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单/多次微骨切开术对正畸牙齿移动速度及其可能并发症的影响:系统评价和荟萃分析。

The effect of single/multiple micro-osteoperforation on the rate of orthodontic tooth movement and its possible complications: A systematic review and meta-analysis.

机构信息

Shahid Beheshti University of Medical Sciences, School of Dentistry, Dentofacial Deformities Research Center, Research Institute of Dental Sciences, Tehran, Iran.

Alborz University of Medical Sciences, School of Dentistry, Department of Orthodontics, Karaj, Iran.

出版信息

Int Orthod. 2021 Jun;19(2):183-196. doi: 10.1016/j.ortho.2021.02.001. Epub 2021 Mar 4.

Abstract

OBJECTIVE

Different surgical and non-surgical approaches have been proposed to accelerate tooth movement and decrease the duration of orthodontic treatments. Recently, less invasive techniques such as micro-osteoperforation (MOP) are becoming more common. Several clinical trials have been performed to analyse the effect of MOP. This systematic review with meta-analyses was done to evaluate the effect of MOP on the rate of orthodontic tooth movement (OTM) and its complications.

MATERIAL AND METHODS

Electronic search was done in PubMed and Cochrane database for studies published until January 2021. Comparative randomized clinical trial studies with 10 or more participants per group were included. The risk of bias (ROB) of the studies was assessed according to the Cochrane Collaborations tool. Meta-analyses were performed to assess the mean difference in tooth movement rate and compare the level of pain between MOP and control groups.

RESULTS

Among a total of 15 included studies, eight studies were at low ROB, while others had unclear ROB. Ten studies evaluated the effect of MOP on OTM rate in canine retraction, and related meta-analysis showed a significant difference between the MOP and control group [SMD=0.42; 95% CI=0.20 to 0.63, P<0.01]. Besides, quantitative analysis showed MOP caused no significant higher anchorage loss [SMD=0.01; 95% CI=-0.15 to 0.13, P=0.89] and pain [SMD=0.54; 95% CI=-0.25 to 1.33, P=0.18].

CONCLUSIONS

Overall, both single and multiple applications of MOP increased the rate of OTM. However, the meta-analysis results of the four studies with low risk of bias showed that there is no significant difference in the rate of tooth movement between MOP and control groups. Besides, it has been shown that MOP did not significantly increase the level of pain, anchorage loss, and periodontal complications.

摘要

目的

为了加速牙齿移动并缩短正畸治疗时间,已经提出了不同的手术和非手术方法。最近,微创技术如微骨切开术(MOP)越来越常见。已经进行了几项临床试验来分析 MOP 的效果。本系统评价和荟萃分析旨在评估 MOP 对正畸牙齿移动(OTM)速度及其并发症的影响。

材料和方法

在 PubMed 和 Cochrane 数据库中进行电子搜索,以查找截至 2021 年 1 月发表的研究。纳入了每组 10 名或以上参与者的比较随机临床试验研究。根据 Cochrane 协作工具评估研究的偏倚风险(ROB)。进行荟萃分析以评估牙齿移动速度的平均差异,并比较 MOP 和对照组之间的疼痛水平。

结果

在总共纳入的 15 项研究中,有 8 项研究的 ROB 较低,而其他研究的 ROB 不明确。有 10 项研究评估了 MOP 对犬牙后缩的 OTM 速度的影响,相关的荟萃分析显示 MOP 组和对照组之间存在显著差异[SMD=0.42;95%CI=0.20 至 0.63,P<0.01]。此外,定量分析表明 MOP 不会导致明显更高的支抗丧失[SMD=0.01;95%CI=-0.15 至 0.13,P=0.89]和疼痛[SMD=0.54;95%CI=-0.25 至 1.33,P=0.18]。

结论

总体而言,MOP 的单次和多次应用均可增加 OTM 速度。然而,四项低 ROB 风险研究的荟萃分析结果表明,MOP 组和对照组之间的牙齿移动速度没有显著差异。此外,已经表明 MOP 不会显著增加疼痛水平、支抗丧失和牙周并发症。

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