School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy.
Descartes-Sorbonne Paris University, Paris, France; APHP, Department of Maxillofacial and Plastic Surgery, Necker-Enfants Malades Hospital, Paris, France.
J Stomatol Oral Maxillofac Surg. 2021 Apr;122(2):162-172. doi: 10.1016/j.jormas.2020.08.008. Epub 2020 Sep 5.
Surgery-first approach (SFA) has been introduced as an alternative for conventional orthognathic approach (COA) in the treatment of patients with dentoskeletal deformities. This review aimed to evaluate skeletal stability, treatment time, surgical complications, and quality of life in SFA and COA. Six databases were accessed up to May 2020 to obtain all systematic reviews (SRs). After title and abstract reading, data extraction was performed from eligible SRs. The methodological quality was calculated for the included SRs using the last version of A Measurement Tool to Assess Systematic Review (AMSTAR-2). Ten SRs were included in this review. A good stability of the jaws was assessed both with SFA and COA by most of low- or critically low-quality SRs. Less treatment time was reported for SFA than COA with a moderate quality level. Slightly higher complications rate was recorded with SFA than COA by SRs with low or moderate quality. A better quality of life with SFA than COA was reported by moderate- or low-quality SRs. SFA may represent a reasonable alternative to COA. However, for the heterogeneity of the included SRs, well-designed studies with a long term follow-up are needed to clarify the findings of this analysis.
手术优先法（SFA）已被引入作为治疗牙颌面畸形患者的传统正颌方法（COA）的替代方法。本综述旨在评估 SFA 和 COA 中的骨骼稳定性、治疗时间、手术并发症和生活质量。截至 2020 年 5 月，我们访问了六个数据库以获取所有系统评价（SRs）。在阅读标题和摘要后，从合格的 SR 中提取数据。使用最新版本的评估系统评价的测量工具（AMSTAR-2）对纳入的 SR 进行了方法学质量计算。本综述纳入了 10 项 SR。大多数低质量或极低级别的 SR 评估 SFA 和 COA 后，颌骨具有良好的稳定性。SFA 报告的治疗时间比 COA 短，具有中等质量水平。SRs 记录的 SFA 并发症发生率略高于 COA，质量水平较低或中等。SRs 报告 SFA 的生活质量优于 COA，质量水平为中等或低。SFA 可能是 COA 的合理替代方法。然而，鉴于纳入的 SR 存在异质性，需要进行设计良好且具有长期随访的研究来阐明本分析的结果。
