Ramesh Keerthana, Ananthanarayanan Venkateswaran, Kailasam Vignesh
Department of Orthodontics and Dentofacial Orthopaedics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), No. 1 Ramachandra Nagar, Porur, 600116, Chennai, Tamil Nadu, India.
J Orofac Orthop. 2025 Sep 23. doi: 10.1007/s00056-025-00617-7.
This systematic review aimed to assess and quantify the dentoalveolar compensation in skeletal class III malocclusion subjects.
Untreated class III subjects whose dentoalveolar compensations were radiologically evaluated were included. Predetermined inclusion and exclusion criteria were applied across PubMed, Scopus, LILACS, Ovid, and Web of Science electronic databases up to 27 January 2025, with no restriction on the year of publication. A total of 1007 articles were obtained, of which 10 studies met the eligibility criteria and were included in the systematic review, while 7 were included for the meta-analysis.
Risk of bias assessment was performed using the Newcastle Ottawa scale. Four studies scored 8 points, four studies scored 7 points, and two studies scored 6 points. The qualitative evaluation indicated that the dentoalveolar compensation in class III malocclusion was a result of proclined maxillary and retroclined mandibular incisors. Quantitative evaluation showed that when compared to class I subjects, maxillary incisors in class III subjects were proclined by 4.75° (95% confidence interval [CI] 0.72-8.77). Mandibular incisors were retroclined with a mean change in inclination of -8.40° (95% CI -11.21 to -5.60), thus, indicating a greater contribution of mandibular incisors to the compensatory mechanism.
The present systematic review and meta-analysis conclusively proved that maxillary incisor proclination and mandibular incisor retroclination contributed to dentoalveolar compensation in class III subjects. Quantitative analysis provided evidence that mandibular incisor retroclination contributed more to dentoalveolar compensation. The findings of this systematic review and meta-analysis would be of importance to the clinician while planning treatment, since respecting the anatomical limits of the underlying structures is essential.
本系统评价旨在评估和量化Ⅲ类骨性错牙合患者的牙槽骨代偿情况。
纳入未经治疗且经影像学评估牙槽骨代偿情况的Ⅲ类患者。截至2025年1月27日，在PubMed、Scopus、LILACS、Ovid和Web of Science电子数据库中应用预定的纳入和排除标准，对发表年份无限制。共获得1007篇文章，其中10项研究符合纳入标准并纳入系统评价，7项纳入荟萃分析。
采用纽卡斯尔-渥太华量表进行偏倚风险评估。四项研究得8分，四项研究得7分，两项研究得6分。定性评估表明，Ⅲ类错牙合的牙槽骨代偿是上颌切牙前倾和下颌切牙后倾的结果。定量评估显示，与Ⅰ类患者相比，Ⅲ类患者的上颌切牙前倾4.75°（95%置信区间[CI] 0.72 - 8.77）。下颌切牙后倾，倾斜度平均变化为-8.40°（95% CI -11.21至-5.60），因此表明下颌切牙对代偿机制的贡献更大。
本系统评价和荟萃分析确凿地证明，上颌切牙前倾和下颌切牙后倾促成了Ⅲ类患者的牙槽骨代偿。定量分析提供证据表明，下颌切牙后倾对牙槽骨代偿的贡献更大。本系统评价和荟萃分析的结果对临床医生制定治疗计划具有重要意义，因为尊重相关结构的解剖学限度至关重要。
