华西口腔医学杂志 ›› 2023, Vol. 41 ›› Issue (4): 463-470.doi: 10.7518/hxkq.2023.2023052

• 系统评价专栏 • 上一篇    下一篇

Twin-block矫治器对安氏类错患者髁突影响的Meta分析

李雨霖(), 徐静晨, 蒋晓鸽, 陈嵩()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院正畸科,成都 610041
  • 收稿日期:2023-02-15 修回日期:2023-05-30 出版日期:2023-08-01 发布日期:2023-07-21
  • 通讯作者: 陈嵩 E-mail:754536457@qq.com;songchen882002@hotmail.com
  • 作者简介:李雨霖,硕士,E-mail:754536457@qq.com
  • 基金资助:
    四川省科技厅重点研发项目(2022YFS0127)

Meta-analysis of condylar changes produced by a Twin-block appliance in Class Ⅱ malocclusion

Li Yulin(), Xu Jingchen, Jiang Xiaoge, Chen Song.()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2023-02-15 Revised:2023-05-30 Online:2023-08-01 Published:2023-07-21
  • Contact: Chen Song. E-mail:754536457@qq.com;songchen882002@hotmail.com
  • Supported by:
    The Key Program of the Sichuan Science and Technology Department(2022YFS0127);Correspondence: Chen Song, E-mail: songchen882002@hotmail.com

摘要:

目的 评价Twin-block矫治器对安氏Ⅱ类错患者髁突生长改建及位置的影响。 方法 计算机检索Pubmed、Embase、Cochrane library、中国生物医学文献数据库(CBM),中国知网(CNKI)、维普(VIP)等数据库,纳入所有应用Twin-block矫治器治疗安氏Ⅱ类错畸形患者并对其髁突进行评估的随机对照试验、临床对照试验及单臂临床试验。2位评价者独立纳入文献、进行偏倚风险评估并提取数据,运用Revman 5.3软件进行统计分析。 结果 最终纳入文献8篇,共8项研究,其中7项为高质量研究。Meta分析结果显示:Twin-block矫治后,髁突向前移位,关节前间隙减小(P<0.000 01),关节后间隙增大(P<0.000 01),而关节上间隙未发现具有统计学意义的改变(P=0.11);关节间隙指数的增大具有统计学意义(P<0.000 01)。治疗后髁突前后径增大(P=0.000 2),髁突高度增大(P<0.000 01),而髁突内外径的增大不具有统计学意义(P=0.42)。 结论 Twin-block矫治器能够促进髁突向后上方的生长改建,并引导其向前移位从而使髁突-关节盘重新定位,达到良好的下颌位置并改善安氏Ⅱ类咬合关系。

关键词: Twin-block矫治器, 安氏Ⅱ类错𬌗畸形, 髁突, 系统评价, Meta分析

Abstract:

Objective To evaluate the effects of a Twin-block appliance on the condyles of patients with ClassⅡmalocclusion by conducting a systematic review and a Meta-analysis. Methods Pubmed, Embase, Cochrane Library, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, and VIP Database were electronically searched. Randomized controlled trials, controlled clinical trials, and single-arm trials on condylar changes produced by a Twin-block appliance in patients with ClassⅡmalocclusion were included. Two reviewers independently extracted and assessed the risk of bias. Meta-analyses were conducted with Review Manager 5.3. Results Eight studies were included; among which, seven were of high quality. After treatment with a twin block appliance, condyles moved anteriorly. The anterior joint spaces decreased (P<0.000 01), whereas the posterior spaces increased (P<0.000 01). The superior spaces were not changed (P=0.11). Moreover, a significant difference was observed in the increase of the condylar space index (P<0.000 01). After treatment, the anteroposterior diameters of the condyles and condylar height increased (P=0.000 2 and P<0.000 01, respectively). By contrast, no significant changes were discovered in the medial external diameters of the condyles (P=0.42). Conclusion A Twin-block appliance can promote the growth of a condyle in the posterior and upper direction and move it forward in favor of the correction of Class Ⅱ malocclusion.

Key words: Twin-block appliance, Class Ⅱ malocclusion, condyle, systematic review, Meta-analysis

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