Dutta Shubhobrata, Rout Tanisha, Patil Amol Somaji, Deshmukh Sonakashee
Department of Orthodontics and Dentofacial Orthopedics, Bharati Vidyapeeth (deemed to be university) Dental college and Hospital, Pune, Maharashtra, India.
Evid Based Dent. 2024 Sep;25(3):165. doi: 10.1038/s41432-024-00997-6. Epub 2024 Mar 15.
AIM: The main objective of this systematic review is to comprehensively evaluate all the relevant studies to evaluate the effectiveness of electrical stimulation to accelerate orthodontic tooth movement in human patients. METHODS: Using a suitable search strategy, various databases like PubMed, CENTRAL, Scopus and Google Scholar were surveyed for relevant randomized controlled trials (RCTs); after which a hand search of related orthodontic journals was completed. The risk of bias of studies was checked using Cochrane's ROB-2 tool. The quality of evidence of the included studies was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. Rate of orthodontic tooth movement was compared and thus efficiency of electrical stimulation to accelerate tooth movement was assessed. Meta-analysis was done on 2 studies out of the 4; rate of orthodontic tooth movement was compared at two time periods after start of treatment (3 month and 5 month) with standardized mean difference (SMD) as summary estimate, with p < 0.05 denoting statistical significance. Publication bias was checked using a funnel plot. RESULTS: Via exploration of the online databases and hand searching, 1080 studies were found after removing duplicates. After full text assessment, 13 studies in total were selected that used electrical stimulation, out of which 4 studies were included in the qualitative analysis as they met the inclusion criteria. The meta-analysis was done for 3 month and 5 month with SMD as 0.69(-1.26-0.12) and 1.64(-3.44-0.16), respectively. The strength of evidence in the meta-analysis is moderate. There was no publication bias as shown by funnel plot. DISCUSSION: The studies included showed increased risk of selection and performance bias. Also due to the limited number of studies available, there was difficulty in reaching definitive conclusions. The meta-analysis showed a significant difference among the control and experimental group for the 3 month. CONCLUSION: Even though a positive correlation is found between electrical stimulation and acceleration of orthodontic tooth movement, it is advised to conduct further studies, particularly with human participants, to establish a more conclusive outcome. REGISTRATION: This review has received no funding. The protocol for the study was registered in the Prospective Registration of Systematic Review (PROSPERO)(CRD42023495077).
目的：本系统评价的主要目的是全面评估所有相关研究，以评价电刺激对加速人类患者正畸牙齿移动的有效性。 方法：采用合适的检索策略，对PubMed、CENTRAL、Scopus和谷歌学术等多个数据库进行检索，查找相关随机对照试验（RCT）；之后完成对相关正畸期刊的手工检索。使用Cochrane的ROB-2工具检查研究的偏倚风险。采用推荐分级、评估、制定与评价（GRADE）框架评估纳入研究的证据质量。比较正畸牙齿移动速率，从而评估电刺激加速牙齿移动的效率。对4项研究中的2项进行荟萃分析；在治疗开始后的两个时间段（3个月和5个月）比较正畸牙齿移动速率，以标准化均数差（SMD）作为汇总估计值，p < 0.05表示具有统计学意义。使用漏斗图检查发表偏倚。 结果：通过在线数据库检索和手工检索，去除重复项后共找到1080项研究。经过全文评估，共选择了13项使用电刺激的研究，其中4项研究符合纳入标准，被纳入定性分析。3个月和5个月时的荟萃分析结果分别为SMD为0.69（-1.26 - 0.12）和1.6（-3.44-0.16）。荟萃分析中的证据强度为中等。漏斗图显示不存在发表偏倚。 讨论：纳入的研究显示存在选择和实施偏倚增加的风险。此外，由于可用研究数量有限，难以得出明确结论。荟萃分析显示，3个月时对照组和实验组之间存在显著差异。 结论：尽管发现电刺激与正畸牙齿移动加速之间存在正相关，但建议进行进一步研究，尤其是针对人类受试者的研究，以得出更具结论性的结果。 注册情况：本评价未获得资助。该研究方案已在系统评价前瞻性注册库（PROSPERO）（CRD42023495077）中注册。
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