Yang X, Su N, Shi Z, Xiang Z, He Y, Han X, Bai D
Department of Orthodontic, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Department of Prosthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Int J Dent Hyg. 2017 Feb;15(1):16-22. doi: 10.1111/idh.12220. Epub 2016 Apr 20.
Self-ligating brackets (SLBs) are widely adopted in clinic owing to their claimed superiorities. Here, we collected and analysed all randomized controlled clinical trials (RCTs) comparing SLBs with conventional brackets (CBs) and thereby investigated whether SLBs can relieve discomfort or promote oral hygiene.
Electronic databases including MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, World Health Organization International Clinical Trials Registry Platform, Chinese BioMedical Literature Database and the China National Knowledge Infrastructure were searched to find out RCTs comparing active or passive SLBs with CBs. Two reviewers extracted the data and assessed risks of bias independently. Any disagreement between them was resolved through discussion with a third reviewer. Meta-analysis was conducted on Review Manager 5.3.
A total of 12 RCTs with 575 participants were included, and eight of the trials were synthesized quantitatively. Two trials were assessed as low risk of bias, whereas others as unclear risk of bias. Passive SLBs and CBs are not significantly different in plaque control. SLBs and CBs are not significantly different in discomfort reduction at any of four time points (4 h, 24 h, 3 days and 7 days).
Clinical evidences from existing RCTs suggest that SLBs do not outperform CBs in reliving discomfort or promoting oral health in clinic.
自结扎托槽（SLBs）因其声称的优势而在临床上被广泛采用。在此，我们收集并分析了所有比较SLBs与传统托槽（CBs）的随机对照临床试验（RCTs），从而研究SLBs是否能减轻不适或促进口腔卫生。
检索包括MEDLINE、Cochrane对照试验中央注册库、EMBASE、世界卫生组织国际临床试验注册平台、中国生物医学文献数据库和中国知网在内的电子数据库，以找出比较主动或被动SLBs与CBs的RCTs。两名研究者独立提取数据并评估偏倚风险。他们之间的任何分歧都通过与第三位研究者讨论来解决。在Review Manager 5.3上进行荟萃分析。
共纳入12项RCTs，575名参与者，其中8项试验进行了定量合成。两项试验被评估为低偏倚风险，而其他试验为偏倚风险不明确。被动SLBs和CBs在菌斑控制方面无显著差异。SLBs和CBs在四个时间点（4小时、24小时、3天和7天）的任何一个时间点，在减轻不适方面均无显著差异。
现有RCTs的临床证据表明，在临床上SLBs在减轻不适或促进口腔健康方面并不优于CBs。
