Fernández-Ferrer L, Montiel-Company J-M, Candel-Martí E, Almerich-Silla J-M, Peñarrocha-Diago M, Bellot-Arcís C
Department d'Estomatologia, Universitat de València, C/ Gascó Oliag 1, 46010-Valencia, Spain,
Med Oral Patol Oral Cir Bucal. 2016 Nov 1;21(6):e703-e712. doi: 10.4317/medoral.21208.
One of the main aims of orthodontists is to reduce the treatment time as much as possible, particularly in view of the rise in demand for orthodontic treatment among adult patients. The objective of this systematic review was to examine the effectiveness of corticotomy as a surgical procedure that accelerates orthodontic tooth movement, together with its possible adverse effects.
A systematic review of articles in 4 databases, Pubmed, Cochrane, Scopus and Embase, complemented by a manual search, identified 772 articles. The duplicates were eliminated and a critical reading of titles and abstracts led to the rejection of articles that did not meet the objectives of the review, leaving 69. After reading the full text of these articles, 49 were excluded because they did not meet the inclusion criteria. On applying the CONSORT criteria as a quality filter, a further 4 were eliminated due to low quality. Finally, 16 articles (4 systematic reviews and 12 controlled trials) were reviewed.
All the studies agree that corticotomy prior to orthodontic treatment accelerates dental movement, reducing the treatment time. With regard to side-effects, no periodontal damage was found, although this was only studied in the short term.
The evidence regarding the results of corticotomy is limited, given the small number of quality clinical studies available. Before this procedure is included as a routine practice in dental surgeries, studies of higher methodological quality are required, studying a greater number of individuals and examining the possible long-term adverse effects and the cost/benefit of the procedure.
正畸医生的主要目标之一是尽可能缩短治疗时间,尤其是考虑到成年患者对正畸治疗的需求不断增加。本系统评价的目的是研究皮质骨切开术作为一种加速正畸牙齿移动的外科手术的有效性及其可能的不良反应。
对4个数据库(PubMed、Cochrane、Scopus和Embase)中的文章进行系统评价,并辅以手工检索,共识别出772篇文章。剔除重复文章,对标题和摘要进行批判性阅读后,排除不符合评价目标的文章,剩余69篇。阅读这些文章的全文后,又排除49篇不符合纳入标准的文章。应用CONSORT标准作为质量过滤器,又因质量低排除4篇。最后,对16篇文章(4篇系统评价和12篇对照试验)进行了综述。
所有研究均一致认为,正畸治疗前进行皮质骨切开术可加速牙齿移动,缩短治疗时间。关于副作用,未发现牙周损伤,不过这仅在短期内进行了研究。
鉴于现有高质量临床研究数量较少,关于皮质骨切开术结果的证据有限。在将该手术纳入牙科手术的常规操作之前,需要开展方法学质量更高的研究,研究更多个体,并考察该手术可能的长期不良反应及成本效益。