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论文摘要

不同快速扩弓装置对牙根吸收影响的系统评价

Influence of different types of rapid maxillary expansion on root resorption: a systematic review

作者:夏恺, 孙闻天, 余丽媛, 刘钧

Author:Xia Kai, Sun Wentian, Yu Liyuan, Liu Jun

收稿日期:2020-01-12          年卷(期)页码:2021,39(1):38-38-47

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:快速扩弓,骨支持式扩弓,牙支持式扩弓,牙根吸收,系统评价,

Key words:rapid maxillary expansion,bone-borne maxillary expansion,tooth-borne maxillary expansion,root resorption,systematic review,

基金项目:国家自然科学基金(81870743)

中文摘要

目的评估不同类型的快速扩弓装置对牙根吸收的影响。方法电子检索文献数据库,包括5个英文库及2个中文库,合格文献类型为随机对照试验、临床对照试验、队列研究以及病例-对照研究。由3名研究者进行数据提取,随机对照试验及非随机试验由不同量表进行偏倚风险评估。结果初筛的400篇研究中,共有7篇符合标准纳入本系统评价。其中3篇被评为高证据质量,2篇为中等证据质量,2篇低证据质量。现有证据表明,牙支持扩弓装置相较于骨支持扩弓装置会产生更明显的支抗牙根吸收。另外,Haas式腭部基托并不能有效减小牙根吸收的程度,牙支持式扩弓装置间的固位体设计差异(采用带环或铸造框架与支抗牙连接)不会造成牙根吸收发生率及程度的差异。结论临床证据表明,相比于其他快扩装置,骨支持快扩装置可产生较小程度的牙根吸收。牙-组织混合支持式(Haas式)与牙支持式(Hyrax式)之间、不同固位体设计的Hyrax式扩弓装置之间所致牙根吸收程度的差异均无统计学意义。

英文摘要

ObjectiveThis study aimed to assess the influence of different types of rapid maxillary expansion on root resorption (RR).

MethodsLiterature searches were carried out electronically in five English and two Chinese databases. Randomized controlled trials (RCTs), controlled clinical trials (CCTs), cohort studies, and case-control studies were included. The data were extracted by three authors. The risk of bias in the RCTs and nonrandomized studies were assessed in accordance with corresponding scales.

ResultsAmong the 400 articles identified, seven were included for the final analysis. Three studies were graded as high value of evidence, while two and another two studies were graded as moderate value and low value, respectively. According to the available evidence, the tooth-borne maxillary expansion caused more obvious RR of anchorage teeth than the bone-borne one. In addition, the Haas-type palatal acrylic pads could not effectively reduce the degree of RR. The difference in the design of the retainer between the tooth-borne maxillary expansion (the use of a band or wire framework to connect the anchorage tooth) did not cause the difference in the incidence and degree of RR.

ConclusionClinical evidence suggested that bone-borne maxillary expansion may decrease the amount of RR, while the amounts of resorption did not significantly differ between Haas and Hyrax and between different retainer types of Hyrax.

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