前牙深覆盖患者单双期矫治对切牙外伤发生率影响的Meta分析

Influence of one-phase and two-phase treatment on the incidence of incisor trauma in patients with deep overjet:a meta-analysis

目的系统评价前牙深覆盖患者双期矫治和单期矫治对切牙外伤发生率的影响,为临床治疗方案的选择提供科学依据。方法计算机检索PubMed、The Cochrane Library、Web of Science、CBM、WanFang Data、CNKI和VIP数据库,搜集所有比较安氏Ⅱ类1分类错牙合前牙深覆盖患者单期矫治和双期矫治的随机对照试验(RCT),检索时限均从建库至2017年12月20日。由2名研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan5.3软件进行Meta分析。结果共纳入4个RCT,共613例患者。Meta分析结果显示:双期矫治(功能矫治器和头帽)和单期矫治后覆盖大小的差异无统计学意义[MD=-0.23,95%CI(-0.57,0.11),P=0.19]。而双期治疗组(功能矫治器和头帽)的切牙外伤发生率低于单期治疗组[RR=0.69,95%CI(0.48,0.99),P=0.05]。结论现有证据显示,双期矫治比单期矫治的切牙外伤发生率更低。受纳入研究数量和质量的限制,上述结论尚需开展更多高质量研究予以验证。

ObjectivesTo systematically review the effectiveness of one-phase treatment and two-phase treatment on the incidence of incisors trauma in patients with deep overjet, and to provide scientific basis for the selection of clinical treatment plans.MethodsPubMed, The Cochrane Library, Web of Science, CBM, CNKI, VIP and WanFang Data databases were searched to collect randomized controlled trials （RCTs） on the clinical effectiveness of one-phase treatment and two-phase treatment on the incidence of incisors trauma from inception to December 20th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 4 studies were included involving 613 patients. The results of meta-analyses showed that, there was no significant difference in the final overjet after one-phase treatment and two-phase treatment （functional appliance and headgear） （MD=–0.23, 95%CI –0.57 to 0.11, P=0.19）. However, the new incidence of incisor trauma was significantly less for two-phase treatment group （functional appliance and headgear） （RR=0.69, 95%CI 0.48 to 0.99, P=0.05）.ConclusionsPatients underwent two-phase treatment have lower incidence of dental trauma than one-phase treatment. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion