牙槽骨微穿孔术加速正畸牙移动的有效性和安全性:系统评价和Meta分析  

Effectiveness and safety of micro-osteoperforation in the acceleration of orthodontic tooth movement:a systematic review and Meta-analysis

作　　者：张慧玲 赵婷婷 熊晖[1] Zhang Huiling;Zhao Tingting;Xiong Hui(School of Stomatology Wuhan University,Wuhan 430070,China;Department of Orthodontics,Hospital of Stomatology Wuhan University,Wuhan 430070,China)

机构地区：[1]武汉大学口腔医学院,武汉430070 [2]武汉大学口腔医院正畸一科,武汉430070

出　　处：《中华口腔正畸学杂志》2024年第4期188-196,共9页Chinese Journal of Orthodontics

摘　　要：目的通过系统综述和Meta分析评价牙槽骨微穿孔术加速正畸牙齿移动的临床疗效和安全性。方法检索9个中英文数据库筛选出有关牙槽骨微穿孔术(micro-osteoperforation,MOP)辅助正畸的随机对照研究,对纳入的研究结果进行定量和定性分析。定量分析采用RevMan 5.3软件,结局指标均为连续型变量,以标准化均差值(standardized mean difference,SMD)作为效应指标,P<0.05为差异有统计学意义。结果共纳入36项研究,其中22项研究尖牙远移,6项研究整体内收关间隙,5项研究前牙排齐,3项研究磨牙矢状向移动,其中19项研究同时报道了相关不良反应。结果显示:MOP辅助正畸能显著提高牙齿移动速率(上尖牙远移:SMD 1mo=1.47,SMD 2mo=0.85,SMD 3mo=0.76,P<0.05;整体内收:SMD=1.20,P<0.05;前牙排齐:SMD=-2.89,P<0.05;磨牙移动:SMD=1.11,P<0.05)。不良反应方面,MOP组的支抗丧失量显著降低(SMD=-0.72,Z=3.12,P<0.05),而牙根长度损失(SMD=0.01,P>0.05)、疼痛评分(SMD day0=0.45,SMD day1=0.46,P>0.05)、牙周状况及不良牙移动和对照组间无显著差异。结论MOP辅助正畸治疗短期内能加速牙齿移动,目前没有证据显示会加重疼痛、支抗丧失、牙根吸收和牙周等不良反应。Objective To evaluate the clinical effects and safety of micro-osteoperforation(MOP)in accelerating orthodontic tooth movement.Methods A comprehensive and rigorous literature search was conducted in nine databases to select randomized controlled trials which assessed the efficiency of MOP in accelerating tooth movement.Quantitative and qualitative analyses were performed on the results of the included studies.Results A total of 36 studies were included:Twenty-two studies evaluating the rate of canine distalization,6 studies examing the rate of en-masse retraction,5 studies assessing the anterior tooth alignment,3 studies calculating the rate of molar sagittal movement,and 19 studies considered complication.The Meta-analysis showed a statistically significant difference between the MOP and control groups in canine distalization(SMD 1mo=1.47,SMD 2mo=0.85,SMD 3mo=0.76,P<0.05),en-masse retraction(SMD=1.20,P<0.05),treatment time of anterior tooth alignment(SMD=-2.89,P<0.05)and molar movement(SMD=1.11,P<0.05).Additionally,MOP significantly reduced anchorage loss(SMD=-0.72,P<0.05),but did not increase the risk of root resorption(SMD=0.01,P>0.05),pain(SMD day0=0.45,SMD day1=0.46,P>0.05)and periodontal involvement.Conclusions MOP can accelerate tooth movement in the short term,and,importantly,does not exacerbate adverse reactions such as pain,anchorage loss,root resorption and periodontal involvement.

关 键 词：微穿孔术 加速正畸牙移动 系统评价 META分析 

分 类 号：R783.5[医药卫生—口腔医学]