局部应用生物物质对正畸牙移动速度的影响：一项系统评价人类研究。
The effect of the local administration of biological substances on the rate of orthodontic tooth movement: a systematic review of human studies.
机构信息
Division of Orthodontics, University of Connecticut Health, 263 Farmington Ave, Farmington, CT, 06032, USA.
L.M. Stowe Library, University of Connecticut Health, Farmington, CT, USA.
出版信息
Prog Orthod. 2021 Feb 1;22(1):5. doi: 10.1186/s40510-021-00349-5.
BACKGROUND
The influence of different biological agents on the rate of orthodontic tooth movement (OTM) has been extensively reviewed in animal studies with conflicting results. These findings cannot be extrapolated from animals to humans. Therefore, we aimed to systematically investigate the most up-to-date available evidence of human studies regarding the effect of the administration of different biological substances on the rate of orthodontic tooth movement.
METHODS
A total of 8 databases were searched until the 16th of June 2020 without restrictions. Controlled randomized and non-randomized human clinical studies assessing the effect of biological substances on the rate of OTM were included. ROBINS-I and the Cochrane Risk of Bias tools were used. Reporting of this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
A total of 11 studies (6 randomized clinical trials and 5 prospective clinical trials) were identified for inclusion. Local injections of prostaglandin E1 and vitamin C exerted a positive influence on the rate of OTM; vitamin D showed variable effects. The use of platelet-rich plasma and its derivatives showed inconsistent results, while the local use of human relaxin hormone showed no significant effects on the rate of OTM.
LIMITATIONS
The limited and variable observation periods after the administration of the biological substances, the high and medium risk of bias assessment for some included studies, the variable concentrations of the assessed biological agents, the different experimental designs and teeth evaluated, and the variety of measurement tools have hampered the quantitative assessment of the results as originally planned.
CONCLUSIONS AND IMPLICATIONS
Despite the methodological limitations of the included studies, this systematic review provides an important overview of the effects of a variety of biological agents on the rate of tooth movement and elucidates the deficiencies in the clinical studies that have been conducted so far to evaluate the effectiveness of these agents in humans, providing some guidelines for future robust research.
TRIAL REGISTRATION
PROSPERO ( CRD42020168481 , www.crd.york.ac.uk/prospero ).
背景
不同生物制剂对正畸牙齿移动（OTM）速度的影响已在动物研究中得到广泛综述，但结果存在冲突。这些发现不能从动物外推到人类。因此，我们旨在系统地调查关于不同生物物质对正畸牙齿移动速度影响的最新人类研究证据。
方法
总共在 8 个数据库中进行搜索，截至 2020 年 6 月 16 日，无限制。纳入评估生物物质对 OTM 速度影响的对照随机和非随机人类临床研究。使用 ROBINS-I 和 Cochrane 偏倚风险工具。本综述的报告基于系统评价和荟萃分析的首选报告项目（PRISMA）指南。
结果
共确定了 11 项研究（6 项随机临床试验和 5 项前瞻性临床试验）纳入。前列腺素 E1 和维生素 C 的局部注射对 OTM 速度有积极影响；维生素 D 显示出不同的效果。血小板富血浆及其衍生物的使用结果不一致，而人松弛素激素的局部使用对 OTM 速度没有显著影响。
局限性
生物物质给药后的观察期有限且多变，一些纳入研究的偏倚风险评估高和中，评估的生物制剂浓度不同，不同的实验设计和评估的牙齿，以及测量工具的多样性，妨碍了最初计划的结果的定量评估。
结论和意义
尽管纳入研究存在方法学上的局限性，但本系统综述提供了各种生物制剂对牙齿移动速度影响的重要概述，并阐明了迄今为止评估这些制剂在人类中有效性的临床研究中的不足，为未来的稳健研究提供了一些指导。
试验注册
PROSPERO（CRD42020168481，www.crd.york.ac.uk/prospero）。
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