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18岁之前的正畸治疗能否改善口腔健康相关生活质量?一项系统评价与Meta分析。

Does orthodontic treatment before the age of 18 years improve oral health-related quality of life? A systematic review and meta-analysis.

作者信息

Javidi Hanieh, Vettore Mario, Benson Philip E

机构信息

Academic Unit of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom.

Academic Unit of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom.

出版信息

Am J Orthod Dentofacial Orthop. 2017 Apr;151(4):644-655. doi: 10.1016/j.ajodo.2016.12.011.

Abstract

INTRODUCTION

Orthodontics aims to improve oral health-related quality of life (OHRQoL). In this systematic review, we examined the evidence for changes in OHRQoL after orthodontic treatment for patients treated before they were 18 years old.

METHODS

The participants were patients aged less than 18 years. The interventions were nonorthognathic and cleft orthodontic treatment. The comparisons were before and after orthodontic treatment, or nonorthodontic control. The outcomes were validated measures of OHRQoL. The study designs were randomized controlled trials, controlled clinical trials, prospective cohort studies, and cross-sectional or case-control studies. Multiple electronic databases were searched, with no language restrictions; authors were contacted, and reference lists screened. The Newcastle-Ottawa scale was used for quality assessments. Screening, data extraction, and quality assessments were performed by 2 investigators independently.

RESULTS

We found 1590 articles and included 13 studies (9 cohort, 3 cross sectional, and 1 case control), with 6 in the meta-analyses. All were judged of low or moderate quality. A moderate improvement in OHRQoL was observed before and after orthodontic treatment (n = 243 participants; standardized mean difference, -0.75; 95% CI, -1.15 to -0.36) particularly in the dimensions of emotional well-being (n = 213 participants; standardized mean difference, -0.61; 95% CI, -0.80 to -0.41) and social well-being (n = 213 participants; standardized mean difference, -0.62; 95% CI, -0.82 to -0.43).

CONCLUSIONS

Orthodontic treatment during childhood or adolescence leads to moderate improvements in the emotional and social well-being dimensions of OHRQoL, although the evidence is of low and moderate quality. More high quality, longitudinal, prospective studies are needed.

摘要

引言

正畸治疗旨在改善与口腔健康相关的生活质量(OHRQoL)。在本系统评价中,我们研究了18岁之前接受正畸治疗的患者正畸治疗后OHRQoL变化的证据。

方法

参与者为18岁以下的患者。干预措施为非正颌正畸治疗和唇腭裂正畸治疗。比较为正畸治疗前后,或非正畸对照。结局为经过验证的OHRQoL测量指标。研究设计为随机对照试验、对照临床试验、前瞻性队列研究以及横断面或病例对照研究。检索了多个电子数据库,无语言限制;联系了作者,并筛选了参考文献列表。采用纽卡斯尔-渥太华量表进行质量评估。筛选、数据提取和质量评估由2名研究者独立进行。

结果

我们找到了1590篇文章,纳入了13项研究(9项队列研究、3项横断面研究和1项病例对照研究),其中6项纳入荟萃分析。所有研究质量均判定为低或中等。正畸治疗前后观察到OHRQoL有中度改善(n = 243名参与者;标准化均数差,-0.75;95%CI,-1.15至-0.36),尤其是在情绪健康维度(n = 213名参与者;标准化均数差,-0.61;95%CI,-0.80至-0.41)和社会健康维度(n = 213名参与者;标准化均数差,-0.62;95%CI,-0.82至-0.43)。

结论

儿童期或青少年期的正畸治疗可使OHRQoL的情绪和社会健康维度有中度改善,尽管证据质量为低和中等。需要更多高质量的纵向前瞻性研究。

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