Villamil-Jaramillo Heidy, Guerrero-García Jaime, Upegui-Ramirez Melissa, Rivera-Quiroz Leidys H, Vivares Anny, Ardila Carlos M
Orthodontics, Fundación Universitaria Visión de Las Américas, Medellín, COL.
Research Department, Faculty of Dentistry, Fundación Universitaria Visión de Las Américas, Medellín, COL.
Cureus. 2024 Sep 6;16(9):e68795. doi: 10.7759/cureus.68795. eCollection 2024 Sep.
Periodontally accelerated orthodontic (PAO) therapy has been found to increase hard tissue, helping to decrease orthodontic relapse rates and improve retention capacity. The aim of this study was to synthesize available evidence on clinical and tomographic changes in periodontal tissues when using PAO techniques. A systematic review with meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered in the International Prospective Register of Systematic Reviews (PROSPERO). The search was carried out in PubMed, Embase, Cochrane, Web of Science, Scopus, and Google Scholar. Randomized and non-randomized clinical trials comparing PAO versus conventional orthodontics were included. Quality assessment was performed using the Downs & Black scale, and the risk of bias was assessed using the revised Cochrane risk-of-bias tool. Mean differences and 95% confidence intervals (CIs) were calculated, and the mean difference was divided by a t-test. During the initial search, 465 studies were identified. Five articles studying 130 patients were included, which assessed both clinical and tomographic changes, along with treatment duration. PAO was administered to patients with skeletal class III in three studies, to class II patients in one study, and to individuals with dental crowding in another study. Two studies showed a moderate risk of bias, and the rest showed a low risk. The meta-analysis revealed a vestibular bone thickness increase of 0.32 mm (0.56-008; P = 0.008), a reduction of 3.12 mm (2.15-4.08; P= 0.001) in gingival retraction, and a treatment duration that was 7.07 months (8.79-5.36; P = 0.001) shorter in patients subjected to PAO compared to those undergoing conventional orthodontic treatment. Considering the limitations of the study and acknowledging that definitive conclusions cannot be drawn, the findings suggest that treatment time decreased in patients undergoing PAO, with an increase in vestibular bone thickness and less gingival retraction observed in those undergoing this intervention.
牙周加速正畸（PAO）疗法已被发现可增加硬组织，有助于降低正畸复发率并提高固位能力。本研究的目的是综合使用PAO技术时牙周组织临床和断层扫描变化的现有证据。按照系统评价和Meta分析的首选报告项目（PRISMA）声明进行了一项系统评价和Meta分析，并在国际前瞻性系统评价注册库（PROSPERO）中注册。检索在PubMed、Embase、Cochrane、科学网、Scopus和谷歌学术中进行。纳入了比较PAO与传统正畸的随机和非随机临床试验。使用唐斯和布莱克量表进行质量评估，并使用修订后的Cochrane偏倚风险工具评估偏倚风险。计算平均差异和95%置信区间（CI），平均差异通过t检验进行划分。在初步检索中，共识别出465项研究。纳入了5篇研究130例患者的文章，这些文章评估了临床和断层扫描变化以及治疗持续时间。三项研究对III类骨骼患者进行了PAO治疗，一项研究对II类患者进行了PAO治疗，另一项研究对牙列拥挤个体进行了PAO治疗。两项研究显示有中度偏倚风险，其余研究显示有低度偏倚风险。Meta分析显示，前庭骨厚度增加0.32毫米（0.56 - 0.08；P = 0.008），牙龈退缩减少3.12毫米（2.15 - 4.08；P = 0.001），与接受传统正畸治疗的患者相比，接受PAO治疗的患者治疗持续时间缩短7.07个月（8.79 - 5.36；P = 0.001）。考虑到本研究的局限性，并承认无法得出确定性结论，研究结果表明，接受PAO治疗的患者治疗时间缩短，接受该干预的患者前庭骨厚度增加，牙龈退缩减少。
