Alfawal Alaa M H, Hajeer Mohammad Y, Ajaj Mowaffak A, Hamadah Omar, Brad Bassel
Orthodontics Department, University of Damascus Dental School, Damascus, Syria.
Oral Medicine Department, University of Damascus Dental School, Damascus, Syria.
Prog Orthod. 2016 Dec;17(1):33. doi: 10.1186/s40510-016-0146-9. Epub 2016 Oct 24.
The objective of this study was to assess systematically the available scientific evidence relating the efficiency of minimally invasive surgical procedures in accelerating orthodontic tooth movement and the adverse effects associated with these procedures.
Electronic search of these databases CENTRAL, EMBASE, Scopus, PubMed, Web of Science, Google Scholar Beta, Trip, OpenGrey and PQDT OPEN was performed (last updated January 2016). The reference lists of the included studies were hand searched. Unpublished literature and ongoing studies were also checked electronically through ClinicalTrials.gov and (ICTRP). Randomized controlled trials (RCTs) with patients who received minimally invasive surgical procedures combined with fixed orthodontic appliances compared with conventional treatment were included. Cochrane's risk of bias tool was used to assess risk of bias.
Four RCTs (61 patients) and nine ongoing protocols were included in this review. Only three RCTs were suitable for quantitative synthesis. Higher tooth movement rate was found with the minimally invasive surgical procedures by a weighted mean difference of 0.65 mm for 1 month of canine retraction (WMD = 0.65: 95 % CI (0.54, 0.76), p < 0.001) and by a weighted mean difference 1.41 mm for 2 months (WMD = 1.41: 95 % CI (0.81, 2.01), p < 0.001). No adverse effects associated with these procedures were reported.
There is limited available evidence about the effectiveness of minimally invasive surgically accelerated orthodontics (MISAO). Although the current review indicated that MISAO can help in accelerating canine retraction, further research in this domain should be performed before it can be recommended in everyday clinical practice.
本研究的目的是系统评估有关微创手术在加速正畸牙齿移动方面的效率以及与这些手术相关的不良反应的现有科学证据。
对CENTRAL、EMBASE、Scopus、PubMed、Web of Science、Google Scholar Beta、Trip、OpenGrey和PQDT OPEN等数据库进行电子检索（最后更新于2016年1月）。对纳入研究的参考文献列表进行手工检索。还通过ClinicalTrials.gov和（ICTRP）对未发表的文献和正在进行的研究进行电子检索。纳入接受微创手术联合固定正畸矫治器的患者与传统治疗进行比较的随机对照试验（RCT）。使用Cochrane偏倚风险工具评估偏倚风险。
本综述纳入了4项RCT（61例患者）和9项正在进行的方案。只有3项RCT适合进行定量综合分析。发现微创手术的牙齿移动速度更高，犬牙后缩1个月时加权平均差为0.65毫米（加权平均差=0.65：95%可信区间（0.54，0.76），p<0.001），2个月时加权平均差为1.41毫米（加权平均差=1.41：95%可信区间（0.81，2.01），p<0.001）。未报告与这些手术相关的不良反应。
关于微创外科加速正畸（MISAO）有效性的现有证据有限。尽管目前的综述表明MISAO有助于加速犬牙后缩，但在日常临床实践中推荐之前，该领域应进行进一步研究。
