Clinical effectiveness of different types of bone-anchored maxillary protraction devices for skeletal Class III malocclusion: Systematic review and network meta-analysis.

IF 1.9 3区 医学 Q1 Dentistry
Jiangwei Wang, Yingying Yang, Yingxue Wang, Lu Zhang, Wei Ji, Zheng Hong, Linkun Zhang
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引用次数: 6

Abstract

Objective: This study aimed to estimate the clinical effects of different types of bone-anchored maxillary protraction devices by using a network meta-analysis.

Methods: We searched seven databases for randomized and controlled clinical trials that compared bone-anchored maxillary protraction with tooth-anchored maxillary protraction interventions or untreated groups up to May 2021. After literature selection, data extraction, and quality assessment, we calculated the mean differences, 95% confidence intervals, and surface under the cumulative ranking scores of eleven indicators. Statistical analysis was performed using R statistical software with the GeMTC package based on the Bayesian framework.

Results: Six interventions and 667 patients were involved in 18 studies. In comparison with the tooth-anchored groups, the bone-anchored groups showed significantly more increases in Sella-Nasion-Subspinale (°), Subspinale-Nasion-Supramentale(°) and significantly fewer increases in mandibular plane angle and the labial proclination angle of upper incisors. In comparison with the control group, Sella-Nasion-Supramentale(°) decreased without any statistical significance in all treated groups. IMPA (angle of lower incisors and mandibular plane) decreased in groups with facemasks and increased in other groups.

Conclusions: Bone-anchored maxillary protraction can promote greater maxillary forward movement and correct the Class III intermaxillary relationship better, in addition to showing less clockwise rotation of mandible and labial proclination of upper incisors. However, strengthening anchorage could not inhibit mandibular growth better and the lingual inclination of lower incisors caused by the treatment is related to the use of a facemask.

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不同类型骨锚定上颌牵引装置治疗骨骼III类错颌的临床效果:系统综述和网络meta分析。
目的:本研究旨在通过网络荟萃分析评估不同类型骨锚定上颌前伸装置的临床效果。经过文献筛选、数据提取和质量评估,我们计算了11个指标的平均差、95%置信区间和表面下累积排名得分。使用R统计软件和基于贝叶斯框架的GeMTC包进行统计分析。结果:18项研究涉及6项干预措施和667名患者。与牙锚定组相比,骨锚定组的Sella Nasion棘下(°)、棘下Nasion顶上(°)的增加明显更多,而下颌平面角和上切牙唇前倾角的增加明显更少。与对照组相比,所有治疗组的上鼻塞(°)均下降,但无统计学意义。IMPA(下切牙和下颌平面的角度)在戴口罩的组中降低,在其他组中增加。结论:骨锚定上颌前伸除可减少下颌顺时针旋转和上切牙唇前旋外,还能促进上颌更大的前移,更好地纠正III类颌间关系。然而,加强锚定并不能更好地抑制下颌生长,治疗引起的下切牙舌侧倾斜与口罩的使用有关。
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来源期刊
Korean Journal of Orthodontics
Korean Journal of Orthodontics Dentistry-Orthodontics
CiteScore
2.60
自引率
10.50%
发文量
48
审稿时长
3 months
期刊介绍: The Korean Journal of Orthodontics (KJO) is an international, open access, peer reviewed journal published in January, March, May, July, September, and November each year. It was first launched in 1970 and, as the official scientific publication of Korean Association of Orthodontists, KJO aims to publish high quality clinical and scientific original research papers in all areas related to orthodontics and dentofacial orthopedics. Specifically, its interest focuses on evidence-based investigations of contemporary diagnostic procedures and treatment techniques, expanding to significant clinical reports of diverse treatment approaches. The scope of KJO covers all areas of orthodontics and dentofacial orthopedics including successful diagnostic procedures and treatment planning, growth and development of the face and its clinical implications, appliance designs, biomechanics, TMJ disorders and adult treatment. Specifically, its latest interest focuses on skeletal anchorage devices, orthodontic appliance and biomaterials, 3 dimensional imaging techniques utilized for dentofacial diagnosis and treatment planning, and orthognathic surgery to correct skeletal disharmony in association of orthodontic treatment.
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