Sawchuk Dena, Currie Kris, Vich Manuel Lagravere, Palomo Juan Martin, Flores-Mir Carlos
Department of Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada.
Department of Orthodontics, Case Western University, Cleveland, OH, USA.
Korean J Orthod. 2016 Sep;46(5):331-42. doi: 10.4041/kjod.2016.46.5.331. Epub 2016 Sep 19.
To evaluate the accuracy and reliability of the diagnostic tools available for assessing maxillary transverse deficiencies.
An electronic search of three databases was performed from their date of establishment to April 2015, with manual searching of reference lists of relevant articles. Articles were considered for inclusion if they reported the accuracy or reliability of a diagnostic method or evaluation technique for maxillary transverse dimensions in mixed or permanent dentitions. Risk of bias was assessed in the included articles, using the Quality Assessment of Diagnostic Accuracy Studies tool-2.
Nine articles were selected. The studies were heterogeneous, with moderate to low methodological quality, and all had a high risk of bias. Four suggested that the use of arch width prediction indices with dental cast measurements is unreliable for use in diagnosis. Frontal cephalograms derived from cone-beam computed tomography (CBCT) images were reportedly more reliable for assessing intermaxillary transverse discrepancies than posteroanterior cephalograms. Two studies proposed new three-dimensional transverse analyses with CBCT images that were reportedly reliable, but have not been validated for clinical sensitivity or specificity. No studies reported sensitivity, specificity, positive or negative predictive values or likelihood ratios, or ROC curves of the methods for the diagnosis of transverse deficiencies.
Current evidence does not enable solid conclusions to be drawn, owing to a lack of reliable high quality diagnostic studies evaluating maxillary transverse deficiencies. CBCT images are reportedly more reliable for diagnosis, but further validation is required to confirm CBCT's accuracy and diagnostic superiority.
评估可用于评估上颌横向发育不足的诊断工具的准确性和可靠性。
对三个数据库从建立之日至2015年4月进行电子检索，并手动检索相关文章的参考文献列表。如果文章报告了混合牙列或恒牙列上颌横向尺寸的诊断方法或评估技术的准确性或可靠性，则考虑将其纳入。使用诊断准确性研究质量评估工具-2对纳入的文章进行偏倚风险评估。
选择了9篇文章。这些研究具有异质性，方法学质量中等至较低，且均具有较高的偏倚风险。四项研究表明，使用牙模测量的牙弓宽度预测指数用于诊断不可靠。据报道，从锥形束计算机断层扫描（CBCT）图像得出的正位头颅侧位片在评估上颌间横向差异方面比前后位头颅侧位片更可靠。两项研究提出了用CBCT图像进行新的三维横向分析，据报道该分析可靠，但尚未针对临床敏感性或特异性进行验证。没有研究报告这些方法诊断横向发育不足的敏感性、特异性、阳性或阴性预测值或似然比，或ROC曲线。
由于缺乏评估上颌横向发育不足的可靠高质量诊断研究，目前的证据无法得出确凿结论。据报道，CBCT图像在诊断方面更可靠，但需要进一步验证以确认CBCT的准确性和诊断优势。
