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论文摘要

Twin-block矫治器对安氏Ⅱ类错患者髁突影响的Meta分析

Meta-analysis of condylar changes produced by a Twin-block appliance in Class Ⅱ malocclusion

作者:李雨霖, 徐静晨, 蒋晓鸽, 陈嵩

Author:Li Yulin, Xu Jingchen, Jiang Xiaoge, Chen Song.

收稿日期:2023-02-15          年卷(期)页码:2023,41(4):463-463-470

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:Twin-block矫治器,安氏Ⅱ类错𬌗畸形,髁突,系统评价,Meta分析,

Key words:Twin-block appliance,Class Ⅱ malocclusion,condyle,systematic review,Meta-analysis,

基金项目:四川省科技厅重点研发项目(2022YFS0127)

中文摘要

目的 评价Twin-block矫治器对安氏Ⅱ类错患者髁突生长改建及位置的影响。 方法 计算机检索Pubmed、Embase、Cochrane library、中国生物医学文献数据库(CBM),中国知网(CNKI)、维普(VIP)等数据库,纳入所有应用Twin-block矫治器治疗安氏Ⅱ类错畸形患者并对其髁突进行评估的随机对照试验、临床对照试验及单臂临床试验。2位评价者独立纳入文献、进行偏倚风险评估并提取数据,运用Revman 5.3软件进行统计分析。 结果 最终纳入文献8篇,共8项研究,其中7项为高质量研究。Meta分析结果显示:Twin-block矫治后,髁突向前移位,关节前间隙减小(P<0.000 01),关节后间隙增大(P<0.000 01),而关节上间隙未发现具有统计学意义的改变(P=0.11);关节间隙指数的增大具有统计学意义(P<0.000 01)。治疗后髁突前后径增大(P=0.000 2),髁突高度增大(P<0.000 01),而髁突内外径的增大不具有统计学意义(P=0.42)。 结论 Twin-block矫治器能够促进髁突向后上方的生长改建,并引导其向前移位从而使髁突-关节盘重新定位,达到良好的下颌位置并改善安氏Ⅱ类咬合关系。

英文摘要

ObjectiveTo evaluate the effects of a Twin-block appliance on the condyles of patients with ClassⅡmalocclusion by conducting a systematic review and a Meta-analysis.MethodsPubmed, Embase, Cochrane Library, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, and VIP Database were electronically searched. Randomized controlled trials, controlled clinical trials, and single-arm trials on condylar changes produced by a Twin-block appliance in patients with ClassⅡmalocclusion were included. Two reviewers independently extracted and assessed the risk of bias. Meta-analyses were conducted with Review Manager 5.3.ResultsEight studies were included; among which, seven were of high quality. After treatment with a twin block appliance, condyles moved anteriorly. The anterior joint spaces decreased (P<0 .000 01), whereas the posterior spaces increased (P<0 .000 01). the superior spaces were not changed (P=0.11). Moreover, a significant difference was observed in the increase of the condylar space index (P<0 .000 01). after treatment, the anteroposterior diameters of the condyles and condylar height increased (P=0.000 2 andP<0 .000 01, respectively). by contrast, no significant changes were discovered in the medial external diameters of the condyles (P=0.42).ConclusionA Twin-block appliance can promote the growth of a condyle in the posterior and upper direction and move it forward in favor of the correction of Class Ⅱ malocclusion.

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