双板矫治器与赫伯氏矫治器治疗儿童安氏Ⅱ类错（牙合）的疗效比较：一项荟萃分析。
Comparison of Twin Block appliance and Herbst appliance in the treatment of Class II malocclusion among children: a meta-analysis.
机构信息
Department of Pediatric Stomatology, Jinan Stomatology Hospital, 101 Jingliu Road, Shizhong District, Jinan City, Shandong Province, 250000, P. R. China.
Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong, Guangzhou, 510182, P. R. China.
出版信息
BMC Oral Health. 2024 Feb 26;24(1):278. doi: 10.1186/s12903-024-04027-w.
BACKGROUND
Our meta-analysis aimed to evaluate the efficacy of applying Herbst and Twin Block appliances in the treatment of Class II malocclusion among children.
METHODS
Databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China VIP Database (VIP), and Wanfang were thoroughly searched from inception to August 9, 2023. The outcomes included skeletal, dental, and soft tissue changes. The weighted mean difference (WMD) was used as the effect indicator, and the effect size was expressed with a 95% confidence interval (CI). The heterogeneity of each outcome effect size was tested, and the heterogeneity statistic I ≥ 50% was analyzed by the random-effect model, otherwise, the fixed-effect model was conducted. Sensitivity analysis was performed.
RESULTS
A total of 12 studies involving 574 patients were included in this meta-analysis. Herbst appliance had a statistically significant increase in mandibular body length (WMD: 1.44, 95% CI: 0.93 to 1.96, P < 0.001) compared with the Twin Block appliance. More increases in angle and distance of L1 to mandibular plane (MP) were found in the Herbst appliance compared with the Twin Block appliance. Significant and greater improvements in molar relationship (WMD: 0.79, 95% CI: 0.28 to 1.29, P = 0.002), posterior facial height (WMD: -1.23, 95% CI: -2.08 to -0.38, P = 0.005), convexity angle (WMD: -1.89, 95% CI: -3.12 to -0.66, P = 0.003), and Sella-Nasion plane angle (U1 to SN) (WMD: 3.34, 95% CI: 2.25 to 4.43, P < 0.001) were achieved in the Twin Block appliance. Herbst and Twin Block appliances produced similar effects in the skeletal and dentoalveolar changes including Sella-Nasion-point A (SNA), Sella-Nasion-point B, point A-Nasion-point B (ANB), overjet, and overbite.
CONCLUSION
As the findings revealed both Herbst and Twin Block appliances contributed successfully to the correction of Class II malocclusion. Compared with the Twin Block appliance, the Herbst appliance may have more advantages in mandibular bone movement. Twin Block therapy resulted in more improvement in the aesthetics of the face.
背景
本荟萃分析旨在评估 Herbst 和 Twin Block 矫治器在儿童安氏 II 类错颌治疗中的疗效。
方法
从建库至 2023 年 8 月 9 日，我们全面检索了 PubMed、Embase、Cochrane 图书馆、Web of Science、中国知网（CNKI）、中国维普数据库（VIP）和万方数据库，纳入的研究对象为应用 Herbst 和 Twin Block 矫治器治疗安氏 II 类错颌的儿童。主要结局指标为骨骼、牙齿和软组织变化。采用加权均数差（WMD）作为效应指标，95%置信区间（CI）表示效应大小。对每个结局的效应量进行异质性检验，当 I²>50%时采用随机效应模型分析，否则采用固定效应模型。进行敏感性分析。
结果
本荟萃分析共纳入 12 项研究，共 574 例患者。与 Twin Block 矫治器相比，应用 Herbst 矫治器可显著增加下颌体长度（WMD：1.44，95%CI：0.93 至 1.96，P<0.001）。与 Twin Block 矫治器相比，应用 Herbst 矫治器可显著增加 L1 与下颌平面角和距离（WMD：0.79，95%CI：0.28 至 1.29，P=0.002）。与 Twin Block 矫治器相比，应用 Herbst 矫治器可显著改善磨牙关系（WMD：0.79，95%CI：0.28 至 1.29，P=0.002）、后面高（WMD：-1.23，95%CI：-2.08 至 -0.38，P=0.005）、凸面角（WMD：-1.89，95%CI：-3.12 至 -0.66，P=0.003）和蝶鞍点-前颅底平面角（U1 至 SN）（WMD：3.34，95%CI：2.25 至 4.43，P<0.001）。Twin Block 矫治器在改善后面高、面凸角、蝶鞍点-前颅底平面角和骨骼变化方面（Sella-Nasion-point A（SNA）、Sella-Nasion-point B、点 A-前颅底-点 B（ANB）、覆颌、覆盖）与 Herbst 矫治器相似。
结论
本荟萃分析结果表明，Herbst 和 Twin Block 矫治器均可成功地用于治疗安氏 II 类错颌。与 Twin Block 矫治器相比，Herbst 矫治器在促进下颌骨运动方面可能具有更多优势。Twin Block 疗法对面部美观的改善更为显著。
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