College of Stomatology, Chongqing Medical University, No.426 Songshibeilu Road, Yubei District, Chongqing, China.
Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.
BMC Oral Health. 2020 Oct 10;20(1):278. doi: 10.1186/s12903-020-01271-8.
Temporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique.
A search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs). The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean differences and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out.
Three RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1.56 mm, 95% CI: 1.14 to 1.98, P < 0.00001) and the mandible (1.62 mm, 95% CI: 1.24 to 2.01, P < 0.00001) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm, 95% CI: 0.16 to 0.69, P = 0.001) and the mandible (0.26 mm, 95% CI: 0.02 to 0.49, P = 0.03).
There is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed.
正畸治疗中，临时支抗装置已经使用了几十年，具有多种用途。本系统评价的目的是评估在两步法中，正畸临时支抗装置在犬牙后移中的有效性。
系统检索了截至 2019 年 6 月 30 日在五个电子数据库（PubMed、Embase、Cochrane 中央对照试验注册库、Web of Science、Scopus）中发表的文章。使用 Cochrane 随机对照试验偏倚风险工具（RCTs）和非随机干预研究偏倚风险工具（ROBINS-I）评估 RCTs 和 CCTs 的偏倚风险。使用推荐评估、制定与评价分级（GRADE）方法评估质量。提取关于近中磨牙移动和犬牙后移程度的均值差异进行统计分析。对连续性数据采用均数差和 95%置信区间进行分析。对可比结局进行随机效应模型的荟萃分析。
最终纳入 3 项 RCTs 和 5 项 CCTs。荟萃分析显示，在种植体支抗组中，上颌（1.56mm，95%CI：1.14 至 1.98，P<0.00001）和下颌（1.62mm，95%CI：1.24 至 2.01，P<0.00001）的支抗保持均显著增加，在上颌（0.43mm，95%CI：0.16 至 0.69，P=0.001）和下颌（0.26mm，95%CI：0.02 至 0.49，P=0.03）的犬牙后移也显著增加。
证据质量非常低，表明在犬牙后移过程中，种植体支抗比传统支抗更有效。需要更多高质量的研究。
