Reynders Reint Meursinge, Cacciatore Giorgio
Private practice, Milan, Italy, and Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, The Netherlands.
Private practice, Milan, Italy, and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy, and reading for a MSc in evidence-based health care at the Centre for Evidence-Based Medicine, University of Oxford, United Kingdom.
Evid Based Dent. 2016 Dec;17(4):111-113. doi: 10.1038/sj.ebd.6401203.
Data sourcesMedline, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, China National Knowledge Infrastructure (CNKI) and SIGLE.Study selectionRandomised controlled trials(RCTs), clinical controlled trials (CCTs) and cohort studies that assessed the success/failure rates of self-drilling and self-tapping mini-screws for orthodontic anchorage were considered.Data extraction and synthesisData was abstracted and assessed for quality by two reviewers independently. The Newcastle-Ottawa scale (NOS) was used to evaluate the methodological quality. Meta-analyses with subgroup analysis of different study designs, follow-up periods, participant age and immediate loading or delayed loading were conducted.ResultsThree CCTs and three cohort studies were included. These were assessed to be of high quality. Meta-analysis (six studies) showed no difference in success rates between the two types of screws; odds ratio (OR) = 0.90 (95%CI; 0.52-1.53). Meta-analysis (two studies) found no difference in the rate of root contact between the two systems; OR = 0.96 (95% CI; 0.53-1.71).ConclusionsCurrently available clinical evidence suggests that the success rates of self-tapping and self-drilling miniscrews are similar. Determination of the position and direction of placement should be more precise when self-drilling miniscrews are used in sites with narrow root proximity.
数据来源
医学文献数据库（Medline）、Cochrane系统评价数据库（CENTRAL）、荷兰医学文摘数据库（Embase）、中国知网（CNKI）和灰色文献数据库（SIGLE）。
研究选择
纳入评估自攻自钻式微型螺钉用于正畸支抗成功率/失败率的随机对照试验（RCT）、临床对照试验（CCT）和队列研究。
数据提取与综合分析
由两名评价者独立提取数据并评估质量。采用纽卡斯尔-渥太华量表（NOS）评估方法学质量。对不同研究设计、随访时间、参与者年龄以及即刻加载或延迟加载进行亚组分析的Meta分析。
结果
纳入三项CCT和三项队列研究。这些研究被评估为高质量。Meta分析（六项研究）显示两种类型螺钉的成功率无差异；优势比（OR）=0.90（95%置信区间[CI]：0.52 - 1.53）。Meta分析（两项研究）发现两种系统的牙根接触率无差异；OR = 0.96（95% CI：0.53 - 1.71）。
结论
现有临床证据表明自攻式和自钻式微型螺钉的成功率相似。在牙根间距狭窄的部位使用自钻式微型螺钉时，其植入位置和方向的确定应更加精确。
