正畸治疗中使用透明牙套进行牙弓扩张的效果：范围综述。

Effectiveness of dental arch expansion in the orthodontic treatment with clear aligners: a scoping review.

机构信息

Post-Graduate program in Dentistry, Faculty of Dentistry, Federal University of Pará (UFPA), Rua Augusto Correa 01, Belém, Pará 66075-110, Brazil.

出版信息

Eur J Orthod. 2024 Dec 1;46(6). doi: 10.1093/ejo/cjae059.

DOI:10.1093/ejo/cjae059

PMID:39449616

Abstract

BACKGROUND

The clinical protocol and effectiveness of dental expansion with Clear Aligner Therapy (CAT), especially among adults is still unclear. There is a need to map and explore knowledge gaps of dental expansion with CAT among children and adults.

OBJECTIVE

This scoping review explores the extent and depth of the available literature regarding the effectiveness and predictability of CAT in performing orthodontic expansion in both children and adults.

METHODS

The following databases were consulted as sources of information: PubMed, MEDLINE, Embase, Web of Science, Scopus, LILACS, COCHRANE Library, and ProQuest Dissertations & Thesis, in which the search was limited to studies on children or adults requiring transverse arch expansion and using clear orthodontic aligners. Two independent reviewers assessed the citations and extracted data, which was then synthesized in a narrative format.

RESULTS

Over all, 698 citations were retrieved, and 33 were included. Among these, 3 were systematic reviews, 4 were cohort studies, 2 were case-control studies, and 24 were case series. Eighty-five percent of the included studies were published in the last 5 years. Despite different protocols and measurement methods, aligners were effective for arch expansion in adults and children, and the expansion predictability was greater for the lower arch than for the upper arch. The evidence suggests that arch width increment is more predictable in the premolar region and less predictable in the canine and second molar areas, with high variability across studies.

CONCLUSIONS

Orthodontic aligners have demonstrated effectiveness in expanding arches in both adults and children. However, the literature suggests a decrease in arch width toward the posterior region, and there is no evidence of skeletal gains. To provide more conclusive evidence, randomized controlled clinical studies are warranted.

REGISTRATION

This review was registered in the Open Science Framework database (DOI: https://doi.org/10.17605/OSF.IO/6EG8F).

摘要

背景

使用 Clear Aligner Therapy (CAT) 进行牙齿扩弓的临床方案和效果尚不清楚，尤其是在成年人中。因此，需要绘制和探索儿童和成人使用 CAT 进行牙齿扩弓的知识空白。

目的

本范围综述旨在探讨有关 CAT 在儿童和成人进行正畸扩弓的有效性和可预测性的现有文献的广度和深度。

方法

本研究检索了以下数据库作为信息来源：PubMed、MEDLINE、Embase、Web of Science、Scopus、LILACS、Cochrane 图书馆和 ProQuest Dissertations & Thesis，并将搜索范围限制为需要横向弓扩张且使用透明正畸直丝弓的儿童或成人的研究。两名独立的综述员评估了引文并提取了数据，然后以叙述形式综合了数据。

结果

共检索到 698 条引文，其中 33 条被纳入。其中 3 篇为系统评价，4 篇为队列研究，2 篇为病例对照研究，24 篇为病例系列研究。纳入的研究中有 85%发表于过去 5 年。尽管方案和测量方法不同，但直丝弓在成人和儿童中均能有效扩弓，下弓的扩弓可预测性大于上弓。证据表明，前磨牙区的牙弓宽度增量更可预测，而尖牙和第二磨牙区的牙弓宽度增量不可预测，各研究间的变异性较大。