AlMaghlouth Basma, AlMubarak Aqilah, Almaghlouth Ibrahim, AlKhalifah Reem, Alsadah Amal, Hassan Ali
Orthodontic Department, Dammam Medical Complex, Dammam, Saudi Arabia.
Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Clin Cosmet Investig Dent. 2021 Jan 11;13:11-19. doi: 10.2147/CCIDE.S283102. eCollection 2021.
To systemically review all clinical trials that evaluate the effectiveness of orthodontic intrusion using bone anchorage devices versus using other orthodontic techniques in adult patients.
All randomized, controlled clinical trials and prospective studies that compare the use of TADs in intrusion versus alternative devices from the year 2000 to 2019 were searched using various electronic databases. Databases used include Pubmed, Cochrane, Scopus, Lilacs, and ScienceDirect. Selection was initially made by reading the titles and abstracts of potential suitable studies. The final selection was made after reading the full retrieved articles. A methodological score developed by Lagravère was used to assess the quality of evidence. The selection process was illustrated using a PRISMA flow chart.
A total of 3942 articles were retrieved, from which only two randomized clinical trials met the inclusion criteria. This presented a low to medium level of evidence to support the hypothesis that TADs are more effective than other orthodontic intrusion techniques for intruding upper incisors and improving upper incisor to lip relation while eliminating the adverse effect of compromising vertical posterior anchorage. Shorter treatment times and less root resorption were found in the TAD group.
There is insufficient evidence to state that TADs can be used as orthodontic anchorage to effectively intrude the incisors without the need for patient cooperation. Future high quality prospective randomized clinical trials are required.
系统评价所有评估在成年患者中使用骨锚固装置与使用其他正畸技术进行正畸压低有效性的临床试验。
使用各种电子数据库检索2000年至2019年期间比较使用微型种植体支抗（TADs）进行压低与使用其他装置进行压低的所有随机对照临床试验和前瞻性研究。使用的数据库包括PubMed、Cochrane、Scopus、Lilacs和ScienceDirect。最初通过阅读潜在合适研究的标题和摘要进行筛选。在阅读全文后进行最终筛选。使用Lagravère制定的方法学评分来评估证据质量。使用PRISMA流程图展示选择过程。
共检索到3942篇文章，其中只有两项随机临床试验符合纳入标准。这为支持以下假设提供了低到中等水平的证据：在压低上切牙、改善上切牙与唇部关系同时消除损害垂直向后方支抗的不利影响方面，TADs比其他正畸压低技术更有效。在TAD组中发现治疗时间更短且牙根吸收更少。
没有足够的证据表明TADs可作为正畸支抗有效压低切牙而无需患者配合。未来需要高质量的前瞻性随机临床试验。
