Lacerda-Santos Rogério, Canutto Rhaíssa Ferreira, Araújo José Lucas Dos Santos, Carvalho Fabiola Galbiatti de, Münchow Eliseu Aldrighi, Barbosa Taís de Souza, Pithon Matheus Melo, Rego Emanuel Braga, Neves Leniana Santos
Department of Orthodontics and Pediatric Dentistry, Dental School, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil.
Department of Orthodontics and Pediatric Dentistry, Dental School, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
Eur J Dent. 2020 Jul;14(3):467-482. doi: 10.1055/s-0040-1708329. Epub 2020 Jun 15.
This systematic review was focused on evaluating tooth autotransplantation, considering its impacts on the teeth, bone, soft tissues, and aesthetics in orthodontic patients. A bibliographic search was conducted without limitations on year of publication or language in the databases of PubMed, Web of Science, Scopus, Medline Complete, Cochrane, Clinical Trials, and Trials Central. For triage of articles, indications, surgical planning, orthodontic movement, risk factors for treatment, and long-term follow-ups were considered. For outcomes, the results with reference to teeth, alveolar bone, periodontal tissues, and esthetic satisfaction were considered. Risk of bias was evaluated using the methodological index for nonrandomized studies-MINORS. The results showed 10 controlled clinical trials, and no randomized clinical trials were found. The selected studies included 715 patients and 934 autotransplanted teeth among which there were premolars, molars, and anterior teeth evaluated in the long term, indicating that orthodontics associated with autotransplantation indicated a result that was generally clinically acceptable. The quality of the set of evidence was considered medium due to the presence of different methodological problems, risk of bias, and significant heterogeneity in the evaluated studies. There was a sufficient body of evidence that justified autotransplantation in patients who needed orthodontic movement. In teeth, there was an increase in root resorption influenced by orthodontics, but without impacting on the general clinical result in the long term. Bone and periodontal tissue do not appear to be affected by orthodontics. The patient's aesthetic satisfaction was not considered in the studies.
本系统评价聚焦于评估牙齿自体移植,考量其对正畸患者牙齿、骨骼、软组织及美观的影响。在PubMed、Web of Science、Scopus、Medline Complete、Cochrane、Clinical Trials和Trials Central数据库中进行了文献检索,对发表年份和语言无限制。文章筛选时考虑了适应证、手术规划、正畸移动、治疗风险因素及长期随访。结果方面,考量了牙齿、牙槽骨、牙周组织及美观满意度的结果。使用非随机研究方法学指标(MINORS)评估偏倚风险。结果显示有10项对照临床试验,未发现随机临床试验。所选研究纳入715例患者和934颗自体移植牙,其中包括前磨牙、磨牙和前牙的长期评估,表明正畸联合自体移植的结果总体上在临床上是可接受的。由于评估研究中存在不同的方法学问题、偏倚风险和显著异质性,证据集质量被认为是中等。有充分的证据证明自体移植对需要正畸移动的患者是合理的。在牙齿方面,正畸会增加牙根吸收,但从长期来看不会影响总体临床结果。骨骼和牙周组织似乎不受正畸影响。研究中未考虑患者的美观满意度。