富血小板浓缩物对正畸牙齿移动速率的有效性：一项系统评价与荟萃分析。

Effectiveness of platelet-rich concentrates on the rate of orthodontic tooth movement: a systematic review and meta-analysis.

作者信息

Mheissen Samer, Daraqel Baraa, Alzoubi Emad Eddin, Khan Haris

机构信息

DDS, Syrian Board in Orthodontics, Private Practice, Damascus, Syria.

Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, China.

出版信息

Eur J Orthod. 2023 Mar 31;45(2):196-207. doi: 10.1093/ejo/cjac049.

DOI:10.1093/ejo/cjac049

PMID:36056906

Abstract

BACKGROUND

Autologous platelet-rich concentrates (PRCs) are recently used as a local biological substance in orthodontics to accelerate the rate of tooth movement.

OBJECTIVES

This systematic review aimed to evaluate the effects of PRCs on the rate of orthodontic tooth movement (OTM).

SEARCH METHODS

Unrestricted search of five electronic databases supplemented by the manual and gray literature search were undertaken in March 2022.

SELECTION CRITERIA

Randomized controlled trials (RCTs) evaluating the effect of PRCs on the rate of OTM with their side effect were included in this systematic review.

DATA COLLECTION AND ANALYSIS

Data items were extracted by two authors using a pre-piloted extraction form. Similar outcomes within a comparable time frame were synthesized in a meta-analysis.

RESULTS

Fourteen studies were deemed eligible for inclusion and seven RCTs were pooled in a meta-analysis. Canine retraction rate was higher in the side of PRCs injection than the control side by 0.28 mm/month (95% CI: 0.16-0.40, I2 = 95.6 per cent, P < 0.001, 345 patients) in the first 4 months after PRCs injection. There was no statistically significant difference between the PRCs side and the control side regarding molar anchorage loss (MAL) (MD = 0.03 mm, 95% CI: -0.18 to 0.24, I2 = 46.3 per cent, P = 0.78, 44 patients), canine rotation (MD = -0.19o, 95% CI: -1.95 to 1.57, I2 = 45.4 per cent, P = 0.96, 48 patients), or en-masse retraction. Likewise, there was no difference between both groups in terms of the duration of de-crowding. The mandibular canine retraction was statistically higher on the PRCs side than on the control side by 0.17 mm/month (P < 0.001, one trial). Regarding root resorption, there was no statistically significant difference between the experimental and control sides within the follow-up time. Mild pain scores were reported by the patients in the first 24 hours after injections.

CONCLUSIONS

Low-level evidence indicates that the effect of PRCs on OTM is minor and clinically insignificant. The findings should be interpreted with caution due to the inherent limitations in the included RCTs.

REGISTRATION

PROSPERO (CRD42022300026).

摘要

背景

自体富血小板浓缩物（PRCs）最近在正畸治疗中作为一种局部生物物质使用，以加快牙齿移动速度。

目的

本系统评价旨在评估PRCs对正畸牙齿移动（OTM）速度的影响。

检索方法

2022年3月对五个电子数据库进行了无限制检索，并辅以手工检索和灰色文献检索。

选择标准

本系统评价纳入了评估PRCs对OTM速度及其副作用影响的随机对照试验（RCTs）。

数据收集与分析

由两名作者使用预先试点的提取表格提取数据项。在荟萃分析中对可比时间框架内的类似结果进行了综合。

结果

14项研究被认为符合纳入标准，7项RCTs被纳入荟萃分析。在注射PRCs后的前4个月，PRCs注射侧的尖牙后移速度比对照侧高0.28毫米/月（95%CI：0.16 - 0.40，I² = 95.6%，P < 0.001，345例患者）。在磨牙支抗丧失（MAL）方面，PRCs侧与对照侧之间无统计学显著差异（MD = 0.03毫米，95%CI： - 0.18至0.24，I² = 46.3%，P = 0.78，44例患者），在尖牙扭转方面（MD = - 0.19°，95%CI： - 1.95至1.57，I² = 45.4%，P = 0.96，48例患者）或整体后移方面也无差异。同样，两组在排齐持续时间方面也无差异。在一项试验中，PRCs侧的下颌尖牙后移在统计学上高于对照侧，为0.17毫米/月（P < 0.001）。关于牙根吸收，在随访期内试验侧与对照侧之间无统计学显著差异。患者在注射后的前24小时报告有轻度疼痛评分。