Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via De Crecchio n. 6, 80138 Naples, Italy.
Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, Building 1613, DK 8000 Aarhus, Denmark.
Eur J Orthod. 2024 Aug 1;46(4). doi: 10.1093/ejo/cjae023.
An update on the knowledge regarding the orthopedic/orthodontic role in treating JIA-related dentofacial deformities is relevant.
This systematic review aimed to assess the level of evidence regarding the management of dentofacial deformity from juvenile idiopathic arthritis (JIA) with orthodontics and/or dentofacial orthopedics.
The following databases were searched without time or language restrictions up to 31 January 2024 (Medline, Embase, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Latin American and Caribbean Health Sciences Literature).
Inclusion criteria were studies dealing with JIA subjects receiving treatment with orthodontic and/or dentofacial orthopedic functional appliances.
After the removal of duplicate studies, data extraction, and risk of bias assessment according to ROBINS-I guidelines were conducted. Data extraction was conducted by two independent authors.
The electronic database search identified 397 eligible articles after the removal of duplicates. Following the application of the pre-defined inclusion and exclusion criteria, 11 articles were left for inclusion. Two trials were associated with a severe risk of bias, four trials were at moderate risk of bias, and the other five presented a low risk of bias. Various research groups employed and documented the effects of different types of appliances and methodologies. The study heterogeneity did not allow for meta-analyses. In addition, a lack of uniformity in treatment objectives was observed across the included studies. After treatment with dentofacial orthopedics skeletal improvement was demonstrated in 10 studies, and a decrease in orofacial signs and symptoms was reported in 7 studies.
Across the available literature, there is minor evidence to suggest that dentofacial orthopedics may be beneficial in the management of dentofacial deformities from JIA. There is little evidence to suggest that it can reduce orofacial signs and symptoms in patients with JIA. Based on current evidence, it is not possible to outline clinical recommendations for specific aspects of orthopedic management in growing subjects with JIA-related dentofacial deformity.
PROSPERO (CRD42023390746).
更新关于骨科/正畸在治疗 JIA 相关牙颌面畸形方面的知识是相关的。
本系统评价旨在评估正畸和/或牙颌面矫形治疗幼年特发性关节炎（JIA）相关牙颌面畸形的管理水平。
无时间和语言限制，检索了以下数据库，直到 2024 年 1 月 31 日（Medline、Embase、Cochrane 中央对照试验注册中心、Scopus、Web of Science 和拉丁美洲及加勒比健康科学文献）。
纳入标准为研究 JIA 患者接受正畸和/或牙颌面矫形功能矫治器治疗的文献。
在去除重复研究后，根据 ROBINS-I 指南进行数据提取和偏倚风险评估。数据提取由两名独立作者进行。
电子数据库搜索在去除重复项后确定了 397 篇合格文章。在应用预先定义的纳入和排除标准后，有 11 篇文章被纳入。两项试验与严重偏倚风险相关，四项试验为中度偏倚风险，其余五项为低度偏倚风险。不同的研究小组采用并记录了不同类型的器具和方法的效果。研究异质性不允许进行荟萃分析。此外，纳入的研究中观察到治疗目标缺乏一致性。经牙颌面矫形治疗后，10 项研究显示骨骼改善，7 项研究显示口面症状和体征减少。
在现有文献中，有少量证据表明牙颌面矫形术可能有益于 JIA 相关牙颌面畸形的治疗。几乎没有证据表明它可以减少 JIA 患者的口面症状和体征。基于目前的证据，不可能为 JIA 相关牙颌面畸形生长中的患者的矫形管理的具体方面制定临床建议。
PROSPERO（CRD42023390746）。
