不同干预措施对正畸牙齿移动加速效果的网状meta分析

Effect of different interventions on orthodontic tooth movement acceleration:A network meta⁃analysis

目的:运用系统评价与网状meta分析方法比较综合正畸治疗中用于加速牙齿运动的各种干预措施的有效性。方法:通过检索PubMed、Willey Library、EBSCO、Web of Science和EMBASE数据库中检索关于不同干预措施对正畸牙齿移动加速效果影响的随机对照实验,筛选符合纳入标准文章后提取文献数据并评价纳入文献偏移风险,采用ADDIS 1.16.6和Stata 16.0软件进行网络Meta分析(NMA)。结果:按照尖牙移动的时间作结局指标进行讨论,分别为尖牙组持续时长1、2、3个月,把各个时间段的牙齿迁移数量当作连续性随机变量进行数据分析。最后一共纳入47篇随机对照实验,干预措施总共包含11种:光生物调节(PBMT)、富血小板血浆(PRP)、电磁(EF)、低强度激光(LLLT)、低强度脉冲超声波(LIPUS)、循环加载振动(LFV)、牙周膜牵张成骨/牙槽骨牵张成骨(DAD)、骨皮质切开术(corti)、压电环切术(Piezo)、微骨穿刺(MOPs)和传统治疗(OT)。根据最佳干预效果SUCRA概率排序,在正畸治疗持续1月时,PBMT(90.6%)、Piezo(87.4%)、MOPs(73.6%)为提高尖牙移动效率的排名前三的干预措施。在正畸治疗持续2月时,Corti(75.7%)、Piezo(69.6%)、LFV(58.9%)为提高尖牙移动效率的排名前三的干预措施。在正畸治疗持续3月时,Corti(73.3%)、LLLT(68.4%)、LFV(60.8%)为提高尖牙移动效率的排名前三的干预措施。结论:PBMT和Piezo在使用1个月时对于尖牙移动效率提高较明显,Corti和LFV在使用2个月和3个月对于尖牙移动效率有较好的效果。

Objective:To explore the effectiveness of various interventions in accelerating tooth movement,a systematic review and net-work meta analysis were used to draw a conclusion.Methods:MEDLINE,EMBASE,Willey Library,EBSCO,Web of Science Databases,and Cochrane Central Register of Controlled Trials databases to identify relevant studies.ADDIS 1.16.6 and Stata 16.0 software were used for NMA.Results:Five thousand five hundred and forty-two articles were searched out.After screening by two independent investigators,forty-seven randomized controlled trials,1390 participants,were included in this network meta-analysis.A total of 11 interventions involving Piezocision(Piezo),Photobiomodulation therapy(PBMT),Platelet-rich plasma(PRP),Electromagnetic field(EF),Low intensity laser therapy(LLLT),Low intensity pulsed ultrasound(LIPUS),Low-frequency vibrations(LFV),Distraction osteogenesis(DAD),Corticotomy(Corti),Micro-osteoperforations(MOPS),Traditional orthodontic(OT)were identi fied and classi fied into 3 classes including surgical treatment,non-surgical treatment and traditional orthodontic treatment.According to SUCRA probability ranking of the best intervention effect,when orthodontic treatment lasted for 1 month,PBMT(90.6%),Piezo(87.4%)and MOPs(73.6%)were the top three interventions to improve the efficiency of canine tooth movement.When orthodontic treatment lasted for 2 months,Corti(75.7%),Piezo(69.6%)and LFV(58.9%)were the top three interventions for improving the mobility efficiency of canine tooth movement.When orthodontic treatment lasted for 3 months,Corti(73.3%),LLLT(68.4%)and LFV(60.8%)were the top three interventions for improving the mobility efficiency of canine tooth movement.Conclusion:PBMT and Piezo can improve the efficiency of canine tooth movement significantly after 1 month,while Corti and LFV can improve the efficiency of canine tooth movement better after 2 and 3 months.