Alshammery Deema, Alqhtani Nasser, Alajmi Asmaa, Dagriri Lamis, Alrukban Nouf, Alshahrani Rahaf, Alghamdi Shahad
Department of Preventive Dental Science, College of Dentistry, Riyadh Elm University, Saudi Arabia.
Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 19942, Saudi Arabia.
J Clin Exp Dent. 2021 Jul 1;13(7):e717-e723. doi: 10.4317/jced.58242. eCollection 2021 Jul.
There are no studies that have systematically reviewed randomized control trials and/or prospective cohort studies that have assessed the significance of temporary skeletal mini-screw anchorage devices (TSAD) for the correction of gummy-smile. The aim of the present systematic review was to assess the significance of non-surgical correction of gummy smile using TSAD.
The addressed focused question was "Are temporary skeletal mini-screw anchorage devices effective for the correction of gummy smile?" Indexed databases were searched up to and including May 2020. Different combinations of the following key-indexing terms were used: anchorage; gummy smile, mini-screw; orthodontic; and vertical maxillary excess. The literature search was performed without time and language barriers. Randomized clinical trials and prospective cohort studies that addressed the focused questions were included. Risk of bias was assessed using the Downs and Black and Cochran collaboration tools. Letters to the Editor, commentaries, case-reports/series and articles published in non-indexed databases were excluded.
The initial search yielded 2118 studies out of which, four studies met the inclusion criteria and were processed for data extraction. All studies had a prospective research design. One study was a clinical trial and 3 had a non-randomized design. Results of the clinical trial showed no statistically significant difference in the extent of intrusion between the test- and control-groups. The non-randomized studies showed that TSAD are useful in reducing deep overbite. All studies had a high risk of bias.
The TSAD are an effective and practical option in facilitating reduction of excessive gingival display or gummy-smile. However, further long-term follow-up, well-designed and power-adjusted clinical trials are warranted in this regard. Anchorage, Excessive gingival display, Gummy-smile, Mini-screw.
尚无研究系统评价过评估临时骨微螺钉支抗装置（TSAD）对改善露龈笑意义的随机对照试验和/或前瞻性队列研究。本系统评价的目的是评估使用TSAD非手术矫正露龈笑的意义。
所提出的核心问题是“临时骨微螺钉支抗装置对矫正露龈笑有效吗？”检索截至2020年5月的索引数据库。使用了以下关键索引词的不同组合：支抗；露龈笑、微螺钉；正畸；以及上颌垂直过度。文献检索不受时间和语言限制。纳入解决核心问题的随机临床试验和前瞻性队列研究。使用唐斯和布莱克工具以及科克伦协作工具评估偏倚风险。排除发表在非索引数据库中的致编辑信、评论、病例报告/系列和文章。
初步检索得到2118项研究，其中4项研究符合纳入标准并进行数据提取。所有研究均采用前瞻性研究设计。1项研究为临床试验，3项为非随机设计。临床试验结果显示，试验组和对照组在压低程度上无统计学显著差异。非随机研究表明，TSAD有助于减少深覆合。所有研究均有较高的偏倚风险。
TSAD是促进减少牙龈过度暴露或露龈笑的一种有效且实用的选择。然而，在这方面有必要进行进一步的长期随访、设计良好且经功效调整的临床试验。支抗、牙龈过度暴露、露龈笑、微螺钉。
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