Aboaf Yohan, Strub Marion, Wagner Delphine
Université de Strasbourg, Faculté de chirurgie dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France.
Université de Strasbourg, Faculté de chirurgie dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France, Hôpitaux Universitaires de Strasbourg, Pôle de médecine et chirurgie bucco-dentaires, 1 place de l'hôpital, 67091 Strasbourg cedex, France.
Orthod Fr. 2021 Sep 1;92(3):303-334. doi: 10.1684/orthodfr.2021.58.
This systematic review aims to compare conventional corticotomy with minimally-invasive protocols (MIP). Electronic database, in MEDLINE and CENTRAL, and hand search were performed. Randomized controlled trials (RCTs) and randomized split-mouth designed studies (RSMSs) were selected for inclusion, reporting either the use of a corticotomy procedure or a MIP. The main outcomes were the rate/velocity of tooth movement, type of tooth movement observed, loss of anchorage, periodontal indexes, inflammatory mediators, root resorption, patient's pain experience, impact on the quality of life, and satisfaction. Twenty-two papers were included for the qualitative synthesis, from which ten RCTs and twelve RSMSs. Eighteen of them compared a conventional orthodontic treatment without and with a surgical adjunctive procedure, two with conventional corticotomy and sixteen with a MIP (piezocision, micro-osteoperforations (MOPs) or interseptal bone reduction). Four trials compared a surgical procedure to another one. Corticotomy, piezocision and MOPs are likely to accelerate tooth movement, in decreasing order. Pain is reported to be higher in experimental groups only on the first day after surgery. Patient satisfaction is high after surgical procedures. Loss of anchorage, periodontal indexes, or root resorption occurrence show no differences between groups. Corticotomy stands as the gold-standard procedure for surgically-assisted orthodontics, but piezocision appears as a good compromise solution as well as MOPs, in a lesser extent. MIP are known to accelerate tooth movement only during the first three months.
本系统评价旨在比较传统皮质切开术与微创方案（MIP）。检索了MEDLINE和CENTRAL电子数据库，并进行了手工检索。纳入了随机对照试验（RCT）和随机双颌设计研究（RSMS），这些研究报告了皮质切开术或MIP的使用情况。主要结局包括牙齿移动的速率/速度、观察到的牙齿移动类型、支抗丧失、牙周指数、炎症介质、牙根吸收、患者的疼痛体验、对生活质量的影响以及满意度。纳入了22篇论文进行定性综合分析，其中包括10项RCT和12项RSMS。其中18项比较了有无手术辅助程序的传统正畸治疗，2项比较了传统皮质切开术，16项比较了MIP（压电切开术、微骨穿孔术（MOP）或牙槽间隔骨减少术）。4项试验比较了一种手术程序与另一种手术程序。皮质切开术、压电切开术和MOP可能会按降序加速牙齿移动。据报道，仅在术后第一天，实验组的疼痛程度较高。手术后患者满意度较高。两组之间在支抗丧失、牙周指数或牙根吸收发生率方面没有差异。皮质切开术是外科辅助正畸的金标准程序，但压电切开术以及程度较轻的MOP似乎也是不错的折衷方案。已知MIP仅在最初三个月内加速牙齿移动。
