Meta-analysis of the efficacy of bone anchorage and maxillary facemask protraction devices in treating skeletal class Ⅲ malocclusion in adolescents

doi:10.7518/hxkq.2020.01.012

Abstract

Abstract:

Objective To assess the efficacy of bone anchorage and maxillary facemask protraction devices in treating skeletal class Ⅲ malocclusion in adolescents. Methods Articles relating to the use of bone anchorage and maxillary facemask protraction devices for treating skeletal class Ⅲ malocclusion in adolescents were searched from the databases of Cochrane Library, PubMed, EmBase, CNKI, and Wanfang database. Several inclusion and exclusion criteria were developed for the article screening. The clinical data were extracted, and the quality of the selected articles was evaluated. A Meta-analysis of SNA, SNB, ANB, ANS-Me, Wits, and U1-PP change was performed by using RevMan 5.3. Results Seven studies (264 patients) were included in the Meta-analysis. Among these studies, three were randomized controlled trials, and four were non-randomized controlled trials. Compared with the maxillary facemask protraction device group, the bone anchorage device group had higher SNA changes and lower ANS-Me, Wits, and U1-PP changes (P<0.05). No significant differences were observed in the SNB and ANB changes between these two groups. Conclusion Compared with the maxillary facemask protraction device, the bone anchorage device can increase the extent of protraction of the maxilla and has better controls for the labial inclination of the maxillary anterior teeth in treating skeletal class Ⅲ malocclusion among adolescents. However, additional high-quality randomized controlled trials must be performed to verify the results.

Key words: bone anchorage, protraction, adolescents, skeletal class Ⅲ malocclusion, Meta-analysis

CLC Number:

R783.5

Shi Hui,Ge Hongshan,Chen Luyi,Li Zhihua. Meta-analysis of the efficacy of bone anchorage and maxillary facemask protraction devices in treating skeletal class Ⅲ malocclusion in adolescents[J]. West China Journal of Stomatology, 2020, 38(1): 69-74.

Figures/Tables 7

Tab 1

Fig 1

Fig 2

Fig 3

Fig 4

Fig 5

Fig 6

References 29

[1]	Liou EJ . Effective maxillary orthopedic protraction for growing Class Ⅲ patients: a clinical application simulates distraction osteogenesis[J]. Prog Orthod, 2005,6(2):154-171.
[2]	Ellis E 3rd, McNamara JA Jr . Components of adult Class Ⅲ malocclusion[J]. J Oral Maxillofac Surg, 1984,42(5):295-305.
[3]	徐宝华 . 骨性前牙反颌的前方牵引治疗[J]. 口腔正畸学, 2001,8(3):133-135.
	Xu BH . The orthopedic treatment of skeletal class Ⅲ malocclusion with maxillary protraction therapy[J]. Chin J Orthod, 2001,8(3):133-135.
[4]	庄金良, 李勋, 姜雨君 , 等. 应用Coben分析法评价前方牵引治疗上颌发育不足的临床疗效[J]. 华西口腔医学杂志, 2015,33(1):58-62.
	Zhuang JL, Li X, Jiang YJ , et al. Using Coben analysis to evaluate the therapeutic effect of maxillary protraction on maxillary maldevelopment[J]. West China J Stomatol, 2015,33(1):58-62.
[5]	De Clerck HJ, Proffit WR . Growth modification of the face: a current perspective with emphasis on Class Ⅲ treatment[J]. Am J Orthod Dentofac Orthop, 2015,148(1):37-46.
[6]	Cevidanes L, Baccetti T, Franchi L , et al. Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion[J]. Angle Orthod, 2010,80(5):799-806.
[7]	Ngan P, Wilmes B, Drescher D , et al. Comparison of two maxillary protraction protocols: tooth-borne versus bone-anchored protraction facemask treatment[J]. Prog Orthod, 2015,16:26.
[8]	Rodríguez de Guzmán-Barrera J, Sáez Martínez C, Boronat-Catalá M , et al. Effectiveness of interceptive treatment of class Ⅲ malocclusions with skeletal anchorage: a systematic review and Meta-analysis[J]. PLoS One, 2017,12(3):e0173875.
[9]	Bozkaya E, Yüksel AS, Bozkaya S . Zygomatic miniplates for skeletal anchorage in orthopedic correction of Class Ⅲ malocclusion: a controlled clinical trial[J]. Korean J Orthod, 2017,47(2):118-129.
[10]	Hong H, Ngan P, Han GL , et al. Use of onplants as stable anchorage for facemask treatment: a case report[J]. Angle Orthod, 2005,75(3):453-460.
[11]	Jamilian A, Showkatbakhsh R . Treatment of maxillary deficiency by miniscrew implants—a case report[J]. J Orthod, 2010,37(1):56-61.
[12]	王晓誉, 贺佳 . 骨种植钉上颌前牵引和支架上颌牵引的比较研究[J]. 齐齐哈尔医学院学报, 2014,35(24):3600-3601.
	Wang XY, He J . Comparison of two protocols for maxillary protraction: bone anchors versus face mask[J]. J Qiqihar Univ Med, 2014,35(24):3600-3601.
[13]	亢静, 彭明慧 . 种植支抗前牵引矫治儿童骨性Ⅲ类错颌后硬软组织变化的临床研究[J]. 实用口腔医学杂志, 2017,33(3):349-353.
	Kang J, Peng MH . Analysis of the profile esthetics of children with skeletal class Ⅲ malocclusion treated with micro-implant[J]. J Pract Stomatol, 2017,33(3):349-353.
[14]	李建华, 封小霞, 杨璞 . 骨支抗前牵引的研究进展[J]. 国际口腔医学杂志, 2013,40(3):416-418.
	Li JH, Feng XX, Yang P . Research progress on the bone-anchored maxillary protraction[J]. Int J Stomatol, 2013,40(3):416-418.
[15]	孟耀, 刘进, 郭鑫 , 等. 骨种植钉前牵引对骨性Ⅲ类错颌患者软硬组织侧貌的影响[J]. 华西口腔医学杂志, 2012,30(3):278-282.
	Meng Y, Liu J, Guo X , et al. Soft and hard tissue changes after maxillary protraction with skeletal anchorage implant in treatment of Class Ⅲ malocclusion[J]. West China J Stomatol, 2012,30(3):278-282.
[16]	Meyns J, Brasil DM, Mazzi-Chaves JF , et al. The clinical outcome of skeletal anchorage in interceptive treatment (in growing patients) for class Ⅲ malocclusion[J]. Int J Oral Maxillofac Surg, 2018, 47(8): 1003-1010.
[17]	Baccetti T, McGill JS, Franchi L , et al. Skeletal effects of early treatment of Class Ⅲ malocclusion with maxillary expansion and face-mask therapy[J]. Am J Orthod Dentofac Orthop, 1998,113(3):333-343.
[18]	Obrador GT, Villa AR, Olvera N , et al. Longitudinal analysis of participants in the KEEP Mexico’s chronic kidney disease screening program[J]. Arch Med Res, 2013,44(8):650-654.
[19]	Stang A . Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in Meta-analyses[J]. Eur J Epidemiol, 2010,25(9):603-605.
[20]	Aglarci C, Esenlik E, Findik Y . Comparison of short-term effects between face mask and skeletal anchorage therapy with intermaxillary elastics in patients with maxillary retrognathia[J]. Eur J Orthod, 2016,38(3):313-323.
[21]	Jamilian A, Haraji A, Showkatbakhsh R , et al. The effects of miniscrew with Class Ⅲ traction in growing patients with maxillary deficiency[J]. Int J Orthod Milwaukee, 2011,22(2):25-30.
[22]	Ge YS, Liu J, Chen L , et al. Dentofacial effects of two facemask therapies for maxillary protraction[J]. Angle Orthod, 2012,82(6):1083-1091.
[23]	Lee NK, Yang IH, Baek SH . The short-term treatment effects of face mask therapy in Class Ⅲ patients based on the anchorage device: miniplates vs rapid maxillary expansion[J]. Angle Orthod, 2012,82(5):846-852.
[24]	Sar C, Arman-Özçırpıcı A, Uçkan S , et al. Comparative evaluation of maxillary protraction with or without skeletal anchorage[J]. Am J Orthod Dentofac Orthop, 2011,139(5):636-649.
[25]	赵志河, 赵美英 . 上颌复合体及上颌牙弓阻力中心位置的研究[J]. 口腔正畸学, 1994,1(1):25-26.
	Zhao ZH, Zhao MY . The study of maxillary complex and the position of maxillary arch resistance center[J]. Chin J Orthod, 1994,1(1):25-26.
[26]	周彦恒, 丁鹏, 林野 , 等. 钛板种植体上颌前方牵引治疗的初步应用研究[J]. 口腔正畸学, 2007,14(3):102-105.
	Zhou YH, Ding P, Lin Y , et al. Preliminary study on miniplate implant anchorage for maxillary protraction[J]. Chin J Orthod, 2007,14(3):102-105.
[27]	Mermigos J, Full CA, Andreasen G . Protraction of the maxillofacial complex[J]. Am J Orthod Dentofac Orthop, 1990,98(1):47-55.
[28]	Saadia M, Torres E . Sagittal changes after maxillary protraction with expansion in class Ⅲ patients in the primary, mixed, and late mixed dentitions: a longitudinal retrospective study[J]. Am J Orthod Dentofac Orthop, 2000,117(6):669-680.
[29]	Takada K, Petdachai S, Sakuda M . Changes in dentofacial morphology in skeletal Class Ⅲ children treated by a modified maxillary protraction headgear and a chin cup: a longitudinal cephalometric appraisal[J]. Eur J Orthod, 1993,15(3):211-221.

作者及发表年	样本量		年龄/岁		性别（男/女）		结局指标	研究设计方案
作者及发表年	骨支抗组	传统方法组	骨支抗组	传统方法组	骨支抗组	传统方法组	结局指标	研究设计方案
Aglarci 2016^[20]	25	25	11.75±1.23	11.21±1.32	12/13	12/13	A、B、C、D、E、F	随机对照试验
Jamilian 2011^[21]	10	10	11.3±0.8	10.5±1.5	5/5	3/7	A、B、C、F	随机对照试验
Cevidanes 2010^[6]	21	34	11.83±1.83	8.25±1.83	10/11	14/20	D、E、F	病例对照试验,回顾性
Ge 2012^[22]	25	24	10.33	10.5	11/14	12/12	A、B、C、E	随机对照试验
Lee 2012^[23]	10	10	11.2±1.2	10.7±1.3	5/5	6/4	A、B、C、E	病例对照试验,回顾性
Ngan 2015^[7]	20	20	9.8±1.2	9.7±16	8/12	8/12	A、B、C、E	病例对照试验,回顾性
Sar 2011^[24]	15	15	10.91	10.31	10/5	8/7	A、B、C、D、E、F	病例对照试验,回顾性