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光生物调节加速正畸牙齿移动的疗效:系统评价和荟萃分析。

The Effectiveness of Photobiomodulation on Accelerating Tooth Movement in Orthodontics: A Systematic Review and Meta-Analysis.

机构信息

Department of Orthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, People's Republic of China.

Department of Psychology, West Virginia University, Morgantown, West Virginia, USA.

出版信息

Photobiomodul Photomed Laser Surg. 2021 Apr;39(4):232-244. doi: 10.1089/photob.2020.4954. Epub 2021 Mar 17.

Abstract

This meta-analysis evaluated the effectiveness of photobiomodulation therapy (PBMT) on accelerating orthodontic tooth movement (OTM) in clinical practice. Data from bilingual journals across seven different databases were compiled and analyzed. Randomized controlled trials (RCTs) and quasi-RCTs regarding the effect of PBMT on OTM in cases with four first premolar extractions in split-mouth design were selected. This study was conducted after approval from the IRB. The outcome variables were the cumulative tooth movement distances in 1, 2, and 3 months. Data extraction was performed by two authors independently and in duplicate. Risk of bias was assessed. Eight RCTs and one quasi-RCT were ultimately included and analyzed in meta-analysis. This study revealed that the pooled mean difference (MD) among these trials was 0.30 [95% confidence interval (CI): -0.02 to 0.62], 0.69 (95% CI: 0.08 to 1.29), and 0.64 (95% CI: -0.01 to 1.29) for 1, 2, and 3 months, respectively. The results remained consistent after sensitivity analysis assessment. There is insufficient evidence to support that photobiomodulation accelerates tooth movement in orthodontic treatments. Our results suggest that the optimal parameters of PBMT on OTM in human might be about 20 mW, 5-8 J/cm, 0.5 W/cm, 0.2 J/point, and 2-10 J/tooth. More large-sample multicenter clinical trials carried out in similar settings are required to confirm and pinpoint treatment efficiency and optimal parameters. Registration: The review protocol was not registered prior to the study.

摘要

这项荟萃分析评估了光生物调节疗法(PBMT)在临床实践中加速正畸牙齿移动(OTM)的效果。从七个不同数据库的双语期刊中汇总和分析数据。选择了在分牙设计中进行四颗第一前磨牙拔牙的情况下,关于 PBMT 对 OTM 影响的随机对照试验(RCT)和准 RCT。本研究在 IRB 批准后进行。主要结局变量是 1、2 和 3 个月时的累积牙齿移动距离。数据由两位作者独立进行重复提取。评估了偏倚风险。最终纳入并进行荟萃分析了 8 项 RCT 和 1 项准 RCT。这项研究表明,这些试验的合并均数差值(MD)分别为 0.30[95%置信区间(CI):-0.02 至 0.62]、0.69(95%CI:0.08 至 1.29)和 0.64(95%CI:-0.01 至 1.29)。在敏感性分析评估后,结果仍然一致。没有足够的证据支持光生物调节能加速正畸治疗中的牙齿移动。我们的结果表明,人 OTM 中 PBMT 的最佳参数可能约为 20mW、5-8J/cm、0.5W/cm、0.2J/点和 2-10J/牙。需要在类似环境中进行更多大样本多中心临床试验,以确认和确定治疗效率和最佳参数。注册:本研究之前未进行综述方案注册。

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