低强度激光促进正畸牙移动的Meta分析和系统评价

Low-level laser therapy for accelerating orthodontic tooth movement: a Meta-analysis and systematic review

目的评价低强度激光治疗(low-level laser therapy,LLLT)促进正畸牙移动的有效性及相关风险。方法依据Cochrane Handbook的规范化要求,检索1980年-2014年Medline、Pub Med等数据库,运用ReviewManager 5.1软件进行Meta分析。结果共纳入6个国家6篇随机对照试验,3篇不完全随机对照试验,211名患者。偏倚风险评价显示5个研究为中度偏倚风险,4个研究为高度偏倚风险。Meta分析结果显示:与对照组相比,LLLT组治疗后7 d,正畸牙移动速度显著增加(MD=0.19,95%CI 0.02-0.37,P=0.03),该优势持续到治疗后2个月(MD=1.08,95%CI 0.16-2.01,P=0.02);相对于高能量密度(20或25 J/cm2)的LLLT治疗,低能量密度(2.5,5或8 J/cm2)的LLLT治疗更为有效。结论低能量密度(2.5、5或8 J/cm2)的LLLT能有效促进正畸牙移动,但还需要更多临床随机对照试验支撑。

Objective To evaluate the efficacy and related risk of low level laser therapy(LLLT) for acceleratingtooth movement during orthodontic treatment. Methods An extensive electronic search was conducted by two review-ers. Randomized controlled trials(RCTs) and quasi-RCTs concerning the efficacy of LLLT for accelerating tooth move-ment during orthodontic treatment were searched in CENTRAL, Pub Med, Medline, Embase, CBM, CNKI. Results SixRCTs and three quasi-RCTs, involving 211 patients from six countries, were selected from 173 relevant studies. All ninearticles were feasible for the systematic review and meta-analysis, five of which were assessed as moderate risk of bias,while the rest were assessed as high risk of bias. The mean difference and the 95 % confidence interval(95 % CI) of accu-mulative moved distance of teeth were observed among all the researches. The results showed that the LLLT could acceler-ate orthodontic tooth movement in 7 days(MD = 0.19, 95% CI 0.02-0.37, P = 0.03) and 2 months(MD = 1.08, 95% CI0.16-2.01, P = 0.02). Moreover, a relatively lower energy density(2.5, 5 and 8 J/cm2) was seemingly more effective than 20 and 25 J/cm2 and even higher ones. Conclusion This systematic review and meta-analysis demonstrated that LLLTmight speed up the tooth movement in orthodontic treatment. A relatively lower energy density(2.5, 5, and 8 J/cm2) wasseemingly more effective than higher ones. More qualified RCTs in human subjects are required.