隐形功能矫治器对比传统功能矫治器前导下颌治疗骨性Ⅱ类错畸形患者疗效的meta分析

doi:10.7518/hxkq.2023.2022453

摘要/Abstract

摘要：

目的以传统功能矫治器为对照，对隐形功能矫治器治疗骨性Ⅱ类错畸形的疗效进行meta分析。方法电子检索PubMed、Web of Science、Embase、Cochrane Library、中国生物医学文摘数据库、中国知网数据库、万方数据库、维普数据库。2组研究者按照PICOS条目制定的纳入、排除标准，筛查文献、提取数据，并使用ROBINS-I进行质量评价。采用Revman 5.4和Stata 17.0软件进行meta分析。结果共纳入9个临床对照试验，总样本量283例。隐形矫治器与功能矫治器在治疗骨性Ⅱ类错畸形患者时，SNA、SNB、ANB、下颌体长度、上前牙角度、覆盖等方面差异无统计学意义；两组间下颌平面角变化存在0.90°的差异；对照组下颌支生长量比隐形组多1.10 mm；隐形组下牙唇倾度比对照组少1.94°。结论隐形组在前导下颌时能更好地控制下颌前牙的唇倾度，下颌平面角基本保持不变，下颌升支的生长量不如对照组，临床中应当采用辅助措施进行改进。

关键词: 骨性Ⅱ类错畸形, 前导下颌, 隐形矫治器, 功能矫治器, meta分析

Abstract:

Objective This study aimed to conduct a meta-analysis of the efficacy of mandibular advance clear alig-ners with traditional functional appliances as the control group. Methods PubMed, Web of Science, Embase, Cochrane Library, China Biomedical Abstracts Database, China Knowledge Network Database, Wanfang Database, and Weipu Database were used in this study. The two groups of researchers screened the literature and extracted data based on the inclusion and exclusion criteria established by PICOS entries, and used the ROBINS-I scale for quality evaluation. Revman 5.4 and Stata 17.0 software were used for meta-analysis. Results Nine clinical controlled trials were included in this study with a total sample size of 283 cases. No significant difference was found in SNA, SNB, ANB, Go-Pog, U1-SN, Overjet, and other aspects between the invisible group and the traditional group in the treatment of skeletal class Ⅱ ma-locclusion patients; there was a 0.90° difference in mandibular plane angle between the two groups; the growth of the mandibular ramus (Co-Go) in the traditional group was 1.10 mm more than that in the invisible group; the lip inclination of the lower teeth in the invisible group was better controlled, 1.94° less than that in the control group. Conclusion The invisible group can better control the lip inclination of the mandibular anterior teeth when guiding the mandible. Furthermore, the mandibular plane angle (MP-SN) can remain unchanged, but the growth of the mandibular ramus is not as good as the traditional group, and auxiliary measures should be taken to improve it in clinical practice.

Key words: skeletal ClassⅡmalocclusion, mandi-bular advancement, clear aligners, functional ortho-dontic appliances, meta-analysis

中图分类号:

R 783.5

余磊, 李紫薇, 康芙嘉, 王宋庆, 谢尊玄, 朱宪春. 隐形功能矫治器对比传统功能矫治器前导下颌治疗骨性Ⅱ类错畸形患者疗效的meta分析[J]. 华西口腔医学杂志, 2023, 41(3): 305-314.

Yu Lei, Li Ziwei, Kang Fujia, Wang Songqing, Xie Zunxuan, Zhu Xianchun.. Mandibular advancement with clear aligners and functional appliances in the treatment of skeletal ClassⅡmalocclusion: a systematic review and meta-analysis[J]. West China Journal of Stomatology, 2023, 41(3): 305-314.

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参考文献 34

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作者	研究类型	平均年龄/岁	治疗时间/月	样本量	干预（对照）措施	结局指标	质量评价
陈雅莉^[14]	CCT	T：10.26±1.10 C：11.12±1.45	10.97±1.01 11.57±0.70	7M/8F 9M/6F	隐适美MA Twin-block矫治器	SNA、SNB、ANB、SN/MP、L1-MP、U1-SN、Co-Go、Go-Pog	低风险
杜雨乐等^[15]	CCT	T：12.6 C：13.1	- -	7M/4F 5M/6F	隐适美MA Twin-block矫治器	SNA、SNB、ANB、FH/MP、L1-NB、U1-SN、Co-Go、Go-Pog、OJ	中风险
孟耀等^[16]	CCT	T：10-12 C：10-12	- -	10 10	隐适美MA Twin-block矫治器	SNA、SNB、ANB、FH/MP、L1-NB、U1-NA	中风险
Caruso等^[17]	CCT	T：10±1.05 C：10±1.05	- -	5M/5F 5M/5F	隐适美MA Twin-block矫治器	SNA、SNB、ANB、FH/MP、L1-GoMe、U1-ANSPNS	中风险
杜欣^[18]	CCT	T：10-14 C：10-14	- -	7M/7F 8M/7F	隐适美MA Twin-block矫治器	SNA、SNB、ANB、SN/Pg-MC、Ar-Go、Go-Gn、OJ	中风险
李阳等^[19]	CCT	T：12.1±0.9 C：11.6±1.2	≥8.7 6~9	6M/4F 8M/4F	隐适美MA Forsus矫治器	SNA、SNB、ANB、SN/MP、L1-MP、U1-SN、OJ	中风险
刘潇等^[20]	CCT	T：11.0±1.0 C：11.0±1.0	- -	17M/13F 15M/15F	隐适美MA Twin-block矫治器	SNA、SNB、ANB、SN/GoGn、U1-SN、OJ	中风险
吕亮^[21]	CCT	T：11.33±1.49 C：11.31±1.25	17.92±4.27 17.00±7.23	5M/7F 9M/10F	隐适美MA Twin-block矫治器	SNA、SNB、ANB、SN/GoGn、L1-GoGn、U1-SN、Go-Me、OJ	低风险
于晓艺等^[22]	CCT	T：11.5 C：11.1	11.1 10.9	8M/13F 18M/10F	时代天使A6 Twin-block矫治器	SNA、SNB、ANB、SN/MP、L1-MP、U1-SN、Ar-Go、Go-Gn、OJ	低风险

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