Gharavi Matine, Jafari-Naeimi Alireza, Ahmadi Seyyed Amir Yasin
Department of Pediatrics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Department of Orthodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Med J Islam Repub Iran. 2025 May 14;39:68. doi: 10.47176/mjiri.39.68. eCollection 2025.
Molar movement control is a fundamental aspect of orthodontic treatment, particularly in managing anchorage and achieving desired occlusal outcomes. The transpalatal arch (TPA) is a commonly used passive or active appliance designed to provide anchorage reinforcement and facilitate specific molar movements. Despite its widespread application, there is limited consensus regarding its quantitative effectiveness. This systematic review and meta-analysis assesses the effectiveness of the TPA in molar movement during orthodontic treatment.
An extensive search of major electronic databases was conducted up to the year 2023 to identify studies evaluating the application of the TPA in molar movement. Data regarding study design, participant characteristics, types of TPA used, and numerical outcomes related to molar displacement were systematically extracted. For each outcome, point estimates and corresponding 95% confidence intervals were computed to assess pre- and post-treatment changes.
Fourteen studies underwent detailed qualitative synthesis, with 2 classified as low risk, 7 with some concerns, and 5 as high risk of bias. Nine studies were included in the meta-analysis. The pooled change in mesial movement U6-PTV (mm) for the TPA group was 2.73 (95% CI: 1.90-3.50), vertical movement U6-PP (mm) was 1.24 (95% CI: 0.96-1.52), vertical movement U6-FH (mm) was 1.34 (95% CI: 0.36-2.32), and mesial tipping U6-FH (°) was 2.94 (95% CI: 1.51-4.37).
This review underscores the TPA's versatility and effectiveness as an anchorage device. Evaluating TPA's full range of applications, beyond comparisons with skeletal devices, is crucial. Future research should incorporate three-dimensional digital models and consider pubertal growth stages for more accurate assessments.
磨牙移动控制是正畸治疗的一个基本方面，特别是在管理支抗和实现理想的咬合结果方面。腭弓（TPA）是一种常用的被动或主动矫治器，旨在提供支抗增强并促进特定的磨牙移动。尽管其应用广泛，但关于其定量有效性的共识有限。本系统评价和荟萃分析评估了TPA在正畸治疗中磨牙移动的有效性。
对主要电子数据库进行了广泛检索，直至2023年，以识别评估TPA在磨牙移动中应用的研究。系统提取了有关研究设计、参与者特征、使用的TPA类型以及与磨牙位移相关的数值结果的数据。对于每个结果，计算点估计值和相应的95%置信区间，以评估治疗前后的变化。
14项研究进行了详细的定性综合分析，其中2项被归类为低风险，7项存在一些问题，5项存在高偏倚风险。9项研究纳入了荟萃分析。TPA组近中移动U6-PTV（mm）的合并变化为2.73（95%CI：1.90-3.50），垂直移动U6-PP（mm）为1.24（95%CI：0.96-1.52），垂直移动U6-FH（mm）为1.34（95%CI：0.36-2.32），近中倾斜U6-FH（°）为2.94（95%CI：1.51-4.37）。
本综述强调了TPA作为一种支抗装置的多功能性和有效性。评估TPA的全面应用，而不仅仅是与骨骼装置进行比较，至关重要。未来的研究应纳入三维数字模型，并考虑青春期生长阶段，以进行更准确的评估。
