Singh Swati, Jain Ravindra Kumar, Balasubramaniam Arthi
Department of Orthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India.
Department of Public Health Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India.
J Dent Res Dent Clin Dent Prospects. 2024 Spring;18(2):85-94. doi: 10.34172/joddd.40932. Epub 2024 Jun 24.
This review aims to collate and analyze the existing evidence on the comparison of external apical root resorption (EARR) in subjects treated with clear aligners (CAs) and fixed appliances (FA). An electronic search was conducted in six databases for articles published in all languages until July 2023. Studies that evaluated EARR in subjects treated with CAs and FAs were included. The RoB 2 tool for RCTs and the ROBINS-I tool for non-randomized studies were used to analyze the risk of bias (ROB). A random effects meta-analysis was performed to assess EARR extent in maxillary and mandibular anterior teeth for subjects treated with CAs and FAs. Ten studies (eight retrospective, one RCT, and one CCT) were included in this review, out of which six studies reported a moderate ROB, one reported a serious ROB, and three reported a low ROB on qualitative analysis. The quantitative analysis of six studies revealed a significant intergroup difference (<0.05) in the mean EARR for maxillary central (SMD=-0.62, <0.00001) and lateral incisors (SMD=-0.47, =0.01) with a moderate heterogeneity (I=56%), as well as the mandibular central incisors (SMD=-0.27, =0.04) with high heterogeneity (I=79%). EARR was lower in subjects treated with CAs than FAs. A moderate quality of the available evidence suggests that EARR was less evident in subjects treated with CAs when compared with FAs.
本综述旨在整理和分析关于使用透明矫治器（CA）和固定矫治器（FA）治疗的受试者根尖外吸收（EARR）比较的现有证据。在六个数据库中进行了电子检索，以查找截至2023年7月以所有语言发表的文章。纳入了评估使用CA和FA治疗的受试者EARR的研究。使用随机对照试验的RoB 2工具和非随机研究的ROBINS-I工具来分析偏倚风险（ROB）。进行了随机效应荟萃分析，以评估使用CA和FA治疗的受试者上颌和下颌前牙的EARR程度。本综述纳入了十项研究（八项回顾性研究、一项随机对照试验和一项队列对照试验），其中六项研究在定性分析中报告了中度ROB，一项报告了严重ROB，三项报告了低度ROB。六项研究的定量分析显示，上颌中切牙（标准化均数差=-0.62，<0.00001）和侧切牙（标准化均数差=-0.47，=0.01）的平均EARR存在显著组间差异（<0.05），异质性中等（I²=56%），下颌中切牙（标准化均数差=-0.27，=0.04）的异质性较高（I²=79%）。使用CA治疗的受试者的EARR低于使用FA治疗的受试者。现有证据质量中等表明，与FA相比，使用CA治疗的受试者的EARR不太明显。
