Kim Dohyoung, Shim Gyu-Jo, Han Michael D, Boboeva Obida, Kwon Tae-Geon
Dept. of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, 2177 Dalgubeol-daero, Jung-gu, Daegu, 41940, Republic of Korea.
Dept. of Oral & Maxillofacial Surgery, University of Illinois Chicago, 801 South Paulina Street, Room 110, Chicago, IL 60612-7211, USA.
Heliyon. 2024 Oct 9;10(20):e39043. doi: 10.1016/j.heliyon.2024.e39043. eCollection 2024 Oct 30.
The recent development of temporary anchorage devices (TADs) allows orthodontic canting correction by selective intrusion of the molars. The purpose of this study was to review the treatment strategy and outcomes after orthodontic correction of occlusal canting using the TADs based on published literature including the case reports.
A systematic review of published English-language human clinical studies was conducted by electronic search of PubMed, Embase & Medline, and Scopus reviews up to Dec 2023. For inclusion, reports required documentation of subject demographic characteristics; location or type of TADs; diagnosis; presence of maxillary occlusal canting (MOC); and treatment outcomes (MOC correction). Studies were excluded if they involved orthognathic surgery to correct MOC. Critical appraisal for all included studies were conducted with the case reports/case series appraisal checklist of the Joanna Briggs Institute (JBI). The current study was registered in PROSPERO (CRD42021226432).
The search identified 260 reports and a total of 33 case reports met inclusion criteria with 46 individual patient cases. The results reported that occlusal canting could be resolved by unilateral intrusion of maxillary posterior teeth using TADs. The reported the amount of maxillary molar intrusion ranged from 1 mm to 4.8 mm. However, there were fundamental limitations in study subjects, paucity of data regarding the long-term stability, lack of standardization in intrusion mechanics, and variations in TAD devices.
Although the previous reports mentioned that orthodontic canting correction with TADs could avoid maxillary surgery or orthognathic surgery itself, it cannot be concluded that non-surgical correction of occlusal canting can be comparable to surgical treatment. Further comparative investigation between surgical and nonsurgical canting correction is needed to clarify whether orthodontic intrusion can be an alternative to surgical canting correction in terms of efficacy and stability.
临时锚固装置（TADs）的最新发展使得通过选择性压低磨牙来进行正畸性倾斜矫正成为可能。本研究的目的是基于已发表的文献（包括病例报告），回顾使用TADs进行正畸性矫正咬合倾斜后的治疗策略及结果。
通过对PubMed、Embase & Medline以及截至2023年12月的Scopus综述进行电子检索，对已发表的英文人体临床研究进行系统评价。纳入标准要求报告记录受试者人口统计学特征、TADs的位置或类型、诊断、上颌咬合倾斜（MOC）的存在情况以及治疗结果（MOC矫正）。如果研究涉及正颌手术来矫正MOC，则将其排除。使用乔安娜·布里格斯研究所（JBI）的病例报告/病例系列评价清单对所有纳入研究进行批判性评价。本研究已在PROSPERO（CRD42021226432）注册。
检索到260篇报告；共有33篇病例报告符合纳入标准，涉及46例个体患者。结果表明，使用TADs单侧压低上颌后牙可解决咬合倾斜问题。报告的上颌磨牙压低量为1毫米至4.8毫米。然而，研究对象存在根本局限性，关于长期稳定性的数据匮乏，压低力学缺乏标准化，且TAD装置存在差异。
尽管先前的报告提到使用TADs进行正畸性倾斜矫正可避免上颌手术或正颌手术本身，但不能得出非手术矫正咬合倾斜可与手术治疗相媲美的结论。需要进一步对比研究手术和非手术倾斜矫正，以明确正畸压低在疗效和稳定性方面是否可替代手术性倾斜矫正。
