压电骨皮质切开术在正畸中加速牙移动临床效果Meta分析

Clinical effect of piezocision on accelerating tooth movement in orthodontics:A Meta⁃analysis

目的评价压电骨皮质切开术在正畸治疗中加速牙齿移动的临床效果。方法根据Cochrane Handbook规范化要求,分别在中国知网(CNKI)、万方、维普、Cochrane Library、PubMed、Embase、Web of Science、ClinicalTrials.gov等数据库,以“Piezosurgery”“Orthodontics”“Tooth Movement Techniques”等主题词及其下位词,以及“加速牙齿移动”“骨皮质切开术”“超声骨刀”“正畸”为检索关键词进行检索,将检索时间限定为2009年1月至2021年6月。由3名成员进行独立标准化检索,根据预先制定标准对检索获得的文献进行筛选、偏倚风险评估和数据搜集。由于研究之间存在异质性,选择随机效应模型,选择RevMan 5.3软件对纳入文献进行Meta分析。结果最终纳入临床随机对照试验4篇,其中共有57例受试者。Meta分析结果示,压电骨皮质切开术后第1个月和第3个月的移动速率与常规正畸治疗相比差异无统计学意义,第2个月移动速率提高0.48毫米/月,差异有统计学意义[WMD=0.48,95%CI(0.36,0.59),P<0.001]。压电骨皮质切开术后前2个月尖牙移动速率提高0.52毫米/月,差异具有统计学意义[WMD=0.52,95%CI(0.45,0.59),P<0.001],研究之间异质性高(I2=69%)。结论压电骨皮质切开术可以在术后第2个月加快尖牙移动的速度,但是这种操作在临床上起到的效果并不显著,且术后第1个月和第3个月对牙齿移动速率可能无影响。

Objective To evaluate the clinical effect of Piezocision on accelerating tooth movement in orthodontic treatment.Methods According to the standardization requirements of Cochrane Handbook,we browsed the CNKI,Wanfang,Weipu,Cochrane Library,PubMed,Web of Science,Embase,ClinicalTrials.gov and other databases.The MeSH“Piezosurgery”“Orthodontics”and“Tooth Movement Techniques”and their subordinate words were adopted as the search keywords and the search time limit was from January 2009 to June 2021.Three members conducted independent standardized searching,assessed the risk of bias and extracted data according to the inclusion and exclusion criteria.On the basis of heterogeneity,a random effect model was selected,and the data were analyzed by RevMan 5.3 software.Results A total of four randomized controlled trials were finally included,with 57 patients in the Meta⁃analysis.The Meta⁃analysis showed that there was no statistically significant difference in canine retraction movement rate at the first month and third month after operation,but there was significant difference in canine retraction movement rate at the second month[WMD=0.48,95%CI(0.36,0.59),P<0.001].There was significant difference in canine retraction movement rate within two months after operation[WMD=0.52,95%CI(0.45,0.59),P<0.001],where the heterogeneity was high,I2=69%.Conclusions Piezocision may accelerate the movement of canine retraction in the second month after operation,but the clinical effect of this operation was not obvious,whereas it may have no effect on the rate of tooth movement in the first and third month.