儿童口腔正畸治疗的Cochrane系统评价证据  

Evidences of Cochrane systematic reviews on orthodontic treatments for children

作　　者：张晓歌[1] 杨帆[2] 吴泰相[3] 黄宁[1] 陈扬熙[1] 

机构地区：[1]四川大学华西口腔医院正畸科 [2]四川大学华西医院国家生物治疗重点实验室人类疾病相关多肽研究室 [3]四川大学华西医院中国循证医学中心,四川成都610041

出　　处：《国际口腔医学杂志》2009年第6期661-664,共4页International Journal of Stomatology

摘　　要：目的评价目前儿童口腔正畸治疗的Cochrane系统评价证据和纳入系统评价的随机对照试验(RCT)/半随机对照试验(qRCT)的方法学质量。方法检索2008年第4期Cochrane Library数据库中有关儿童口腔正畸治疗的系统评价。结果检索到儿童前牙开的正畸和矫形治疗、阻鼾器和功能矫治器治疗儿童阻塞性睡眠呼吸暂停综合征效果、儿童上牙前突正畸治疗和儿童上前牙内倾性深覆正畸治疗的4篇系统评价,共纳入12个RCT。依照Cochrane Handbook for Systematic Reviews of Interventions5.0.0版推荐的质量评价方法得出,仅2个RCT为A级,1个RCT为B级,其余9个RCT均为C级。结论Cochrane系统评价是公认的最高质量的研究证据,但目前尚缺少足够强度的RCT证据来支持儿童正畸和矫形治疗疗效的系统评价。建议推行临床试验透明化,实施临床试验注册制度和按照RCT报告的统一标准声明来严格规范RCT的报告。Objective To assess the evidences of Cochrane systematic reviews of orthodontic treatment for children and the methodological quality of all randomized and quasi-randomized controlled trigs （RCT/qRCT） of the included systematic reviews. Methods Issue 4, 2008 of the Cochrane Library was searched for systematic reviews on orthodontic treatments for children. All randomized or quasi_rafidomized controlled trigs of Cochrane systematic reviews of orthodontic treatment for children were evaluated. Results Four systematic reviews with twelve RCT were included. The included reviews were orthodontic and orthopaedic treatment for anterior open bite in children, oral appliances and functional orthopaedic appliances for obstructive sleep apnoea in children, orthodontic treatment for prominent upper front teeth in children and orthodontic treatment for deep bite and retroclined upper front teeth in children. The risk of bias was assessed independently by two authors using the criteria which were described in the Cochrane Handbook for Systematic Reviews of Interventions 5.0.0. The methods of 9 studies were rated of category C of the methodological quality with high risk of various bias. The methods of 2 studies were category A, and one study was category B. Conclusion Cochrane systematic reviews are received as the highest quality of research evidences. There is insufficient, consistent evidence to support orthodontic and orthopaedic treatment for children. Further high quality RCT need to be conducted. To improve the quality of RCT reporting, clinical trig registration and revised consolidated standards of reporting trig statement should be introduced into the trig design and strictly performed. Clinical evidence should be summarized in order to improve orthodontic treatment for children.

关 键 词：正畸 系统评价 随机对照试验 方法学 

分 类 号：R783.5[医药卫生—口腔医学]