Yassir Yassir A, Sofar Mostafa K, McIntyre Grant T, Bearn David R
Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq.
Department of Orthodontics, College of Dentistry, University of Wasit, Iraq.
J Orthod Sci. 2024 Sep 17;13:26. doi: 10.4103/jos.jos_46_24. eCollection 2024.
To evaluate the clinical effectiveness of treatment with customized compared to noncustomized fixed orthodontic appliances.
A comprehensive search was performed using 13 databases until February 20, 2024. Study eligibility criteria were based on studies that compared orthodontic treatment with customized fixed appliances (labial or lingual) with noncustomized appliances. All ages and types of malocclusions were included.
The search identified 95 studies, of which only four fulfilled the inclusion criteria. Three studies compared labial customized brackets with self-ligating brackets, while one study compared lingual customized brackets with labial conventional brackets. There were no significant differences between these systems for treatment duration, outcome, number of appointments, analgesic consumption, patient satisfaction, and the archwire bends requirement. On the other hand, treatment planning was longer and the finishing and detailing phase was shorter in the customized appliances. There was a greater tendency for mandibular incisor proclination and bracket repositioning in the noncustomized appliances group and a greater number of bracket failures, complaints, and requirements for archwire changes in the customized appliances. Qualitative synthesis was applied due to heterogeneity in investigating the difference between the two appliance systems.
Based on the current limited evidence, the clinical effectiveness of customized and noncustomized orthodontic appliances was similar for the majority of clinical outcomes. Further high-quality clinical studies are required to confirm this finding.
Proper treatment planning and clinical management are the key factors for adequate outcomes apart from the type of appliance used.
评估定制式与非定制式固定正畸矫治器治疗的临床效果。
截至2024年2月20日，使用13个数据库进行了全面检索。研究纳入标准基于将定制式固定矫治器（唇侧或舌侧）与非定制式矫治器的正畸治疗进行比较的研究。纳入所有年龄和类型的错牙合畸形。
检索到95项研究，其中只有4项符合纳入标准。3项研究比较了唇侧定制托槽与自锁托槽，而1项研究比较了舌侧定制托槽与唇侧传统托槽。这些系统在治疗持续时间、治疗结果、就诊次数、镇痛药物消耗、患者满意度和弓丝弯制需求方面没有显著差异。另一方面，定制式矫治器的治疗计划时间更长，而精细调整阶段更短。在非定制式矫治器组中，下颌切牙前倾和托槽重新定位的趋势更大，而在定制式矫治器中，托槽失败、患者投诉和弓丝更换需求的数量更多。由于在研究两种矫治器系统之间的差异时存在异质性，因此采用了定性综合分析。
基于目前有限的证据，定制式和非定制式正畸矫治器在大多数临床结果方面的临床效果相似。需要进一步的高质量临床研究来证实这一发现。
除了所使用的矫治器类型外，正确的治疗计划和临床管理是取得良好治疗效果的关键因素。
