Katyal Sakshi, Bhatia Navleen Kaur, Sardana Rinkle, Singh Surjit, Chugh Ankita, Shamim Muhammad Aaqib, Anil Abhishek, Negi Anurag, Chugh Vinay Kumar
Department of Dentistry, All India Institute of Medical Sciences, Bibinagar, Hyderabad Metropolitan Region- 508126, Telangana, India.
Department of Dentistry, All India Institute of Medical Sciences, Basni Industrial Area Phase-2, Jodhpur- 342005, Rajasthan, India.
Eur J Orthod. 2024 Dec 4;47(1). doi: 10.1093/ejo/cjae074.
The infrazygomatic miniscrew implants (IZC-MSI) serve as innovative temporary anchorage devices placed parallel to the roots of molars in the infrazygomatic crest region, leveraging their extra-radicular location to support the en masse distalization and intrusion of the maxillary dentition. The efficacy and stability of these screws are crucial for their application in contemporary orthodontic practices.
This systematic review aimed to estimate the success rate and factors affecting the stability of IZC-MSI.
An electronic search was conducted on 7 February 2024 across the following databases: PubMed, Scopus, EMBASE, and Cochrane databases without any restriction on language and time of publication.
The review included clinical trials (both randomized and non-randomized) and retrospective cohort studies that utilized infrazygomatic miniscrew anchorage for orthodontic tooth movement in human participants.
The proportion of success rate was calculated and factors affecting stability (patient and implant-related factors) such as age, sex, implant position, and loading characteristics were subjected to subgroup analysis and meta-regression. The quality assessment of studies was done using the Cochrane risk-of-bias tools for randomized (RoB 2.0) and non-randomized trials (ROBINS-I).
Fourteen studies (n = 1683 IZC-MSI) were included in the meta-analysis revealing a 92% success rate of IZC-MSI (C.I. 87%-95%; prediction interval: 66%-99%; I2 = 80%). Studies with sample size > 100 presented a 94% success rate (C.I. 91%-96%; I2 = 63%) and moderate heterogeneity. Meta-regression analysis revealed no significant relation between age and success rate. Significant heterogeneity was observed in the subgroup analysis of host-, implant- and other related risk factors affecting stability and limited correlation was found. The risk-of-bias assessment revealed high risk in five, moderate in five, and low in four studies.
IZC-MSI have shown a good success rate for their clinical application. Although some factors appear to influence IZC-MSI stability, the majority of them necessitate additional investigation due to the low quality of evidence. Furthermore, high-quality studies are needed to confirm the results of this meta-analysis and address other important factors such as operator's experience, insertion torque, and sinus penetration that could not be analysed due to limited data.
CRD42024469048.
颧下微螺钉种植体（IZC-MSI）是一种创新的临时锚固装置，平行于磨牙牙根放置在颧下嵴区域，利用其根外位置来支持上颌牙列的整体远中移动和压低。这些螺钉的有效性和稳定性对其在当代正畸实践中的应用至关重要。
本系统评价旨在评估IZC-MSI的成功率及影响其稳定性的因素。
于2024年2月7日在以下数据库进行电子检索：PubMed、Scopus、EMBASE和Cochrane数据库，对发表语言和时间无任何限制。
该评价纳入了利用颧下微螺钉锚固进行人类正畸牙齿移动的临床试验（随机和非随机）及回顾性队列研究。
计算成功率比例，并对影响稳定性的因素（患者和种植体相关因素）如年龄、性别、种植体位置和加载特征进行亚组分析和meta回归。使用Cochrane偏倚风险工具对随机试验（RoB 2.0）和非随机试验（ROBINS-I）进行研究质量评估。
14项研究（n = 1683颗IZC-MSI）纳入meta分析，显示IZC-MSI的成功率为92%（置信区间87%-95%；预测区间：66%-99%；I² = 80%）。样本量>100的研究成功率为94%（置信区间91%-96%；I² = 63%），异质性中等。Meta回归分析显示年龄与成功率之间无显著关系。在影响稳定性的宿主、种植体及其他相关危险因素的亚组分析中观察到显著异质性，相关性有限。偏倚风险评估显示5项研究为高风险，5项为中度风险，4项为低风险。
IZC-MSI在临床应用中显示出良好的成功率。尽管一些因素似乎影响IZC-MSI的稳定性，但由于证据质量低，其中大多数因素需要进一步研究。此外，需要高质量研究来证实该meta分析的结果，并解决因数据有限而无法分析的其他重要因素，如操作者经验、植入扭矩和鼻窦穿透情况。
CRD42024469048
