Machado Vanessa, Botelho João, Mascarenhas Paulo, Mendes José João, Delgado Ana
Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, C.R.L., Monte de Caparica, Almada, Portugal.
Orthodontics Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, C.R.L., Monte de Caparica, Almada, Portugal.
J Orthod. 2020 Mar;47(1):7-29. doi: 10.1177/1465312519886322. Epub 2019 Nov 13.
The purpose of this study was to seek and summarise the Bolton overall index (OI) and anterior index (AI) regarding normal occlusion and Angle's malocclusion according to gender, and to assess if these indices support Bolton's standards as general references.
PubMed, LILACS, Embase, CENTRAL and Google Scholar databases were searched up to June 2019 (CRD42018088438). Non-randomised clinical studies, published in English and assessing Bolton's OI and/or AI in normal occlusion and Angle's malocclusion groups, were included. OI and AI means, sample size and SDs were collected. The National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the risk of bias. Pairwise random-effects and multilevel Bayesian network meta-analyses were used to synthesise available data.
Fifty-three observational studies were included (11,411 participants; 3746 men, 4430 women; 15 studies lacked gender information). For normal occlusion, pooled estimates for OI and AI means were 91.78% (95% confidence interval [CI] = 91.42-92.14; I = 92.87%) and 78.25% (95% CI = 77.87-78.62; I = 90.67%), respectively. We could identify in Angle's Class III patients meaningful OI and AI mean deviations from normal occlusion (0.76, 95% credible interval [CrI] = 0.55-0.98 and 0.61, 95% CrI = 0.35-0.87, respectively), while in Class II patients we found a meaningful mean deviation from normal occlusion only for OI (-0.28, 95% CrI = -0.52--0.05). Concerning gender impact, male patients presented higher OI (0.30, 95% CI = 0.00-0.59) and AI (0.41, 95% CI = 0.00-0.83) mean values than female patients in Class I.
Normal occlusion OI and AI mean values differ from Bolton's original values. Class II division 2, for OI mean values, and Class III, for both OI and AI, are proportionally larger than normal occlusion patients. Gender had almost no impact on teeth mesiodistal proportion.
本研究的目的是根据性别寻找并总结正常咬合和安氏错牙合的博尔顿总指数（OI）和前牙指数（AI），并评估这些指数是否支持将博尔顿标准作为一般参考。
检索了截至2019年6月的PubMed、LILACS、Embase、CENTRAL和谷歌学术数据库（CRD42018088438）。纳入以英文发表的、评估正常咬合组和安氏错牙合组的博尔顿OI和/或AI的非随机临床研究。收集了OI和AI的均值、样本量和标准差。使用美国国立心肺血液研究所的观察性队列和横断面研究质量评估工具来评估偏倚风险。采用成对随机效应和多水平贝叶斯网络荟萃分析来综合现有数据。
纳入了53项观察性研究（11411名参与者；3746名男性，4430名女性；15项研究缺乏性别信息）。对于正常咬合，OI和AI均值的合并估计分别为91.78%（95%置信区间[CI]=91.42 - 92.14；I² = 92.87%）和78.25%（95%CI = 77.87 - 78.62；I² = 90.67%）。我们可以确定，在安氏III类患者中，OI和AI均值与正常咬合有有意义的偏差（分别为0.76，95%可信区间[CrI]=0.55 - 0.98和0.61，95%CrI = 0.35 - 0.87），而在II类患者中，仅发现OI与正常咬合有有意义的均值偏差（-0.28，95%CrI = -0.52 - -0.05）。关于性别影响，在I类患者中，男性患者的OI（0.30，95%CI = 0.00 - 0.59）和AI（0.41，95%CI = 0.00 - 0.83）均值高于女性患者。
正常咬合的OI和AI均值与博尔顿的原始值不同。对于OI均值，II类2分类，以及对于OI和AI两者，III类与正常咬合患者相比成比例地更大。性别对牙齿近远中比例几乎没有影响。
