快速扩弓联合前方牵引矫治骨性Ⅲ类错疗效的Meta分析

The effects of maxillary protraction therapy with rapid maxillary expansion on class Ⅲ malocclusion: A meta-analysis

目的:系统评价前方牵引联合快速扩弓治疗骨性Ⅲ类错的疗效。方法:计算机检索Cochrane Library、Embase、PubMed、Medline、中国生物医学文献数据库、万方、知网、维普等中外文数据库中符合要求的随机对照试验、半随机对照试验及临床对照试验,按照严格的排除纳入标准对文献进行筛选评价及资料提取,采用Rev Man 5.3软件进行Meta分析。结果:最终纳入7篇文献,共228名患者,其中扩弓联合前牵组114人,单纯前牵组114人。Meta分析显示:2组数据除U1-NA、SN-MP、ANS-Me外、SNA、SNB、ANB、SN-PP差异均无统计学意义。结论:前方牵引联合快速扩弓适用于切牙唇向倾斜的骨性Ⅲ类错。

Objective： To evaluate the effects of maxillary protraction with or without rapid maxillary expansion in the treatment of Class Ⅲ malocclusion by Meta-Analysis. Methods： The randomized controlled trail, quasi-randomized controlled trail and the clinical controlled trail about the treatment of Class Ⅲ malocclusion by protraction with or without expansion were searched in the database of Cochrane Library, Embase, PubMed, Medline, CBM, Wan Fang, CNKI, VIP. 2 authors qualified and extracted the data independently. Then the Meta-analysis was performed by using the RevMan 5.3 software. Results： 7 studies with 228 cases were included, 114 cases were treated by maxillary protraction with expansion and the other 114 cases by maxillary protraction without expansion. The Meta-analysis showed that： there was no significant difference in SNA, SNB, ANB and SN-PP except ANS-Me, U1-NA, SN-MP. A favorable improvement of the sagittal relationship between maxillary and mandibular was observed by using protraction whether with expansion or not. The expansion did not shorten the course of treatment, but it lowered the inclination of upper incisors, resulting in more clockwise rotation of mandibular plane and increase of the facial vertical dimension. Conclusion： Maxillary protraction with rapid maxillary expansion can be used in the treatment of class Ⅲ malocclusion with incisor labioclination.