Dos Santos André-Luiz-Campos, Wambier Letícia-Maira, Wambier Denise-Stadler, Moreira Kelly-Maria-Silva, Imparato José-Carlos-Pettorossi, Chibinski Ana-Cláudia-Rodrigues
Departament of Dentistry; State University of Ponta Grossa; Ponta Grossa, Paraná, Brazil.
Departament of Dentistry; São Leopoldo Mandic Faculty, Campinas, São Paulo, Brazil.
J Clin Exp Dent. 2022 Sep 1;14(9):e746-e755. doi: 10.4317/jced.59768. eCollection 2022 Sep.
This systematic review compared the bonding failures of orthodontic brackets bonded by indirect or direct techniques. Data sources: The searched databases were Cochrane Library, LILACS, BBO, PubMed, Scopus, Web of Science.
A search for randomized clinical trials comparing the two techniques was carried out to answer the research question: When considering orthodontic bracket bonding on permanent teeth, does the indirect technique reduce the number of bonding failures compared to the direct one over time? The quality of the included papers was assessed with Cochrane risk of bias tool and the quality of evidence with GRADE.
From 3096 articles identified, seven were included in the systematic review (five at unclear; two at low risk of bias). Meta-analysis was carried out according to the follow-up periods (0-6 months and 12-15 months).
In the first period, bonding techniques were similar with regard to adhesion failures (RR = 0.59; 95% CI 0.10-3.62; = 0.00001; I2 = 92%); in the 12-to-15-month period, the direct bonding technique proved to be superior (RR = 1.44; 95% CI 1.05 - 1.99; = 0.41; I2 = 0%). The quality of evidence was classified as low for the 0-6 months follow-up and high for the 12 months.
Based on the absence of heterogeneity and the high quality of evidence, it is concluded that the direct bracket bonding technique has a lower failure rate than the indirect technique in the long term (12-15 months). Orthodontic brackets, fixed orthodontics, systematic review.
本系统评价比较了采用间接或直接技术粘结正畸托槽时的粘结失败情况。
检索的数据库有考克兰图书馆、拉丁美洲及加勒比地区卫生科学数据库、英国正畸文献在线数据库、医学期刊数据库、Scopus数据库、科学引文索引数据库。
检索比较这两种技术的随机临床试验，以回答研究问题：在恒牙上粘结正畸托槽时，随着时间推移，与直接技术相比，间接技术是否能减少粘结失败的数量？采用考克兰偏倚风险工具评估纳入论文的质量，并用GRADE评估证据质量。
从识别出的3096篇文章中，7篇被纳入系统评价（5篇偏倚风险不明确；2篇偏倚风险低）。根据随访期（0 - 6个月和12 - 15个月）进行荟萃分析。
在第一个时期，两种粘结技术在粘结失败方面相似（相对危险度=0.59；95%可信区间0.10 - 3.62；P = 0.00001；I² = 92%）；在12至15个月期间，直接粘结技术更优（相对危险度=1.44；95%可信区间1.05 - 1.99；P = 0.41；I² = 0%）。0 - 6个月随访的证据质量为低，12个月随访的证据质量为高。
基于不存在异质性和高质量的证据，得出结论：长期（12 - 15个月）来看，直接托槽粘结技术的失败率低于间接技术。正畸托槽、固定正畸、系统评价。
