Twin-block矫治器治疗青少年下颌后缩畸形疗效的Meta分析  

META ANALYSIS OF TWIN-BLOCK REMOVABLE APPLIANCE IN TREATMENT OF MANDIBULAR RETROGNATHISM AMONG TEENAGERS

作　　者：刘卫华 李贵凤[2] 陈建伟[2] 胡海琨[2] 李钒[2] 邹淑娟[2] 

机构地区：[1]新疆伊宁农四师医院口腔科,伊宁835000 [2]四川大学华西口腔医院正畸科

出　　处：《现代预防医学》2010年第10期1821-1824,1831,共5页Modern Preventive Medicine

摘　　要：[目的]排除自然生长因素影响后,评价Twin-block功能矫治器治疗青少年下颌后缩错合畸形的有效性,从而更加真实、准确的评价该种矫治器的有效性。[方法]计算机检索中国期刊网全文数据库(CNKI1996-2010.3)、万方数据库(1996-2010.3)、中文科技期刊全文数据库(VIP1994-2010.3)、中国生物医学文献数据库(CBM1996-2010.3)、PubMed(1996-2010.3)、ScienceDirect(1996-2010.3),手工检索华西口腔医学杂志(1995-2010)等4种中文期刊,并辅以文献追溯的方法收集国内外学者15年内公开发表的有关Twin-block治疗效果的120篇文献。纳入Twin-block矫治器治疗青少年下颌后缩畸形的临床对照实验(RCT),对Twin-block矫治器用于混合牙列期的头影测量指标SNB、Overjet、Co-Gn、Ar-Go、Pog/OLp运用Meta分析进行综合定量分析,根据资料的异质性检验,均采用随机效应模型,计算WMD及其95%CI。[结果](1)共纳入10个RCT,652个受试者。(2)资料的异质性检验:头影测量指标SNB、Overjet、Co-Gn、Ar-Go、Pog/OLp异质性检验P值都小于0.05,具有异质性。(3)Meta分析结果SNB、Over-jet、Co-Gn、Ar-Go、Pog/OLp的合并WMD均不包括0,结果具有统计学意义,分别是1.43(1.23,1.64)、-2.83(-2.90,-2.76)、3.41(2.93,3.89)、2.29(1.77,2.81)、0.85(0.69,1.00)。[结论]Twin-block矫治器治疗青少年下颌后缩错合畸形能明显减小覆盖,促进下颌生长,使下颌总长度、下颌升支、下颌体长度增加。[Objective] To evaluate the effect of twin-block removable appliance in treatment of mandibular retrognathism among teenagers excluding the influence of natural growth, so that to objectively, actually and accurately reflect the treatment effect. [Methods] Several electronic databases were searched, including CNKI （1996-2010.3）, ChinInfo database （1996-2010.3）, VIP （1994-2010.3）, CBM （1996-2010.3）, PubMed （1996-2010.3） and ScienceDirect （1996-2010.3）. Four Chinese journals were hand searched for possible missing articles. Also, we used literature retrospective searching to collect 120 literatures published within 15 years regarding effect of Twin-block treatment. Randomized controlled trials （RCTs） on the efficacy of Twin-block appliance in mandibular retrousion adolescents without any surgical intervention or syndromic characteristics were considered. Meta-analysis was used to evaluate the effect of functional appliance used in the late mixed, or preadolescent dentition with cephalometric analysis such as SNB, Overjet, Co-Gn, Ar-Go and Pog/OLp According to Homogeneity test. Random effect model was used. Random effect model should be selected to calculate the total pooling WMD and its 95% confidence interval （95%CI）. [Results] ① Ten RCTs including 289 patients were identified. ② Homogeneity test showed that all factors （P≤0.05） were significant heterogeneity. ③Result of meta-analysis： the total pooled WMD value （95%CI） of SNB, Overjet, Co-Gn, Ar-Go and Pog/OLp were above 0, and were 1.43 （1.23, 1.64）, -2.83 （-2.90, -2.76）, 3.41 （2.93, 3.89） , 2.29 （1.77, 2.81） and 0.85 （0.69, 1.00） , respectively. All data showed significant statistical difference. [Conclusion] For mandibular retrousion adolescents, Twin-block appliance can effectively treat mandibular retrognathism among teenagers, and decrease overlap, improve growth of mandible, and increase the length and ascending limb of mandible.

关 键 词：TWIN-BLOCK 下颌后缩 META分析 

分 类 号：R783[医药卫生—口腔医学]