Zymperdikas Vasileios F, Koretsi Vasiliki, Papageorgiou Spyridon N, Papadopoulos Moschos A
*Dental Unit, Medical Company, 71st Airmobile Brigade, Nea Santa, Greece.
**Department of Orthodontics, School of Dentistry, University Medical Centre Regensburg, Germany, Departments of.
Eur J Orthod. 2016 Apr;38(2):113-26. doi: 10.1093/ejo/cjv034. Epub 2015 May 19.
To assess the treatment effects of fixed functional appliances (FFAs) in treated versus untreated Class II patients by means of lateral cephalometric radiographs.
Unrestricted electronic search of 18 databases and additional manual searches up to October 2014.
Prospective randomized and non-randomized controlled trials reporting on cephalometric angular measurements of Class II patients treated with FFAs and their matched untreated controls.
Skeletal, dental, and soft tissue cephalometric data were annualized and stratified according to the time of evaluation in effects. Following risk of bias evaluation, the mean differences (MDs) and 95 % confidence intervals (CIs) were calculated with random-effects models. Patient- and appliance-related subgroup analyses and sensitivity analyses were performed with mixed-effects models.
Nine studies were included (244 patients; mean age: 13.5 years and 174 untreated controls; mean age: 12.8 years) reporting on cephalometric effects directly after the removal of FFAs. FFAs were found to induce a small reduction of SNA angle (MD = -0.83 degree/year, 95 % CI: -1.17 to -0.48), a small increase of SNB angle (MD = 0.87 degree/year, 95 % CI: 0.30-1.43), and moderate decrease of ANB angle (MD = -1.74 degree/year, 95 % CI: -2.50 to -0.98) compared to untreated Class II patients. FFA treatment resulted in significant dentoalveolar and soft tissue changes. Several patient- or appliance-related factors seem to affect the treatment outcome. Long-term effectiveness of FFAs could not be assessed due to limited evidence.
According to existing evidence, FFAs seem to be effective in improving Class II malocclusion in the short term, although their effects seem to be mainly dentoalveolar rather than skeletal.
通过头颅侧位片评估固定功能矫治器（FFAs）对已治疗和未治疗的Ⅱ类患者的治疗效果。
对18个数据库进行无限制电子检索，并截至2014年10月进行额外的手工检索。
前瞻性随机和非随机对照试验，报告接受FFAs治疗的Ⅱ类患者及其匹配的未治疗对照的头颅测量角度数据。
骨骼、牙齿和软组织头颅测量数据按评估时间进行年度化和分层。在进行偏倚风险评估后，采用随机效应模型计算平均差（MDs）和95%置信区间（CIs）。采用混合效应模型进行患者和矫治器相关亚组分析及敏感性分析。
纳入9项研究（244例患者；平均年龄：13.5岁，174例未治疗对照；平均年龄：12.8岁），报告了FFAs拆除后直接的头颅测量效果。与未治疗的Ⅱ类患者相比，发现FFAs可使SNA角略有减小（MD=-0.83度/年，95%CI：-1.17至-0.48），SNB角略有增加（MD=0.87度/年，95%CI：0.30 - 1.43），ANB角中度减小（MD=-1.74度/年，95%CI：-2.50至-0.98）。FFA治疗导致了显著的牙牙槽和软组织变化。一些患者或矫治器相关因素似乎会影响治疗结果。由于证据有限，无法评估FFAs的长期有效性。
根据现有证据，FFAs似乎在短期内对改善Ⅱ类错牙合有效，尽管其效果似乎主要是牙牙槽方面的而非骨骼方面的。
