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正畸压低后牙根吸收的评估:系统评价和荟萃分析。

Evaluation of root resorption following orthodontic intrusion: a systematic review and meta-analysis.

机构信息

Department of Orthodontics, Bauru Dental School, University of São Paulo.

Department of Orthodontics, Federal University of Pará, Belém, Brazil.

出版信息

Eur J Orthod. 2021 Aug 3;43(4):432-441. doi: 10.1093/ejo/cjaa054.


DOI:10.1093/ejo/cjaa054
PMID:32968763
Abstract

BACKGROUND/OBJECTIVE: To quantify the expected amount of orthodontically induced root resorption (OIRR) after orthodontic intrusion and assess the treatment-related factors. SEARCH METHODS AND ELIGIBILITY CRITERIA: Six electronic databases and partial grey literature were searched without limitations regarding language or publication year until April 2020. Randomized clinical trials and non-randomized prospective and retrospective studies evaluating root resorption after orthodontic intrusion were included. DATA COLLECTION AND ANALYSIS: Risk of bias (RoB) assessment was performed with the Cochrane Collaboration's RoB Tool 2.0 and ROBINS-I tool for the randomized and non-randomized studies, respectively. The data were combined into two random-effects meta-analyses estimating OIRR following orthodontic intrusion. One evaluated OIRR in the anterior region, while the other assessed OIRR in the posterior region. Sub-group analyses regarding the type of mechanics applied, duration of intrusion, amount of force, and sensitivity analysis of the study design and imaging examinations were also performed. The certainty of the evidence was assessed through the Grade of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. RESULTS: The qualitative analysis included 14 studies; however, the meta-analysis was performed with 7 records. The random-effects model assumes that 0.72 mm [95% confidence interval (CI): 0.16 to 1.28] and 0.41 mm (95% CI: -0.24 to 1.07) of OIRR should be expected in the incisors and the molars, respectively. Sub-group analyses showed that the assessed treatment-related factors presented minimum impact in OIRR after orthodontic intrusion. The GRADE resulted in moderate and low certainty regarding the meta-analysis. LIMITATIONS: The major limitation of the present meta-analysis is that OIRR can be affected by several factors, some of which are assessed in this review. CONCLUSIONS: Orthodontic intrusion, evaluated as an isolated mechanic, caused less than 1 mm of OIRR, which is within the acceptable limits for clinical implication. Treatment-related factors did not show a significant influence on OIRR. REGISTRATION: This review was registered in PROSPERO, protocol number CRD42018098495.

摘要

背景/目的:定量评估正畸内收治疗后预期的正畸牙根吸收量(OIRR),并评估相关治疗因素。

检索方法和入选标准:2020 年 4 月前,我们无语言和出版年限限制地在 6 个电子数据库和部分灰色文献中进行了检索。纳入了评估正畸内收后牙根吸收的随机临床试验和非随机前瞻性及回顾性研究。

数据收集和分析:使用 Cochrane 协作的 RoB 工具 2.0 和 ROBINS-I 工具分别对随机和非随机研究进行了偏倚风险(RoB)评估。我们将数据合并为两项随机效应荟萃分析,以评估正畸内收后 OIRR。一项评估了正畸内收在前牙区的 OIRR,另一项评估了后牙区的 OIRR。我们还进行了关于应用的力学类型、内收持续时间、力的大小的亚组分析,以及对研究设计和影像学检查的敏感性分析。通过推荐评估、制定与评价(GRADE)方法评估证据的确定性。

结果:定性分析纳入了 14 项研究,但仅对 7 项研究进行了荟萃分析。随机效应模型假设,在前牙和磨牙中,预计 OIRR 分别为 0.72 mm(95%置信区间[CI]:0.16 至 1.28)和 0.41 mm(95% CI:-0.24 至 1.07)。亚组分析表明,评估的治疗相关因素对内收治疗后 OIRR 的影响最小。GRADE 表明,荟萃分析的确定性为中等和低等。

局限性:本荟萃分析的主要局限性在于,OIRR 可能受到多种因素的影响,其中一些因素在本综述中进行了评估。

结论:作为一种孤立的力学方法,正畸内收引起的 OIRR 小于 1 mm,这在临床可接受的范围内。治疗相关因素对 OIRR 没有显著影响。

注册:本综述已在 PROSPERO 注册,注册号为 CRD42018098495。

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