正畸粘接系统能否抑制固定正畸治疗过程中白斑病变的形成和发展?系统性综述。

Marwan El Helou, Sandra Chakar, Emmanuel Nicolas, Elias Estephan, Frederic Cuisinier, Stéphane Barthélemi
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引用次数: 0

摘要

目的:本研究旨在评估正畸粘接系统是否能预防正畸诱发的白斑病(OIWSLs),通过对现有证据进行全面系统的回顾,探索其疗效并确定相关因素:该研究符合系统综述和元分析首选报告项目(PRISMA)指南。两名评估者筛选了记录,并从 PubMed/MEDLINE、Cochrane Library 和 EM Premium 中提取了有关正畸粘接系统、结果和参与者特征的数据。搜索等式侧重于白斑病变和正畸粘接。仅纳入了体内研究和人体临床试验,而排除了体外研究。使用 Cochrane 的 RoB2 工具评估了 RCT 的偏倚风险,使用 ROBINS-I 工具评估了非随机研究的偏倚风险,并评估了与偏倚相关的关键领域:系统性综述包括12篇文章、550名参与者和2000颗牙齿,结果显示,使用纳米nCaF2-原液颗粒和含无定形磷酸钙的粘合剂进行粘接能有效减少WSL。相比之下,不含底漆的一步法粘接剂(GC Ortho Connect™)的WSL更高、更严重。释放氟化物的底层粘合剂(Opal Seal™ 和 Clearfil™)在减少脱矿方面没有优势。在两项研究中,加入 TiO2 纳米粒子的抗菌效果结果相互矛盾:讨论:粘合剂或底涂中加入的各种纳米粒子在预防固定正畸治疗中的白斑病变方面表现出良好的前景。然而,所使用的评估方法,如临床检查或先进的成像,对结果的解释有很大影响。正畸粘合剂在预防白斑病方面的效果应在生物相容性、粘接强度和脱矿控制之间取得平衡,以满足患者的特定需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed Orthodontic Treatment? A Systematic Review.

Purpose: This study aims to assess whether orthodontic bonding systems prevent orthodontic-induced white spot lesions (OIWSLs), exploring efficacy and identifying associated factors through a comprehensive systematic review of existing evidence.

Materials and methods: The study complied to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two evaluators screened records, and data were extracted on orthodontic bonding systems, outcomes, and participant characteristics from PubMed/MEDLINE, Cochrane Library, and EM Premium. The search equation focused on white spot lesions and orthodontic bonding. Only in-vivo studies and clinical trials on humans were included, while in-vitro studies were excluded. The risk of bias was assessed using Cochrane's RoB2 tool for RCTs and ROBINS-I tool for non-randomized studies, evaluating key domains related to bias.

Results: The systematic review, including 12 articles with 550 participants and 2,000 teeth, revealed that bonding with nanoparticles of nCaF2-primer and amorphous calcium phosphate-containing adhesives effectively reduced WSLs. In contrast, one-step adhesive without primer (GC Ortho Connect™) was associated with higher and more severe WSLs. Fluoride-releasing primers (Opal Seal™ and Clearfil™) did not exhibit an advantage in demineralization reduction. The inclusion of TiO2 nanoparticles in two studies yielded conflicting results on antibacterial effects.

Discussion: Various nanoparticles incorporated into adhesives or primers exhibit promise in preventing white spot lesions in fixed orthodontic treatment. However, the used evaluation methods, such as clinical examinations or advanced imaging, significantly impact result interpretation. The effectiveness of orthodontic adhesives in preventing WSLs should balance between biocompatibility, bond strength and demineralization control tailored to patient-specific needs.

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