隐形矫治器远移成年患者上颌磨牙疗效的Meta分析

Meta-analysis of the efficacy of invisible orthodontic appliances for maxillary molar distalization in adult patients

摘要

目的 评价无托槽隐形矫治器远中移动成年患者上颌磨牙的临床疗效，以提高正畸医生对疗效的预估性。方法 检索Web of Science、The Cochrane Library、Embase、Pubmed、万方数据库、知网数据库、维普数据库公开发表的隐形矫治器远移成年患者上颌磨牙疗效的研究。检索时限为建库以来至2023年8月1日。共3名研究者进行文献筛选及质量评估，将满足质量标准的文献进行Meta分析。结果 本研究共纳入13个前后对照试验，总样本量281例。Meta分析结果显示，治疗后颌骨矢状向及垂直向指标与治疗前相比差异无统计学意义（P>0.05）；治疗后上颌第一磨牙远中移动量MD = -2.34，95%CI（-2.83，-1.85），压低移动量MD = -0.95，95%CI（-1.34，-0.56），远中倾斜量MD = -2.51，95%CI（-3.56，-1.46），与治疗前相比差异均有统计学意义（P<0.05）；治疗后上颌切牙平均内收距离MD = -0.82，95%CI（-1.54，-0.09），唇倾度减小MD = -1.61，95%CI（-2.86，-0.36)，与治疗前相比差异均有统计学意义（P<0.05）。结论 隐形矫治器能够有效远中移动上颌磨牙并控制磨牙垂直向位置，磨牙远移的同时伴有一定的压低及远中倾斜移动，对高角型患者有利。上颌切牙的矢状向内收有利于患者侧貌的改善。

Abstract

Objective To evaluate the clinical efficacy of invisible orthodontic appliances without brackets for the distal movement of maxillary molars to improve the ability of orthodontists to predict treatment outcomes. Methods Web of Science, Cochrane Library, Embase, PubMed, Wanfang Database, CNKI Database, and VIP Database were searched for studies investigating the efficacy of invisible orthodontic appliances for distal movement of maxillary molars in adult patients and published from database inception to August 1, 2023. A total of three researchers screened the studies and evaluated their quality and conducted a meta-analysis of those that met quality standards. Results This study included 13 pre- and postcontrol trials with a total sample size of 281 patients. The meta-analysis revealed no significant differences in the sagittal or vertical parameters of the jawbone after treatment when compared with those before treatment (P>0.05). The displacement of the first molar was MD=-2.34, 95% CI (-2.83, -1.85); the displacement was MD=-0.95, 95% CI (-1.34, -0.56); and the inclination was MD=-2.51, 95% CI (-3.56, -1.46). There was a statistically significant difference in the change in sagittal, vertical, and axial tilt of the first molar before and after treatment. After treatment, the average adduction distance of the incisors was MD=-0.82, 95% CI (-1.54, -0.09), and the decrease in lip inclination was MD=-1.61, 95% CI (-2.86, -0.36); these values were significantly different from those before treatment (P<0.05). Conclusion Invisible orthodontic appliances can effectively move the upper molars in a distal direction and control the vertical position of the molars. When the molars move further away, there is some degree of compression and distal tilt movement, which is beneficial for patients with high angles. The sagittal movement of incisors is beneficial for improving the patient's profile.

关键词

Meta分析 / 隐形矫治器 / 磨牙远移 / 正畸 / 错??畸形 / 安氏Ⅱ类 / 牙齿移动 / 切牙内收

Key words

Meta-analysis / invisible appliance / molar distalization / orthodontics / malocclusion / Angle ClassⅡ malocclusion / teeth movement / incisor adduction

Author summay

康芙嘉，住院医师，硕士，Email：[e-mail]