Shukla Neeteesh K, Sharma Vipul K, Chaturvedi T P, Parihar Ajit V, Chugh Vinay K
Department of Orthodontics, FODS, IMS, Banaras Hindu University, UP, India.
Department of Dentistry, AIIMS, Jodhpur, India.
J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):344-353. doi: 10.1016/j.jobcr.2021.02.012. Epub 2021 Mar 4.
This systematic review was aimed to find out possible predictive variables measured on panoramic radiographs to predict spontaneous eruption of palatally displaced canine (PDC) after interceptive extraction in late mixed dentition.
Electronic database searches were performed in MEDLINE, Cochrane's CENTRAL, Scopus, and in other sources up to June 2020. Randomized and nonrandomized controlled trials, and pre-post prospective studies without control groups were considered for review. Study selection, data extraction, risk of bias assessment (by RoB 2.0, ROBINS-I, and NHLBI score), and the certainty of evidence evaluation (GRADE approach) were performed during reviewing process. Only qualitative analyses of included literature were done due to presence of between study heterogeneity.
Out of 970 retrieved records, 3 controlled trials and 3 prospective before and after studies without control fulfilled the eligibility criteria and were included in the review. Studies were assessed at low risk to high risk of bias. Overall certainty was moderate to very low. Results shows that PDCs in distal sectors, lower alpha angle, younger subjects, PDCs with less advanced developed root were significantly benefited from interceptive extraction. However, Vertical distance had insignificant roll on eruption prediction.
Interceptive extraction at younger age, mesial canine crown position (sectors), and mesial inclination of PDC (alpha angulation) are the most important variables predicting the spontaneous eruption of palatally displaced canine. Findings of this review can be utilized to make evidence-based decisions for managing PDCs with diverse sectors and mesial inclinations. However, well designed clinical trials are recommended to strengthen the evidence.
本系统评价旨在找出在全景X线片上测量的可能预测变量，以预测混合牙列晚期截除阻生尖牙（PDC）后其自行萌出的情况。
截至2020年6月，在MEDLINE、Cochrane中心对照试验注册库、Scopus及其他来源进行了电子数据库检索。纳入综述的研究包括随机和非随机对照试验，以及无对照组的前后瞻性研究。在综述过程中进行了研究选择、数据提取、偏倚风险评估（采用RoB 2.0、ROBINS - I和NHLBI评分）以及证据确定性评估（GRADE方法）。由于研究间存在异质性，仅对纳入文献进行了定性分析。
在检索到的970条记录中，3项对照试验和3项无对照组的前后瞻性研究符合纳入标准并被纳入综述。研究的偏倚风险评估为低风险至高风险。总体证据确定性为中等至非常低。结果表明，位于远中区域的PDC、较小的α角、较年轻的受试者、牙根发育程度较低的PDC在截除阻生后明显受益。然而，垂直距离对萌出预测的影响不显著。
较年轻的年龄、尖牙近中牙冠位置（区域）以及PDC的近中倾斜度（α角）是预测腭侧阻生尖牙自行萌出的最重要变量。本综述的结果可用于为管理不同区域和近中倾斜度的PDC做出基于证据的决策。然而，建议开展设计良好的临床试验以加强证据。
