髁突高位切除术治疗单侧髁突肥大患者偏颌畸形效果的系统性评价  

Systematic review of the effects of high condylectomy on improving facial deformity in patients with unilateral condylar hyperplasia

作　　者：赵可臻 常士平 张哲儒 宗春琳 马秦 田磊 ZHAO Kezhen;CHANG Shiping;ZHANG Zheru;ZONG Chunlin;MA Qin;TIAN Lei(State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shaanxi Clinical Research Center for Oral Diseases,Department of Cranio-facial Trauma and Orthognathic Surgery,The Third Hospital Affiliated of Air Force Military Medical University,710032 Xi'an,China;Department of ophthalmology and otorhinolaryngology,The People's Liberation Army Joint Logistic Support Force,Guiyang)

机构地区：[1]军事口腔医学国家重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病临床医学研究中心,空军军医大学第三附属医院颌面创伤正颌外科,西安710032 [2]中国人民解放军联勤保障部队第九二五医院五官科

出　　处：《实用口腔医学杂志》2023年第3期355-363,共9页Journal of Practical Stomatology

基　　金：陕西省自然科学基础研究计划(编号:2022JZ-50);军事口腔医学国家重点实验室自主课题研究项目(编号:2018ZA04);陕西省科技创新团队项目(编号:2021TD-46)。

摘　　要：目的:通过系统评价研究髁突高位切除术治疗单侧髁突肥大(UCH)导致偏颌畸形的治疗效果。方法:运用计算机网络检索Medline(Pubmed)、Embase、Corchane图书馆、WebofScience、中国生物医学文献数据库中关于髁突高位切除术治疗UCH的研究,检索时间限制在1985~2022年。使用纽卡斯尔-渥太华量表(NOS)和MINORS清单对纳入的文献进行质量评价。使用Corchane图书馆支持的ReviewManager5.1软件进行Meta分析。结果:经过有效文献分析后发现,髁突高位切除术是治疗UCH的一种有效治疗方式;髁突高位切除术与髁突比例切除术对避免患者进行二次正颌手术的效果差异无统计学意义(RR=2.37,95%CI:0.33-17.16,P>0.05);髁突高位切除术后患者进行正畸治疗对咬合关系改善的效果优于不进行正畸治疗(RR=0.05,95%CI:0.00-0.74,P<0.05)。结论:髁突高位切除手术是治疗UCH的一种有效方式,患者在术后需要行正畸治疗以改善咬合关系。Objective:To study the effects of high condylectomy on mandibular deformity caused by unilateral condylar hyperplasia(UCH)through systematic review.Methods:Medline(Pubmed),Embase,Corchane Library,Web of Science and the Chinese biomedical literature database(Sinomed)from 1985 to 2022 were retrieved about the study on the treatment of UCH by high condylectomy.Quality assessment of the included studies was performed using the newcastle-ottawa scale(NOS)and MINORS,Meta analysis was conducted using Review Manager 5.1 software supported by Cochrane Library.Results:After analysis of the included studies,high condylectomy was proved to be an effective treatment for patients with UCH.The high condylectomy and proportional condylectomy both provided obvious facial profile improvement so that avoiding second orthognathic surgery,and the difference of surgical effects showed no statistical significance(RR=2.37,95%CI:0.33-17.16,P>0.05).Patients underwent orthodontic treatment after high condylectomy aquired more improvement on occlusion than those without orthodontic treatment(RR=0.05,95%CI:0.00-0.74,P<0.05).Conclusion:High condylectomy is an effective treatment for patients with UCH.Postoperative orthodontic treatment is still necessary for patients to improve the occlusion.

关 键 词：髁突高位切除术 髁突比例切除术 正颌外科 单侧髁突肥大 系统性评价 META分析 

分 类 号：R782.2[医药卫生—口腔医学]