School of Dentistry, University of Dundee, Nethergate, Dundee, DD1 4HN, UK.
Prog Orthod. 2018 Jan 5;18(1):41. doi: 10.1186/s40510-017-0196-7.
This review aims to compare the effectiveness of en masse and two-step retraction methods during orthodontic space closure regarding anchorage preservation and anterior segment retraction and to assess their effect on the duration of treatment and root resorption.
An electronic search for potentially eligible randomized controlled trials and prospective controlled trials was performed in five electronic databases up to July 2017. The process of study selection, data extraction, and quality assessment was performed by two reviewers independently. A narrative review is presented in addition to a quantitative synthesis of the pooled results where possible. The Cochrane risk of bias tool and the Newcastle-Ottawa Scale were used for the methodological quality assessment of the included studies.
Eight studies were included in the qualitative synthesis in this review. Four studies were included in the quantitative synthesis. En masse/miniscrew combination showed a statistically significant standard mean difference regarding anchorage preservation - 2.55 mm (95% CI - 2.99 to - 2.11) and the amount of upper incisor retraction - 0.38 mm (95% CI - 0.70 to - 0.06) when compared to a two-step/conventional anchorage combination. Qualitative synthesis suggested that en masse retraction requires less time than two-step retraction with no difference in the amount of root resorption.
Both en masse and two-step retraction methods are effective during the space closure phase. The en masse/miniscrew combination is superior to the two-step/conventional anchorage combination with regard to anchorage preservation and amount of retraction. Limited evidence suggests that anchorage reinforcement with a headgear produces similar results with both retraction methods. Limited evidence also suggests that en masse retraction may require less time and that no significant differences exist in the amount of root resorption between the two methods.
本综述旨在比较整体后退和两步后退方法在正畸间隙关闭时对支抗保持和前牙段后退的效果，并评估它们对治疗时间和牙根吸收的影响。
电子检索了五个电子数据库中截至 2017 年 7 月的潜在合格的随机对照试验和前瞻性对照试验。两名评审员独立进行了研究选择、数据提取和质量评估的过程。本文呈现了叙述性综述，以及在可能的情况下对汇总结果的定量综合。纳入研究的方法学质量评估采用 Cochrane 偏倚风险工具和纽卡斯尔-渥太华量表。
8 项研究被纳入定性综述，4 项研究被纳入定量综合。整体/微型螺钉联合治疗在支抗保持方面表现出统计学上显著的标准均数差-2.55mm（95%置信区间-2.99 至-2.11）和上颌切牙后退量 0.38mm（95%置信区间-0.70 至-0.06），与两步/常规支抗联合治疗相比。定性综述表明，整体后退所需时间少于两步后退，牙根吸收量无差异。
整体后退和两步后退方法在间隙关闭阶段均有效。整体/微型螺钉联合治疗在支抗保持和后退量方面优于两步/常规支抗联合治疗。有限的证据表明，头帽支抗强化与两种后退方法产生相似的结果。有限的证据还表明，整体后退可能需要更少的时间，并且两种方法之间的牙根吸收量没有显著差异。
