Clinic of Orthodontics and Pediatric Dentistry Center of Dental Medicine, University of Zurich, Plattenstrasse, 11, Zurich, Switzerland.
Prog Orthod. 2020 Oct 5;21(1):37. doi: 10.1186/s40510-020-00334-4.
Adults with fixed orthodontic appliances are increasing nowadays. Compared with adolescents, adults present biological differences that might influence treatment duration. Therefore, the aim of the study was to compare duration of treatment with fixed appliances between adults and adolescents.
Eight databases were searched up to September 2019 for randomized and non-randomized clinical studies comparing treatment duration with fixed appliances in adolescents and adult patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane ROBINS-I tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE.
A total of 11 unique studies (one prospective and 10 retrospective non-randomized) with 2969 adolescents and 1380 adult patients were finally included. Meta-analysis of 7 studies found no significant difference in the duration of comprehensive treatment with fixed appliances (MD = - 0.8 month; 95% CI = - 4.2 to 2.6 months; P = 0.65; I = 92%) between adults and adolescents. Similarly, both distalization of upper first molars with skeletal anchorage for class II correction and the retraction of canines into the premolar extraction spaces lasted similarly long among adults and adolescents. On the other hand, alignment of palatally displaced canines lasted considerably longer in adults compared to adolescents (1 study; MD = 3.8 months; 95% CI = 1.4 to 6.2 months; P = 0.002). The quality of evidence for the meta-analysis was low due to the inclusion of non-randomized studies with considerable risk of bias.
While existing evidence does not indicate a difference in the overall duration of treatment with fixed appliances between adults and adolescents, the alignment of palatally displaced canines lasted significantly longer in adults. However, our confidence in these estimates is low due to the risk of bias in the included studies.
PROSPERO: ( CRD42019148169 ).
如今，患有固定正畸器械的成年人越来越多。与青少年相比，成年人具有可能影响治疗时间的生物学差异。因此，本研究的目的是比较成年人和青少年固定矫治器治疗的时间。
截至 2019 年 9 月，我们在 8 个数据库中搜索了比较青少年和成年患者固定矫治器治疗时间的随机和非随机临床研究。在重复研究选择、数据提取和使用 Cochrane ROBINS-I 工具评估偏倚风险后，我们进行了均值差（MD）及其 95%置信区间（CI）的随机效应荟萃分析，随后使用 GRADE 评估证据质量。
最终共纳入 11 项独特的研究（1 项前瞻性研究和 10 项回顾性非随机研究），共包括 2969 名青少年和 1380 名成年患者。7 项研究的荟萃分析发现，成年人和青少年的固定矫治器综合治疗时间无显著差异（MD=-0.8 个月；95%CI=-4.2 至 2.6 个月；P=0.65；I=92%）。同样，使用骨骼锚固对上颌第一磨牙远移以矫正 II 类错牙合和将尖牙拉入拔牙间隙的后移，在成年人和青少年中所需时间相似。另一方面，上颌错位尖牙的排齐时间在成年人中明显长于青少年（1 项研究；MD=3.8 个月；95%CI=1.4 至 6.2 个月；P=0.002）。由于纳入的研究存在较高的偏倚风险，因此荟萃分析的证据质量较低。
虽然现有证据表明成年人和青少年固定矫治器治疗的总时间没有差异，但上颌错位尖牙的排齐时间在成年人中明显更长。然而，由于纳入研究的偏倚风险，我们对这些估计的信心较低。
PROSPERO（CRD42019148169）。
