West China School of Stomatology, Sichuan University, Chengdu, China.
Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
BMC Oral Health. 2023 Apr 25;23(1):241. doi: 10.1186/s12903-023-02982-4.
The purpose of this systematic review was to research the difference between root-filled teeth (RFT) and vital pulp teeth (VPT) in orthodontically induced external apical root resorption (EARR) and to offer suggestions for clinicians on therapeutic sequence and timing when considering combined treatment of endodontic and orthodontic.
An electronic search of published studies was conducted before November 2022 in PubMed, Web of Science and other databases. Eligibility criteria were based on the Population, Intervention, Comparison, Outcome, and Study design (PICOS) framework. RevMan 5.3 software was used for statistical analysis. Single-factor meta-regression analysis was used to explore the sources of literature heterogeneity, and a random effects model was used for analysis.
This meta-analysis comprised 8 studies with 10 sets of data. As there was significant heterogeneity among the studies, we employed a random effects model. The funnel plot of the random effects model exhibited a symmetrical distribution, indicating no publication bias among the included studies. The EARR rate of RFT was significantly lower than that of VPT.
In the context of concurrent endodontic and orthodontic treatment, priority should be given to endodontic therapy, as it serves as the foundation for subsequent orthodontic procedures. The optimal timing for orthodontic tooth movement post-root canal therapy is contingent upon factors such as the extent of periapical lesion resolution and the degree of dental trauma sustained. A comprehensive clinical assessment is essential in guiding the selection of the most suitable approach for achieving optimal treatment outcomes.
本系统评价的目的是研究在正畸诱导的根尖外吸收(EARR)中,根管治疗后的牙齿(RFT)和有活力的牙髓牙齿(VPT)之间的差异,并为临床医生提供关于联合治疗牙髓病和正畸时治疗顺序和时机的建议。
在 2022 年 11 月之前,我们在 PubMed、Web of Science 和其他数据库中进行了已发表研究的电子搜索。纳入标准基于人群、干预、比较、结局和研究设计(PICOS)框架。RevMan 5.3 软件用于统计分析。单因素 meta 回归分析用于探索文献异质性的来源,采用随机效应模型进行分析。
本荟萃分析包括 8 项研究,共 10 组数据。由于研究之间存在显著的异质性,我们采用了随机效应模型。随机效应模型的漏斗图显示出对称分布,表明纳入研究没有发表偏倚。RFT 的 EARR 率明显低于 VPT。
在同时进行牙髓病和正畸治疗的情况下,应优先考虑牙髓治疗,因为它是后续正畸程序的基础。根管治疗后进行正畸牙齿移动的最佳时机取决于根尖周病变缓解的程度和牙齿创伤的程度等因素。全面的临床评估对于指导选择最适合的方法以实现最佳治疗效果至关重要。