Department of Orthodontics, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun South Avenue, Haidian District, Beijing, China.
Clin Oral Investig. 2018 Sep;22(7):2639-2652. doi: 10.1007/s00784-018-2363-8. Epub 2018 Feb 10.
The objective of this study was to evaluate the stability of treatment effects of maxillary protraction therapy in Class III children.
Multiple electronic databases were searched from 01/1996 to 10/2016. Randomized clinical trials, controlled clinical trials, and cohort studies with untreated Class III controls and a follow-up over 2 years were considered for inclusion. The methodological quality of the studies and publication bias were evaluated. Mean differences and 95% confidence intervals (CI) of six variables (SNA, SNB, ANB, mandibular plane angle, overjet, and lower incisor angle) were calculated.
Ten studies were included in the qualitative analysis, and four studies were included in the quantitative analysis. Compared with the control group, after treatment, the treated group showed significant changes: SNA +1.79° (95% CI: 1.23, 2.34), SNB -1.16° (95% CI -2.08, -0.24), ANB +2.92° (95% CI 2.40, 3.44), mandibular plane angle +1.41° (95% CI 0.63, 2.20), overjet +3.94 mm (95% CI 2.17, 5.71) and lower incisor angle -3.07° (95% CI -4.92, -1.22). During follow-up, the changes in five variables reflected significant relapse. Overall, the treated group showed significant changes only in ANB +1.66° (95% CI 0.97, 2.35) and overjet +2.41 mm (95% CI 1.60, 3.23).
Maxillary protraction can be a short-term effective therapy and might improve sagittal skeletal and dental relationships in the medium term. But some skeletal and dental variables showed significant relapse during the follow-up period. Long-term studies are still required to further evaluate its skeletal benefits.
The study evaluated the medium-term stability of skeletal and dental effects of maxillary protraction in Class III children and discussed whether the therapy can reduce the need for orthognathic surgery.
本研究旨在评估上颌骨牵引治疗 III 类错颌儿童的疗效稳定性。
检索了 1996 年 1 月至 2016 年 10 月的多个电子数据库。纳入了随机临床试验、对照临床试验和队列研究，这些研究均设未治疗的 III 类错颌对照组，并随访 2 年以上。评估了研究的方法学质量和发表偏倚。计算了 6 个变量（SNA、SNB、ANB、下颌平面角、覆合、和下切牙角度）的均值差值和 95%置信区间（CI）。
10 项研究纳入了定性分析，4 项研究纳入了定量分析。与对照组相比，治疗后治疗组显示出显著变化：SNA +1.79°（95%CI：1.23，2.34），SNB -1.16°（95%CI：-2.08，-0.24），ANB +2.92°（95%CI：2.40，3.44），下颌平面角 +1.41°（95%CI：0.63，2.20），覆合 +3.94mm（95%CI：2.17，5.71）和下切牙角度 -3.07°（95%CI：-4.92，-1.22）。随访期间，五个变量的变化反映了明显的复发。总的来说，治疗组仅在 ANB +1.66°（95%CI：0.97，2.35）和覆合 +2.41mm（95%CI：1.60，3.23）方面表现出显著变化。
上颌骨牵引可作为一种短期有效的治疗方法，并可能在中期改善矢状骨骼和牙齿关系。但在随访期间，一些骨骼和牙齿变量显示出明显的复发。仍需要进行长期研究以进一步评估其骨骼获益。
本研究评估了 III 类错颌儿童上颌骨牵引的骨骼和牙齿疗效的中期稳定性，并讨论了该治疗方法是否可以减少正颌手术的需求。
