压膜保持器与Hawley保持器正畸保持效果的系统评价  

Clinical Effectiveness of Vacuum-Formed versus Hawley Retainers:A Systematic Review

作　　者：焦鑫[1,2] 田金徽[1] 杨克虎[1] 葛振林[2] 

机构地区：[1]兰州大学循证医学中心,兰州730000 [2]兰州大学口腔医学院,兰州730000

出　　处：《中国循证医学杂志》2012年第5期596-601,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价在正畸治疗保持期,压膜保持器与Hawley保持器的临床保持效果。方法计算机检索PubMed、Cochrane Library、EMbase、CBM、CNKI、VIP和WanFang Data中比较压膜保持器与Hawley保持器正畸保持效果的随机对照试验,检索时限均从建库至2011年12月31日。由两位研究者独立评价纳入研究的质量并提取资料后,采用RevMan 5.1.4软件进行Meta分析。结果最终纳入6个研究,共935例患者。Meta分析结果显示,压膜保持器与Hawley保持器相比,两者在上颌前牙不整齐指数变化[MD=0.13,95%CI(0.04,0.21)]和下颌前牙不整齐指数变化[MD=0.29,95%CI(0.24,0.33)]方面的差异有统计学意义,而在上颌尖牙间宽度变化[MD=–0.01,95%CI(–0.03,0.01)]、下颌尖牙间宽度变化[MD=0.04,95%CI(–0.02,0.10)]、上颌第一磨牙间宽度变化[MD=–0.01,95%CI(–0.03,0.00)]和下颌第一磨牙间宽度变化[MD=–0.02,95%CI(–0.08,0.04)]方面的差异无统计学意义。定性分析结果与Meta分析结果一致,且两种保持器在覆和覆盖变化方面差异无统计学意义。结论在正畸治疗保持期,压膜保持器保持上下颌前牙位置比Hawley保持器更有效,而在其他方面,两种保持器疗效相当。由于纳入的原始研究质量均偏低且观察指标不全面,以上结论还需更多高质量临床随机对照试验加以证实。Objective To assess the clinical effectiveness of vacuum-formed versus Hawley retainers in the period of retention.Methods PubMed,The Cochrane Library,EMbase,CBM,CNKI,VIP,and WanFang Data were searched from the date of their establishment to December 31,2011,to collect the randomized controlled trials（RCTs） about the clinical effectiveness of vacuum-formed versus Hawley retainers.The quality of the included studies was evaluated by two reviewers independently,and meta-analysis was performed by using RevMan 5.1.4 software.Results Six RCTs including 935 patients were identified.The results of meta-analyses showed significantly fewer changes in irregularity of the maxillary incisors（MD=0.13,95%CI 0.04 to 0.21） and mandibular incisors（MD=0.29,95%CI 0.24 to 0.33） in the vacuum-formed group than in the Hawley group.There were no significant differences between the two groups in maxillary intercanine width（MD=–0.01,95%CI –0.03 to 0.01）,mandibular intercanine width（MD=0.04,95%CI –0.02 to 0.10）,maxillary intermolar width（MD=–0.01,95%CI –0.03 to 0.00） and mandibular intermolar width（MD=–0.02,95%CI –0.08 to 0.04）.The results of qualitative analysis were consistent with the results of meta-analysis and there were no significant differences in overjet and overbite.Conclusion Vacuum-formed retainers are more effective than Hawley retainers at maintaining position of incisors in the period of retention.In other aspects,they are similar.In consideration of the factors such as the limited quality and incomplete measure index of primary studies,RCTs of higher methodological quality are needed.

关 键 词：正畸治疗 压膜保持器 HAWLEY保持器 系统评价 META分析 随机对照试验 

分 类 号：R783.5[医药卫生—口腔医学]