电子检索未发现的其他出版物。纳入的最低证据水平为病例对照研究或连续治疗的病例系列。两位作者独立审查并从选定的研究中提取数据。
通过电子数据库和有限的灰色文献检索共识别出83篇原始文章。应用选择标准后，只有3篇文章满足所有纳入标准，并对选定的文章进行了单独分析。
除了明显的根尖牙根吸收外，二维根尖片不能完全显示与上颌扩弓治疗相关的牙根外部吸收量。三维锥形束计算机断层扫描显示与上颌扩弓治疗相关的牙根体积有统计学意义的减少。然而，考虑体积减少百分比时，未发现统计学意义。
