Department of Stomatology, Inner Mongolia Medical University, Hohhot, Peoples R, China.
Department of Orthodontics, Inner Mongolia Medical University Third Affiliated Hospital, Baotou, Peoples R, China.
PLoS One. 2021 Jul 9;16(7):e0253968. doi: 10.1371/journal.pone.0253968. eCollection 2021.
Recently, increasing attention has been paid to the periodontal health of orthodontic patients in the maintenance stage in clinical practice. The focus of this meta-analysis was to compare the effects of vacuum-formed retainers (VFR) and Hawley retainers (HR) on periodontal health, in order to provide a reference for clinical selection.
From the establishment of the database until November 2020, a large number of databases were searched to find relevant randomized control trials, including the Cochrane Library databases, Embase, PubMed, Medline via Ovi, Web of Science, Scopus, Grey Literature in Europe, Google Scholar and CNKI. Related literature was manually searched and included in the analysis. Two researchers screened the literature according to relevant criteria. The size of the effect was determined using RevMan5.3 software, and the mean difference and 95% confidence intervals (CI) were used to estimate the results using a random effects model.
This meta-analysis included six randomized controlled trials involving 304 patients. The results of the meta-analysis showed that there was no statistical difference in sulcus probing depth status between the VFR group and the HR group, including at 1, 3, and 6 months. Compared with the VFR group, the HR group showed a lower gingival index at 1 month (mean difference = 0.12, 95%CI: 0.06 to 0.19) and 3 months (mean difference = 0.11, 95%CI: 0.06 to 0.17), while there was no statistically significant difference at 6 months (mean difference = 0.10, 95%CI: -0.07 to 0.27). The plaque index of the HR group also showed a good state at 1 month (mean difference = 0.06, 95%CI: 0.01 to 0.12), 3 months (mean difference = 0.12, 95%CI: 0.08 to 0.16), and 6 months (mean difference = 0.19, 95%CI: 0.09 to 0.29). Subgroup analysis of PLI showed that when all teeth were measured, PLI status was lower in the HR group at 6 months (mean difference = 0.32, 95%CI: 0.18 to 0.46). PLI status was also low for the other teeth group (mean difference = 0.15, 95%CI: 0.08 to 0.22).
Our meta-analysis showed that patients using the Hawley retainer had better periodontal health compared with those using vacuum-formed retainers. However, more research is needed to look at the periodontal health of patients using these two retainers.
最近，临床实践中越来越关注正畸患者保持阶段的牙周健康。本荟萃分析的重点是比较真空成型保持器（VFR）和 Hawley 保持器（HR）对牙周健康的影响，为临床选择提供参考。
从数据库建立到 2020 年 11 月，检索了大量数据库以查找相关的随机对照试验，包括 Cochrane 图书馆数据库、Embase、PubMed、Medline 通过 Ovi、Web of Science、Scopus、欧洲灰色文献、Google Scholar 和中国知网。手动搜索相关文献并纳入分析。两位研究人员根据相关标准筛选文献。使用 RevMan5.3 软件确定效应大小，使用随机效应模型使用均值差和 95%置信区间（CI）估计结果。
本荟萃分析纳入了六项随机对照试验，共涉及 304 名患者。荟萃分析结果显示，VFR 组与 HR 组在龈沟探诊深度状态方面无统计学差异，包括在 1、3 和 6 个月时。与 VFR 组相比，HR 组在 1 个月时（均数差=0.12，95%CI：0.06 至 0.19）和 3 个月时（均数差=0.11，95%CI：0.06 至 0.17）的牙龈指数较低，而 6 个月时无统计学差异（均数差=0.10，95%CI：-0.07 至 0.27）。HR 组的菌斑指数在 1 个月（均数差=0.06，95%CI：0.01 至 0.12）、3 个月（均数差=0.12，95%CI：0.08 至 0.16）和 6 个月（均数差=0.19，95%CI：0.09 至 0.29）时也表现出良好状态。PLI 的亚组分析表明，当所有牙齿均被测量时，HR 组在 6 个月时 PLI 状态较低（均数差=0.32，95%CI：0.18 至 0.46）。对于其他牙齿组，PLI 状态也较低（均数差=0.15，95%CI：0.08 至 0.22）。
我们的荟萃分析表明，与使用真空成型保持器的患者相比，使用 Hawley 保持器的患者具有更好的牙周健康。然而，需要更多的研究来观察使用这两种保持器的患者的牙周健康。
