First Clinic, School and Hospital of Stomatology, Kunming Medical University, Kunming, China.
Department of Stomatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China.
Ann Palliat Med. 2021 Dec;10(12):12319-12334. doi: 10.21037/apm-21-3205.
This systematic review aimed to evaluate and compare the treatment effects of activator appliances on untreated class II skeletal malocclusion patients in terms of skeletal, dental, and soft tissue changes.
We searched 11 databases from January 1966 to May 2021 for randomized and clinical controlled trials that compared the treatment effects of activator appliances on untreated Class II skeletal malocclusion patients. All data were analyzed using RevMan 5.3 software.
According to the inclusion/exclusion criteria, 16 articles qualified for the final analysis. Thirteen outcome indicators of teeth, bone tissue, and soft tissue were compared and analyzed: SNA°, SNB°, ANB°, SN-MP°, ANS-Me, Co-Gn, Go-Me, overjet, overbite, U1-SN°, L1-MP°, UL-E, and LL-E. Five randomized controlled trials (RCTs) evaluations were of medium quality, and 11 controlled clinical trials (CCTs) evaluations were of B grade. Bone tissue changes: compared with the untreated group, the SNA and ANB decreased, and the SNB, SN-MP, ANS-Me, Co-Gn, and Go-Me increased after activator appliance treatment, and the differences were statistically significant (P<0.001). Dental changes: compared with the untreated group, the overjet, overbite and U1-SN in the treated group decreased significantly, while the L1-MP increased significantly (P<0.0001). Soft tissue changes: compared with untreated patients, the UL-E of patients treated with an activator appliance decreased significantly (P<0.0001); however, there was no significant difference in the LL-E between the two groups (P=0.09).
Since the imprecision and high level of heterogeneity of the articles, further large-sample and high-quality clinical trials are necessary to evaluate effects of orthodontic treatment with activator appliance on patients with skeletal Class II malocclusion. In addition, this study failed to explore the long-term stability of activator treatment, so long-term studies are needed to assess the stability of its effect on the skeletal, dental, and soft tissue changes.
本系统评价旨在评估和比较激活器矫治器对未经治疗的 II 类骨骼错颌畸形患者在骨骼、牙齿和软组织变化方面的治疗效果。
我们从 1966 年 1 月至 2021 年 5 月，检索了 11 个数据库，以查找比较激活器矫治器对未经治疗的 II 类骨骼错颌畸形患者的治疗效果的随机和临床对照试验。所有数据均使用 RevMan 5.3 软件进行分析。
根据纳入/排除标准，有 16 篇文章符合最终分析的条件。对牙齿、骨骼和软组织的 13 个结果指标进行了比较和分析：SNA°、SNB°、ANB°、SN-MP°、ANS-Me、Co-Gn、Go-Me、覆颌、覆盖、U1-SN°、L1-MP°、UL-E 和 LL-E。五项随机对照试验（RCT）的评估质量为中等，11 项对照临床试验（CCT）的评估为 B 级。骨骼组织变化：与未治疗组相比，激活器治疗后 SNA 和 ANB 减小，SNB、SN-MP、ANS-Me、Co-Gn 和 Go-Me 增大，差异有统计学意义（P<0.001）。牙齿变化：与未治疗组相比，治疗组的覆颌、覆盖和 U1-SN 显著减小，而 L1-MP 显著增大（P<0.0001）。软组织变化：与未经治疗的患者相比，接受激活器治疗的患者的 UL-E 显著降低（P<0.0001）；然而，两组之间的 LL-E 没有显著差异（P=0.09）。
由于文章的不精确性和高度异质性，需要进一步进行大样本、高质量的临床试验，以评估激活器矫治器治疗骨骼 II 类错颌畸形患者的效果。此外，本研究未能探讨激活器治疗的长期稳定性，因此需要进行长期研究来评估其对骨骼、牙齿和软组织变化的效果稳定性。
