›› 2020, Vol. 40 ›› Issue (12): 1088-1093.

• 临床研究 • 上一篇    下一篇

无托槽隐形矫治中牙根吸收的系统评价再评价

郑小雯,袁玲君,房兵   

  1. 上海交通大学医学院附属第九人民医院
  • 收稿日期:2020-06-04 修回日期:2020-07-27 出版日期:2020-12-28 发布日期:2020-12-22
  • 通讯作者: 房兵 E-mail:fangbing@sjtu.edu.com
  • 基金资助:
    上海市青年科技英才杨帆计划;国家自然科学基金

The root resorption of clear aligner: An overview

  • Received:2020-06-04 Revised:2020-07-27 Online:2020-12-28 Published:2020-12-22
  • Contact: Bing Fang E-mail:fangbing@sjtu.edu.com

摘要: 目的 对无托槽隐形矫治牙根吸收的系统评价进行再评价。方法 检索PubMed,Embase, Cochrane library, 中国学术期刊网络出版总库,万方数据库,中国生物医学文献数据库,搜索公开发表的关于无托槽隐形矫治的系统评价,时限均为建库至2020年4月。2名作者独立筛选并提取数据。采用A Measurement Tool to Access Systematic Review 2(AMSTAR 2)工具评价各系统, 采用结局指标描述性研究的进行证据质量评估。结果 共纳入3篇系统评价,其中高质量2篇,中等质量1篇。证据评估3篇系统评价报道了统一的合并的牙根吸收程度结局指标,2个结局指标证据质量较高,1篇结局指标证据质量为中等。与固定矫治器相比,无托槽隐形矫治器牙根吸收程度减少,无托槽隐形矫治器牙根吸收均数0.44mm(SD=0.12);固定矫治器牙根吸收均数1.13mm(SD=0.18),P<0.05。全口牙标准化平均差SMD=-0.65,95%CI[-0.74,-0.55],P<0.01;牙根吸收程度也与牙位,施加轻重力,矫治设计方案,患者配合程度等因素相关。个别系统评价认为无托槽隐形矫治器与固定矫治器牙根吸收在个别牙位和轻力条件下无统计学差异。结论 系统评价再评价结果表明,与固定矫治器相比,无托槽隐形矫治器牙根吸收程度降低。但是研究数量较少,部分证据结果相冲突,结局指标可靠性一般,临床医生需有选择参考。

关键词: 无托槽隐形矫治器, 系统评价再评价, 系统评价, Meta分析, 牙根吸收

Abstract: Objective To reevaluate the systematic review of root resorption in the orthodontic treatment of clear aligners. Methods To search PubMed, EMBASE, Cochrane Library, Chinese Academic Journal Online Publishing Database, Wanfang database, Chinese biomedical literature database, search the published systematic review of clear aligners, and the time limit is from the establishment of the database to April 2020. Two authors screened and extracted data independently. A measurement tool to access systematic review 2 (AMSTAR2) was used to evaluate each systematic review, and a descriptive study of outcome indicators was used to evaluate the quality of evidence. Results Three systematic reviews were included, including two of high quality and one of medium quality. There were 3 systematic reviews reports on the unified outcome indicators of root resorption degree. The quality of two outcome indicators was high, and the quality of one outcome indicator was medium. Compared with the fixed appliance, the root absorption of the clear aligners decreased. The root absorption of the clear aligner appliance was 0.44mm (SD = 0.12), the root absorption of the fixed appliance was 1.13mm (SD = 0.18), P < 0.05. The standardized mean difference of total teeth was SMD = -0.65, 95% CI [-0.74, - 0.55], P < 0.01; however, the degree of root resorption was also related to the tooth position, the application of light gravity, the design of correction, the degree of patient cooperation and other factors. According to individual systematic reviews, there was no significant difference in root resorption between clear aligner appliance and fixed appliance under individual tooth position and light force condition. Conclusions The results of overview show that the degree of the root resorption of clear aligner is lower than that of fixed appliance. However, the number of studies is small and some of the evidence conflict. The reliability of outcome indicators is general. So clinicians need to have a choice of reference.

Key words: clear aligners, overview, systematic reviews, Metaanalysis, root resorption

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