Angle Orthod. 2019 Jul;89(4):651-660. doi: 10.2319/060218-419.1. Epub 2019 Feb 11.
To identify the scientific evidence that demonstrates which of the transverse maxillary treatments has the least effect on periodontal tissues.
PubMed (MEDLINE), Cochrane Library, Scopus, Web of Science, Virtual Health Library, Google Scholar, and OpenGrey were searched without restrictions. A hand search was also carried out in the reference lists of the articles selected. The related articles tool in the PubMed database was checked for each article included. Risk of bias assessment was performed using Cochrane Collaboration's Risk of Bias tool for randomized clinical trials and the ROBINS-I tool for nonrandomized studies of interventions. The GRADE tool was used to assess the quality of the evidence.
After examination of the full texts, three studies were finally included. Two studies used a Haas expander with different protocols, and one study used a Haas expander compared with a quad-helix appliance. These studies evaluated periodontal parameters and periodontal indices by clinical examination with a millimeter probe, and one study examined computed tomography images. After quality assessment, two studies were considered as having a "low" risk of bias. One study was scored as having a moderate risk of bias. The evidence was graded as moderate quality for alveolar bone level, tooth displacement, and inclination and very low for all other outcomes.
There were no significant differences to enable a sound conclusion about which type of maxillary expansion has the least periodontal side effects.
确定哪些上颌横向扩弓治疗对牙周组织的影响最小的科学证据。
无限制地检索了 PubMed(MEDLINE)、Cochrane 图书馆、Scopus、Web of Science、Virtual Health Library、Google Scholar 和 OpenGrey。还对所选文章的参考文献进行了手工搜索。检查了纳入的每篇文章的 PubMed 数据库中的相关文章工具。使用 Cochrane 协作对随机临床试验进行风险偏倚评估工具和 ROBINS-I 工具对干预措施的非随机研究进行风险偏倚评估。使用 GRADE 工具评估证据质量。
在检查全文后,最终纳入了三项研究。两项研究使用了不同方案的 Haas 扩张器,一项研究使用了 Haas 扩张器与四螺旋器械进行比较。这些研究通过毫米探针的临床检查评估了牙周参数和牙周指数,一项研究检查了计算机断层扫描图像。经过质量评估,两项研究被认为具有“低”风险偏倚。一项研究的风险偏倚被评为中度。牙槽骨水平、牙齿移位、倾斜的证据被评为中质量,而所有其他结果的证据质量均为极低。
没有足够的证据支持哪种上颌扩张方式对牙周副作用最小的结论。