Rodríguez de Guzmán-Barrera Jorge, Sáez Martínez Carla, Boronat-Catalá Montserrat, Montiel-Company Jose María, Paredes-Gallardo Vanessa, Gandía-Franco José Luís, Almerich-Silla José Manuel, Bellot-Arcís Carlos
Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
Preventive Dentistry Teaching Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
PLoS One. 2017 Mar 22;12(3):e0173875. doi: 10.1371/journal.pone.0173875. eCollection 2017.
Recently, new strategies for treating class III malocclusions have appeared. Skeletal anchorage appears to reduce the dentoalveolar effects while maximising the orthopaedic effect in growing patients. The purpose of this systematic review and meta-analysis is to examine the effectiveness of bone anchorage devices for interceptive treatment of skeletal class III malocclusions. Searches were made in the Pubmed, Embase, Scopus and Cochrane databases, as well as in a grey literature database, and were complemented by hand-searching. The criteria for eligibility were: patients who had undergone orthodontic treatment with skeletal anchorage (miniplates and miniscrews). Patients with syndromes or craniofacial deformities or who had undergone maxillofacial surgery were excluded. The following variables were recorded for each article: author, year of publication, type of study, sample size, dropouts, demographic variables, treatment carried out, radiographic study (2D or 3D), follow-up time, and quality of the articles on the Newcastle-Ottawa Scale. The means and confidence intervals of the following variables were employed: Wits, overjet, ANB, SNA and SNB. Initially, 239 articles were identified. After removing the duplicates and applying the selection criteria, 9 were included in the qualitative synthesis and 7 in the quantitative synthesis (meta-analysis). It may be concluded that skeletal anchorage is an effective treatment for improving skeletal Class III malocclusion, but when compared with other traditional treatments such as disjunction and face mask, there is no clear evidence that skeletal anchorage improves the results.
最近，治疗III类错牙合畸形的新策略已经出现。骨锚固似乎可以减少牙牙槽效应，同时在生长发育期患者中最大限度地发挥矫形效果。本系统评价和荟萃分析的目的是研究骨锚固装置对骨骼III类错牙合畸形进行阻断性治疗的有效性。我们在PubMed、Embase、Scopus和Cochrane数据库以及灰色文献数据库中进行了检索，并辅以手工检索。纳入标准为：接受过骨锚固（微型钛板和微型螺钉）正畸治疗的患者。患有综合征或颅面畸形或接受过颌面外科手术的患者被排除。为每篇文章记录以下变量：作者、发表年份、研究类型、样本量、失访情况、人口统计学变量、实施的治疗、影像学研究（二维或三维）、随访时间以及文章在纽卡斯尔-渥太华量表上的质量。采用以下变量的均值和置信区间：Wits值、覆盖、ANB角、SNA角和SNB角。最初，共识别出239篇文章。在去除重复项并应用选择标准后，9篇文章纳入定性分析，7篇纳入定量分析（荟萃分析）。可以得出结论，骨锚固是改善骨骼III类错牙合畸形的有效治疗方法，但与其他传统治疗方法如分离术和面罩相比，没有明确证据表明骨锚固能改善治疗效果。
