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正畸治疗中上颌和下颌前牙牙槽骨变化的系统评价和荟萃分析。

Alveolar bone changes in maxillary and mandibular anterior teeth during orthodontic treatment: A systematic review and meta-analysis.

机构信息

Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.

Department of Dental Medical Center, China-Japan Friendship Hospital, Beijing, China.

出版信息

Orthod Craniofac Res. 2021 May;24(2):165-179. doi: 10.1111/ocr.12421. Epub 2020 Sep 16.

Abstract

The association between tooth movement and remodelling of surrounding bone is controversial. To analyse the effect of tooth movement on alveolar bone changes in maxillary and mandibular anterior teeth by cone-beam computed tomography (CBCT). The Embase, Cochrane Library and Medline databases were searched without any language restrictions. Longitudinal studies using CBCT to observe alveolar bone changes of maxillary and mandibular anterior teeth during orthodontic treatment were included. Two independent reviewers performed the study selection, data extraction and methodological quality assessment. A total of 26 studies were included in this review, 14 of which were eligible for quantitative synthesis. In extraction cases, meta-analysis showed vertical bone loss on the labial (0.36 mm) and lingual (0.94 mm) sides of maxillary incisors, and lingual bone thickness decreased significantly at the cervical level (0.57 mm). In non-extraction cases, vertical alveolar bone loss was significant on the labial side (0.97 mm) and lingual side (0.86 mm) of mandibular incisors. Subgroup analysis for skeletal class III patients indicated that vertical alveolar bone loss was 1.16 mm on the labial side and 0.83 mm on the lingual side of mandibular incisors. The absence of high-quality studies and the high heterogeneity of the included studies were limitations of this systematic review and meta-analysis. Based on limited evidence, alveolar bone height and thickness, especially at the cervical level, decreased during both labial and lingual movement of anterior teeth.

摘要

牙齿移动与周围骨改建的关系存在争议。本研究旨在通过锥形束 CT(CBCT)分析牙齿移动对上颌前牙和下颌前牙牙槽骨变化的影响。检索了 Embase、Cochrane Library 和 Medline 数据库,未对语言进行任何限制。纳入了使用 CBCT 观察正畸治疗中上颌前牙和下颌前牙牙槽骨变化的纵向研究。两名独立的审查员进行了研究选择、数据提取和方法学质量评估。本综述共纳入 26 项研究,其中 14 项符合定量综合条件。在拔牙病例中,Meta 分析显示上颌切牙唇侧(0.36mm)和舌侧(0.94mm)的垂直骨丢失,以及颈段舌侧骨厚度明显减少(0.57mm)。在非拔牙病例中,下颌切牙唇侧(0.97mm)和舌侧(0.86mm)的牙槽骨垂直丢失显著。对于骨骼 III 类患者的亚组分析表明,下颌切牙唇侧的牙槽骨垂直丢失为 1.16mm,舌侧为 0.83mm。本系统评价和 Meta 分析的局限性在于缺乏高质量的研究和纳入研究的高度异质性。基于有限的证据,在前牙唇侧和舌侧移动过程中,牙槽骨高度和厚度,尤其是颈段,均有下降。

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