Alsino Hallaj I, Hajeer Mohammad Y, Burhan Ahmad S, Alkhouri Issam, Darwich Khaldoun
Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR.
Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus, SYR.
Cureus. 2022 May 14;14(5):e24985. doi: 10.7759/cureus.24985. eCollection 2022 May.
The current review aimed to critically and systematically evaluate the available evidence regarding the effectiveness of periodontally accelerated osteogenic orthodontics (PAOO) in accelerating orthodontic tooth movement and supporting the alveolar bone. Additionally, this review aimed to analyze the untoward effects of this procedure and the patient-reported outcome measures. A comprehensive electronic search was performed on 10 databases in addition to a manual search to retrieve all relevant studies. Randomized controlled trials (RCTs) were only included in this review. The interventional group was the PAOO procedure, whereas the control group was either a non-accelerated traditional fixed orthodontic treatment or an accelerated treatment using any other intervention. The Cochrane risk of bias tool for randomized controlled trials (RoB 2) was employed to estimate the risk of bias in the included studies. The current review included eight RCTs evaluating 175 participants (63 males and 112 females) with a mean age ranging from 18.8 to 29.6 years. Five of them assessed the effectiveness of PAOO versus traditional orthodontic treatment, i.e. without any adjuvant surgical intervention. At the same time, the remaining three studies evaluated the effectiveness of PAOO versus corticotomy-only as an adjunctive procedure. The PAOO accelerated the leveling and alignment stage from 39% to 47% and accelerated the retraction of the upper anterior teeth from 41% to 61% compared to conventional orthodontic treatment. One study only indicated that PAOO reduced treatment time by 30.3% versus a corticotomy-only as an adjunctive procedure. No significant side effects have been reported with the PAOO procedure. The PAOO procedure was effective in accelerating orthodontic movement and tended to increase the thickness of the alveolar bone. But most periodontal outcome measures regarding PAOO application were not comprehensively covered in the included trials.
本综述旨在批判性地、系统地评估关于牙周加速成骨正畸术(PAOO)在加速正畸牙齿移动和支持牙槽骨方面有效性的现有证据。此外,本综述旨在分析该手术的不良影响以及患者报告的结局指标。除手动检索外,还对10个数据库进行了全面的电子检索,以检索所有相关研究。本综述仅纳入随机对照试验(RCT)。干预组为PAOO手术,而对照组为非加速的传统固定正畸治疗或使用任何其他干预措施的加速治疗。采用随机对照试验的Cochrane偏倚风险工具(RoB 2)来评估纳入研究中的偏倚风险。本综述纳入了8项RCT,评估了175名参与者(63名男性和112名女性),平均年龄在18.8至29.6岁之间。其中5项评估了PAOO与传统正畸治疗相比的有效性,即无任何辅助手术干预。同时,其余3项研究评估了PAOO与仅行皮质切开术作为辅助程序相比的有效性。与传统正畸治疗相比,PAOO将整平排齐阶段加速了39%至47%,并将上前牙的内收加速了41%至61%。一项研究仅表明,与仅行皮质切开术作为辅助程序相比,PAOO将治疗时间缩短了30.3%。未报告PAOO手术有明显副作用。PAOO手术在加速正畸移动方面有效,且倾向于增加牙槽骨厚度。但纳入试验中未全面涵盖大多数关于PAOO应用的牙周结局指标。