比较种植体支抗和J钩临床效果的Meta分析

Clinical effects of implant anchorage versus J-hook headgear:A Meta-analysis

背景:正畸治疗常用的有面弓形口外弓和J钩,两者都能很好地增强支抗,但临床效果可能有差异。目的:比较种植体支抗和J钩在临床治疗效果及牙根吸收方面的差异。方法:计算机检索PubMed(1950-01/2010-08)、Embase(1966-01/2010-08)、Cochrane library(2010年第2期)、中文科技期刊数据库(VIP)(1989-01/2010-08)、中国生物医学文献数据库(CBM)(1978-01/2010-08)、中国期刊全文数据库(CNKI)(1979-01/2010-08)。手工检索并辅以文章追溯的方法收集国内、国外学者10年内公开发表的有关比较种植体支抗和J钩效果的文献。运用Meta分析对头影测量结果进行定量分析。采用RevMan5.0版统计软件进行统计分析。采用卡方检验对纳入研究进行异质性检验。采用固定效应模型及随机效应模型,计算合并加权均数差及其95%CI。结果及结论:共纳入4篇文献,87例受试者。Meta分析结果显示:种植体组比J钩组在覆合、覆盖减少量和上中切牙切缘至腭平面的垂直距离减少量3项指标变化上差异有显著性意义。单个研究结果:相对于J钩,种植支抗引起牙根吸收量较少,结果有显著性差异。在支抗控制方面,种植体支抗可以很好的替代J钩。但是尚需要更多高质量,大样本的RCT进一步验证两者的差异。

BACKGROUND：Implant anchorage and J-hook are commonly used in orthodontic treatment,both of which can enhance the anchorage,but the effects of them may be different.OBJECTIVE：To compare the differences of implant anchorage and J-hook headgear between clinical therapeutic efficacy and root adsorption.METHODS：PubMed database （1950-01/2010-08）,Embase （1966-01/2010-08）,Cochrane library （the second phase,2010）,VIP database （1989-2010-08）,CBM database （1978-01-2010-08）,CNKI database （1979-01-2010-08） was retrieved by computer.Literatures addressing implant anchorage and J-hook headgear effect published in 10 years by domestic and foreign scholars were collected with manual research and supplemented with the article retrospective approach.Cephalometric measurements were quantitatively analyzed by Meta analysis.Revman 5.0 was used for data management.Chi-square test was used to undergo homogeneity test of included studies.Fixed effect model and random effect model were adopted to calculate weighted mean difference （MD） and 95% confidence interval （95% CI）.RESULTS AND CONCLUSION：A total of 4 literatures were included,87 cases of objects.Meta analysis demonstrated that there were significant differences among overbite decrement,overjet decrement,and the vertical distance of upper central incisor cutting to palatal plane （PP） decrement in index changes.Individual results showed that compared to J-hook headgear,the reduction of root adsorption was caused by implant anchorage;there were significant differences in results.In terms of anchorage control,implant anchorage is a good alternative to J-hook headgear.However,it still needs more high quality RCT of large sample to further verify the differences between implant anchorage and J-hook headgear.