Lo Giudice Antonino, Galletti Cosimo, Gay-Escoda Cosme, Leonardi Rosalia
Department of Medical-Surgical Specialties - Section of Orthodontics, School of Dentistry, University of Catania, Azienda Ospedaliero - Universitaria "PoliclinicoVittorio Emanuele", Via S. Sofia, 78 - 95123 Catania, Italy.
Department of Biomedical and Dental Sciences and Morphofunctional Imaging - Section of Orthodontics, School of Dentistry, University of Messina, Policlinico Universitario "G. Martino", Via Consolare Valeria - 98123 Messina, Italy.
J Clin Exp Dent. 2018 May 1;10(5):e484-e494. doi: 10.4317/jced.54745. eCollection 2018 May.
The present systematic review analyzed the current literature to investigate whether rapid maxillary expansion (RME) causes radicular resorption, assessed by cone-beam computed tomography (CBCT).
Eighteen electronic databases and reference lists of studies were searched up to November 2017. Grey literature was also screened. To be included, articles must be human studies on growing subjects with transversal maxillary deficiency treated with maxillary expansion protocol and with 3-D radiographic assessment of radicular volume by CBCT images. Two authors independently performed study selection, data extraction, and risk of bias assessment. Study characteristics (study design, sample size, age, sex, skeletal maturity, type of appliance, daily activation, teeth evaluated, CBCT settings), and study outcomes (radicular volume loss) were reported according to the PRISMA statement.
Only 3 articles were considered eligible and an individual analysis of the selected articles was undertaken. The risk of bias assessment revealed low methodological quality for all the studies included. In all the considered studies, significant radicular volume loss was observed in posterior teeth, following RME. When reported in percentage, the radicular volumetric loss was similar between anchored (first molars and first premolars) and unanchored teeth (second premolars).
A preliminary evaluation of the patient-related risk factors for RR is warmly advisable when administering RME. RME, maxillary expansion, root resorption, external root resorption.
本系统评价分析了当前文献,以调查快速上颌扩弓(RME)是否会导致牙根吸收,通过锥形束计算机断层扫描(CBCT)进行评估。
检索了截至2017年11月的18个电子数据库和研究的参考文献列表。还筛选了灰色文献。纳入的文章必须是关于生长发育期横向上颌骨发育不足患者的人体研究,采用上颌扩弓方案治疗,并通过CBCT图像对牙根体积进行三维影像学评估。两位作者独立进行研究选择、数据提取和偏倚风险评估。根据PRISMA声明报告研究特征(研究设计、样本量、年龄、性别、骨骼成熟度、矫治器类型、每日加力、评估的牙齿、CBCT设置)和研究结果(牙根体积损失)。
仅3篇文章被认为符合要求,并对所选文章进行了个体分析。偏倚风险评估显示,所有纳入研究的方法学质量较低。在所有纳入研究中,RME后后牙均观察到明显的牙根体积损失。以百分比报告时,锚固牙(第一磨牙和第一前磨牙)和非锚固牙(第二前磨牙)的牙根体积损失相似。
在进行RME时,强烈建议对与牙根吸收相关的患者风险因素进行初步评估。RME、上颌扩弓、牙根吸收、牙根外部吸收。