Sampaziotis Dimitrios, Tsolakis Ioannis A, Bitsanis Elias, Tsolakis Apostolos I
Department of Orthodontics, School of Dentistry, School of Medicine, National and Kapodistrian University of Athens, Greece.
Department of Experimental Surgery and Surgical Research, School of Medicine, National and Kapodistrian University of Athens, Greece.
Eur J Orthod. 2018 Jan 23;40(1):11-22. doi: 10.1093/ejo/cjw077.
This study aims to compare the effectiveness of two different canine exposure techniques (open and closed) regarding periodontal outcomes, duration of surgical treatment and canine's eruption, patient's inconvenience, aesthetics, and orthodontic treatment complications.
Electronic database searches of published and unpublished literature were performed. The reference lists of eligible studies were hand searched for additional studies.
Randomized clinical trials (RCTs), quasi-randomized clinical trials (Q-RCTs) and non-randomized trials of prospective and retrospective design with patients of any age that compared group with palatally impacted canines treated by open exposure to a similar group treated by closed exposure technique were selected. There was not any restriction in language or year of publication.
Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate.
Search strategy resulted in 159 articles and nine articles were selected for the final analysis. They were three non-randomized trials, one Q-RCT, and two reports of another Q-RCT and three reports of one RCT. The level of reported evidence was high for the RCT and one Q-RCT but poorer for the other trials. Four articles reported periodontal outcomes, three searched the duration of surgical procedure, two the duration of canine eruption, two investigated patient's inconvenience, two reported on failure rates and two addressed aesthetic outcomes. The results are inconsistent and there is considerable disagreement for the majority of the outcomes among studies.
According to existing articles we may conclude that there is no difference between the two techniques regarding the periodontal outcomes and aesthetic appearance. The surgical procedure is shorter in the open exposure group and the amount of postoperative pain during the first day is similar between the open and closed surgical exposure patients. However, these conclusions are based on two single trials with high level of evidence, while the rest of the studies present high risk of bias.
本研究旨在比较两种不同的犬齿暴露技术（开放和闭合）在牙周治疗效果、手术治疗持续时间、犬齿萌出情况、患者不便程度、美观度以及正畸治疗并发症方面的差异。
对已发表和未发表的文献进行电子数据库检索。对符合条件的研究的参考文献列表进行手工检索以寻找其他研究。
选取随机临床试验（RCT）、半随机临床试验（Q-RCT）以及前瞻性和回顾性设计的非随机试验，纳入任何年龄的患者，比较经开放暴露治疗的腭侧阻生犬齿组与经闭合暴露技术治疗的相似组。对语言或发表年份没有任何限制。
研究选择、数据提取和偏倚风险评估由两人分别独立进行。
检索策略共获得159篇文章，最终纳入9篇文章进行分析。其中有3篇非随机试验、1篇Q-RCT、另一篇Q-RCT的2份报告以及1篇RCT的3份报告。RCT和1篇Q-RCT的报告证据水平较高，而其他试验的证据水平较差。4篇文章报告了牙周治疗效果，3篇研究了手术持续时间，2篇研究了犬齿萌出持续时间，2篇调查了患者的不便程度，2篇报告了失败率，2篇探讨了美观效果。结果不一致，各研究在大多数结果上存在较大分歧。
根据现有文章，我们可以得出结论，两种技术在牙周治疗效果和美观方面没有差异。开放暴露组的手术时间较短，开放和闭合手术暴露患者术后第一天的疼痛程度相似。然而，这些结论基于两项证据水平较高的单一试验，而其余研究存在较高的偏倚风险。
