Department of Orthodontics, Dental School, Federal University of Pará, Belém, Brazil.
Int J Paediatr Dent. 2021 Sep;31(5):583-597. doi: 10.1111/ipd.12726. Epub 2020 Nov 3.
The beneficial effect of the extraction of primary canines in the resolution of incisor irregularity and its side effects are controversial.
To systematically review the effects of the extraction of primary canines in incisor irregularity and dental arch morphology.
Controlled non-randomized (non-RCT) and randomized clinical trials (RCT) evaluating children treated with extraction of primary canines compared with those without intervention.
A total of 984 articles were found, of which two RCTs and one non-RCT met the inclusion criteria. Both had a low RoB. A high level of evidence was observed through GRADE. A meta-analysis showed the extraction of primary canines produced a significant decrease in incisor irregularity (95% CI: -3.56, -2.09 mm). This decrease, however, was associated with a reduction of arch length (95% CI: -1.58, -0.94 mm), intermolar width (95% CI: -0.61, -0.22 mm), and overjet (95% CI: -075, -018). A mild overbite increase was found (95% CI: 0.10, 0.76 mm).
A high level of evidence showed that the extraction of primary canines improved incisor irregularity in the mixed dentition. Side effects included reduced arch length and intermolar width. A slight reduction in overjet and a mild increase in overbite were also observed. When they are not part of the treatment goal, these occlusal changes can be prevented by installing a lingual arch.
拔除乳切牙对解决切牙不齐的有益影响及其副作用存在争议。
系统评价拔除乳切牙对切牙不齐和牙弓形态的影响。
评价拔除乳切牙治疗儿童与不干预相比的效果的非随机对照（非 RCT）和随机临床试验（RCT）。
共发现 984 篇文章，其中 2 项 RCT 和 1 项非 RCT 符合纳入标准。两者的 RoB 均较低。通过 GRADE 观察到高水平的证据。荟萃分析显示，拔除乳切牙可显著降低切牙不齐（95%CI：-3.56，-2.09mm）。然而，这种减少与牙弓长度（95%CI：-1.58，-0.94mm）、磨牙间宽度（95%CI：-0.61，-0.22mm）和覆𬌗（95%CI：-0.75，-0.18mm）的减少有关。还发现轻度的深覆𬌗增加（95%CI：0.10，0.76mm）。
高水平的证据表明，拔除乳切牙可改善混合牙列的切牙不齐。副作用包括牙弓长度和磨牙间宽度的减少。覆𬌗也略有减少，深覆𬌗轻度增加。如果这些咬合变化不是治疗目标的一部分，可以通过安装舌弓来预防。
