Reynders Reint Meursinge, Ladu Luisa
Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Private Practice of Orthodontics, Via Matteo Bandello 15, 20123 Milan, Italy.
Evid Based Dent. 2017 Oct 27;18(3):82-85. doi: 10.1038/sj.ebd.6401257.
Data sourcesPubmed, Embase, Cochrane Central Register of Controlled Trials and the Web of Science databases. Hand searches of the journals European Journal of Orthodontics, Journal of Orthodontics, Journal of Clinical Orthodontics, Seminars in Orthodontics, American Journal of Orthodontics & Dentofacial Orthopaedics and Angle Orthodontist.Study selectionTwo reviewers independently selected studies. Randomised controlled trials (RCTs) and controlled clinical trials (CCTs) of orthodontic patients requiring extraction of the maxillary first premolars and closure of the spaces without anchorage loss were considered.Data extraction and synthesisData extraction and risk of bias assessment were carried out independently by two reviewers. Meta-analysis and sensitivity analysis were conducted.ResultsFourteen studies; seven RCTS and seven CCTs were included. In total 303 patients received TISADs with 313 control patients. Overall the quality of the studies was considered to be moderate. Overall the TISAD group had significantly less anchorage loss than the control group. On average, TISADs enabled 1.86mm more anchorage preservation than did conventional methods.ConclusionsThe results of the meta-analysis showed that TISADs are more effective than conventional methods of anchorage reinforcement. The average difference of 2mm seems not only statistically but also clinically significant. However, the results should be interpreted with caution because of the moderate quality of the included studies. More high-quality studies on this issue are necessary to enable drawing more reliable conclusions.
数据来源
PubMed、Embase、Cochrane对照试验中央注册库和科学网数据库。手工检索《欧洲正畸学杂志》《正畸学杂志》《临床正畸学杂志》《正畸学研讨会》《美国正畸学与牙颌面正畸学杂志》以及《安格尔正畸医师》等期刊。
研究选择
两名评审员独立选择研究。纳入需要拔除上颌第一前磨牙且关闭间隙且无支抗丧失的正畸患者的随机对照试验(RCT)和对照临床试验(CCT)。
数据提取与综合
两名评审员独立进行数据提取和偏倚风险评估。进行荟萃分析和敏感性分析。
结果
纳入14项研究;7项RCT和7项CCT。共有303例患者接受了临时支抗装置(TISADs),313例为对照患者。总体而言,研究质量被认为中等。总体而言,TISAD组的支抗丧失明显少于对照组。平均而言,TISADs比传统方法能多保留1.86mm的支抗。
结论
荟萃分析结果表明,TISADs比传统的支抗增强方法更有效。2mm的平均差异似乎不仅在统计学上而且在临床上都具有显著意义。然而,由于纳入研究的质量中等,结果应谨慎解读。需要更多关于此问题的高质量研究以得出更可靠的结论。