双期和单期矫治Ⅱ类错骀儿童临床随机对照试验的系统评价

A systematic review of RCTs comparing one-phase and two-phase treatments for classⅡ maloclusion in children

目的 对于Ⅱ类错[牙合]儿童，采用双期或者单期矫治仍然存在争议，有必要对比较这两种治疗方案疗效的临床随机对照试验进行系统评价。资料来源 我们搜索了MEDLINE和Cochrane中心注册资料库所收录发表的临床随机对照试验，不设发表语言限制，并且检索了所有相关文章的参考文献。评价方法 本文最终收录了两篇临床随机对照试验，包括451个患者。对其方法学质量进行了评价，用头影测量、PAR指数、拔牙率和外科手术率指标衡量结果。由于资料不充分，没有做Meta分析，对结果进行描述总结。结果 对于Ⅱ类错胎的青春期儿童，两个临床随机对照试验都没有显示双期矫治优于单期矫治的疗效。结论 尚缺乏比较儿童Ⅱ类错胎双期和单期治疗并全面报告其相关临床结果的随机对照试验研究。现有的证据表明双期矫治相比较于单期矫治疗效没有差异。需要更多的临床随机对照试验来指导临床决策。

Objective To evaluate the efficacy of one-phase and two-phase treatments in patients with Class Ⅱ malocclusion. Data sources We searched MEDLINE and Cochrane Central Register for Controlled Trials for randomized controlled trials published in any language. References in retrieved articles were also examined for potentially relevant studies. Review methods Sixty-eight articles were retrieved and analyzed from 501 abstracts screened. Only two studies with a total of 451 patients met our inclusion criteria and reported desired outcomes of interest. We critically appraised the methodological quality of the studies and assessed the following outcomes： cephalometirc measures, Peer Assessment Rating（PAR） scores, orthognathic surgery and extraction rates. Meta-analysis was not possible due to the paucity and heterogeneity of the data. Results There was no significant difference between the one-phase and two-phase groups for all the results. Conclusions Sound evidence on the two-phase treatment of Class Ⅱ malocclusion is sparse. Evidence suggests that there is no difference between two-phase treatment and one-phase treatment. More randomized controlled trials and better analyses are needed.