不同尺寸和材料的初始弓丝对正畸治疗中初始疼痛影响的系统评价与贝叶斯网状Meta分析  

Effects of initial archwires of different sizes and materials on initial pain during orthodontic treatment:a systematic review and Bayesian network meta-analysis

作　　者：魏志 刘畅 王艳[1] 赖文莉[1] Wei Zhi;Liu Chang;Wang Yan;Lai Wenli(State Key Laboratory of Oral Diseases&National Center for Stomatology&National Clinical Research Center for Oral Diseases&Dept.of Orthodontics,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病防治全国重点实验室、国家口腔医学中心、国家口腔疾病临床医学研究中心、四川大学华西口腔医院口腔正畸科,成都610041

出　　处：《国际口腔医学杂志》2025年第3期366-379,共14页International Journal of Stomatology

摘　　要：目的 评价不同尺寸和材料的初始弓丝对正畸治疗初始疼痛的影响。方法 对7个常用数据库对正畸弓丝与疼痛的文献进行电子检索,检索时间截至2023年10月1日;筛选出纳入文献并参照Cochrane推荐的偏倚风险评估表对纳入文献进行方法学质量评价和提取数据。应用R软件4.3.2 (调用JAGS 4.3.1)和GeMTC 0.14.3进行网状Meta分析。结果 最终纳入11篇文献,涉及632名患者,涉及10种干预措施。11篇文献中,3篇为低偏倚风险,1篇为高偏倚风险,7篇偏倚风险情况不清。Meta分析结果显示:1)初戴固定矫治器后1、2、7 d,10种弓丝引起患者疼痛的视觉模拟评分(VAS)两两之间的差异均无统计学意义(P>0.05);2)森林图结果显示热激活镍钛弓丝(HANT)疼痛程度低于超弹镍钛弓丝(P<0.05);3)排秩概率图分析表明正畸疼痛最轻的弓丝最有可能是0.012英寸(0.305 mm) HANT。结论 10种不同尺寸和材料的初始弓丝对正畸疼痛上的差异无统计学意义,0.012英寸HANT可能是正畸治疗初始疼痛最轻的初始弓丝。Objective The effects of variations in the size and materials of initial archwires on initial pain during ortho-dontic treatment were explored.Methods Seven commonly used databases were searched from inception to October 1,2023 for publications related to orthodontic archwires and pain.Relevant literature was selected on the basis of inclusion criteria.Moreover,the methodological quality of the included studies was assessed using the risk of bias assessment tool for the nonrandomized studies of interventions recommended by Cochrane,and data were extracted accordingly.Net‐work meta-analysis was performed using R software 4.3.2(calling JAGS 4.3.1)and GeMTC 0.14.3 software.Results A total of 11 studies involving 632 patients and 10 intervention measures were included.Among the 11 studies,three had low risk of bias,one had high risk of bias,and seven had unclear bias risk.One,two,and seven days after the initial place‐ment of fixed orthodontic appliances,no statistically significant difference in the visual analog scale(VAS)scores of pain was found between any two of the 10 archwires.However,forest plots results show that the pain level of heat-activated nickel-titanium archwires(HANT)is lower than that of superelastic nickel-titanium archwires(P<0.05),and rank proba‐bility plot analysis indicated that the material with the smallest VAS score was most likely the 0.012-inch(0.305 mm)HANT.Conclusion No difference in orthodontic pain intensity was found among the 10 initial archwires of different sizes and materials,and using the 0.012-inch HANT archwire as the initial archwire during fixed ortho-dontic treatment may cause the least amount of initial pain.

关 键 词：正畸弓丝 疼痛 系统评价 视觉模拟评分 

分 类 号：R783.5[医药卫生—口腔医学]