下颌前移装置对成人阻塞性睡眠呼吸暂停患者的长期牙齿和骨骼影响：一项系统评价。
Long-term dental and skeletal effects of mandibular advancement devices in adults with obstructive sleep apnoea: A systematic review.
作者信息
Patel Sita, Rinchuse Daniel, Zullo Thomas, Wadhwa Rekha
机构信息
Seton Hill University, Department of Orthodontics and Dentofacial Orthopedics, Greensburg, PA, USA.
Seton Hill University, Department of Orthodontics and Dentofacial Orthopedics, Greensburg, PA, USA.
出版信息
Int Orthod. 2019 Mar;17(1):3-11. doi: 10.1016/j.ortho.2019.01.004. Epub 2019 Feb 13.
OBJECTIVE
This systematic review aimed to clarify whether there are any significant long-term sequelae to wearing mandibular advancement devices focusing on dental and skeletal effects in adults with OSA.
MATERIALS AND METHODS
Databases, including PubMed, Medline, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and SAGE Journals. Hand searches and grey literature were also used. A piloted data collection form was used to extract the appropriate data.
RESULTS
Twenty-three reports of 19 studies were included. Five had serious risk of bias while 18 had moderate risk of bias. Meta-analysis revealed a significant change in overbite and overjet. I-squared analysis showed a high level of statistical heterogeneity. A moderate correlation was found between wear time and amount of change.
CONCLUSION
Mandibular advancement devices will cause a small but statistically significant change in the dentition of long-term wearers. Skeletal changes are generally secondary to dental changes.
目的
本系统评价旨在阐明佩戴下颌前移装置是否会对阻塞性睡眠呼吸暂停（OSA）成年患者产生任何显著的长期后遗症，重点关注牙齿和骨骼方面的影响。
材料与方法
检索数据库，包括PubMed、Medline、Embase、科学引文索引、Cochrane对照试验中心注册库和SAGE期刊。还进行了手工检索和灰色文献检索。使用预先设计的数据收集表提取相关数据。
结果
纳入了19项研究的23篇报告。5项研究存在严重偏倚风险，18项研究存在中度偏倚风险。荟萃分析显示覆牙合和覆盖有显著变化。I²分析显示存在高度的统计异质性。发现佩戴时间与变化量之间存在中度相关性。
结论
下颌前移装置会使长期佩戴者的牙列产生微小但具有统计学意义的变化。骨骼变化通常继发于牙齿变化。
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