Ahmad Marwan Alhamwi, Ahmad Sharafeddin Burhan, Fehmieh Rafik Nawaya, Kinda Sultan
{"title":"成长期患者III类骨科治疗相关软组织改变：系统回顾和荟萃分析","authors":"Ahmad Marwan Alhamwi, Ahmad Sharafeddin Burhan, Fehmieh Rafik Nawaya, Kinda Sultan","doi":"10.1186/s40510-025-00558-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Achieving a harmonious soft tissue profile and enhancing facial appearance are key goals of early treatment for skeletal class III malocclusion.</p><p><strong>Aim: </strong>To summarize the current evidence regarding the effects of Class III orthodontic treatment on facial soft tissues, and to compare various Class III orthodontic appliances.</p><p><strong>Methods: </strong>A comprehensive search was conducted up to July 2024, using seven databases, with no language restrictions. RCTs and controlled non-randomized studies were included in this systematic review. The GRADE framework was applied to evaluate the quality of evidence.</p><p><strong>Results: </strong>Thirty studies were included in this review, of which sixteen were appropriate for quantitative synthesis. The age range fell between 6.6 and 12.3 years. The FM/RME protocol resulted in a 1.58 mm increase in upper lip protrusion and a 4.73-degree decrease in the nasolabial angle compared to the control group. Chincup treatment led to a 2.13 mm increase in upper lip protrusion and a 2.63 mm decrease in lower lip protrusion compared to the control group. The pooled estimate demonstrated a significant increase of 1.82 mm in upper lip protrusion, a significant retrusion of 3.14 mm in the lower lip, and a backward movement of the chin by 4.8 mm in patients treated with miniplate-anchored orthopaedic facemask (FM/MP) compared to the untreated group. However, no significant difference was found between FM/RME and FM/MP, except for a noticeable decrease in the nasolabial angle in the FM/RME group. The analysis of FM/Alt-RAMEC versus FM/RME did not reveal any difference in soft tissue outcomes, except for the upper lip protrusion. The Alt-RAMEC group showed a more pronounced anterior movement of the upper lip by 0.67 mm compared to the RME group. The quality of evidence supporting these findings ranged from low to moderate.</p><p><strong>Conclusions: </strong>There is low to moderate evidence suggesting that early treatment positively influences the soft tissues in Class III patients. However, these conclusions are based on a two-dimensional analysis of cephalometric images, which may not provide complete or accurate information. Therefore, more RCTs using comprehensive 3D analysis are needed to confirm these results.</p><p><strong>Registration: </strong>PROSPERO ( CRD42024517924 ).</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"26 1","pages":"10"},"PeriodicalIF":4.8000,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911289/pdf/","citationCount":"0","resultStr":"{\"title\":\"Soft tissue changes associated with Class III orthopaedic treatment in growing patients: a systematic review and meta-analysis.\",\"authors\":\"Ahmad Marwan Alhamwi, Ahmad Sharafeddin Burhan, Fehmieh Rafik Nawaya, Kinda Sultan\",\"doi\":\"10.1186/s40510-025-00558-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Achieving a harmonious soft tissue profile and enhancing facial appearance are key goals of early treatment for skeletal class III malocclusion.</p><p><strong>Aim: </strong>To summarize the current evidence regarding the effects of Class III orthodontic treatment on facial soft tissues, and to compare various Class III orthodontic appliances.</p><p><strong>Methods: </strong>A comprehensive search was conducted up to July 2024, using seven databases, with no language restrictions. RCTs and controlled non-randomized studies were included in this systematic review. The GRADE framework was applied to evaluate the quality of evidence.</p><p><strong>Results: </strong>Thirty studies were included in this review, of which sixteen were appropriate for quantitative synthesis. The age range fell between 6.6 and 12.3 years. The FM/RME protocol resulted in a 1.58 mm increase in upper lip protrusion and a 4.73-degree decrease in the nasolabial angle compared to the control group. Chincup treatment led to a 2.13 mm increase in upper lip protrusion and a 2.63 mm decrease in lower lip protrusion compared to the control group. The pooled estimate demonstrated a significant increase of 1.82 mm in upper lip protrusion, a significant retrusion of 3.14 mm in the lower lip, and a backward movement of the chin by 4.8 mm in patients treated with miniplate-anchored orthopaedic facemask (FM/MP) compared to the untreated group. However, no significant difference was found between FM/RME and FM/MP, except for a noticeable decrease in the nasolabial angle in the FM/RME group. The analysis of FM/Alt-RAMEC versus FM/RME did not reveal any difference in soft tissue outcomes, except for the upper lip protrusion. The Alt-RAMEC group showed a more pronounced anterior movement of the upper lip by 0.67 mm compared to the RME group. The quality of evidence supporting these findings ranged from low to moderate.</p><p><strong>Conclusions: </strong>There is low to moderate evidence suggesting that early treatment positively influences the soft tissues in Class III patients. However, these conclusions are based on a two-dimensional analysis of cephalometric images, which may not provide complete or accurate information. Therefore, more RCTs using comprehensive 3D analysis are needed to confirm these results.</p><p><strong>Registration: </strong>PROSPERO ( CRD42024517924 ).</p>\",\"PeriodicalId\":56071,\"journal\":{\"name\":\"Progress in Orthodontics\",\"volume\":\"26 1\",\"pages\":\"10\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-03-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911289/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Progress in Orthodontics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s40510-025-00558-2\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Dentistry\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Progress in Orthodontics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40510-025-00558-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Dentistry","Score":null,"Total":0}
Soft tissue changes associated with Class III orthopaedic treatment in growing patients: a systematic review and meta-analysis.
Introduction: Achieving a harmonious soft tissue profile and enhancing facial appearance are key goals of early treatment for skeletal class III malocclusion.
Aim: To summarize the current evidence regarding the effects of Class III orthodontic treatment on facial soft tissues, and to compare various Class III orthodontic appliances.
Methods: A comprehensive search was conducted up to July 2024, using seven databases, with no language restrictions. RCTs and controlled non-randomized studies were included in this systematic review. The GRADE framework was applied to evaluate the quality of evidence.
Results: Thirty studies were included in this review, of which sixteen were appropriate for quantitative synthesis. The age range fell between 6.6 and 12.3 years. The FM/RME protocol resulted in a 1.58 mm increase in upper lip protrusion and a 4.73-degree decrease in the nasolabial angle compared to the control group. Chincup treatment led to a 2.13 mm increase in upper lip protrusion and a 2.63 mm decrease in lower lip protrusion compared to the control group. The pooled estimate demonstrated a significant increase of 1.82 mm in upper lip protrusion, a significant retrusion of 3.14 mm in the lower lip, and a backward movement of the chin by 4.8 mm in patients treated with miniplate-anchored orthopaedic facemask (FM/MP) compared to the untreated group. However, no significant difference was found between FM/RME and FM/MP, except for a noticeable decrease in the nasolabial angle in the FM/RME group. The analysis of FM/Alt-RAMEC versus FM/RME did not reveal any difference in soft tissue outcomes, except for the upper lip protrusion. The Alt-RAMEC group showed a more pronounced anterior movement of the upper lip by 0.67 mm compared to the RME group. The quality of evidence supporting these findings ranged from low to moderate.
Conclusions: There is low to moderate evidence suggesting that early treatment positively influences the soft tissues in Class III patients. However, these conclusions are based on a two-dimensional analysis of cephalometric images, which may not provide complete or accurate information. Therefore, more RCTs using comprehensive 3D analysis are needed to confirm these results.
期刊介绍：
Progress in Orthodontics is a fully open access, international journal owned by the Italian Society of Orthodontics and published under the brand SpringerOpen. The Society is currently covering all publication costs so there are no article processing charges for authors.
It is a premier journal of international scope that fosters orthodontic research, including both basic research and development of innovative clinical techniques, with an emphasis on the following areas:
• Mechanisms to improve orthodontics
• Clinical studies and control animal studies
• Orthodontics and genetics, genomics
• Temporomandibular joint (TMJ) control clinical trials
• Efficacy of orthodontic appliances and animal models
• Systematic reviews and meta analyses
• Mechanisms to speed orthodontic treatment
Progress in Orthodontics will consider for publication only meritorious and original contributions. These may be:
• Original articles reporting the findings of clinical trials, clinically relevant basic scientific investigations, or novel therapeutic or diagnostic systems
• Review articles on current topics
• Articles on novel techniques and clinical tools
• Articles of contemporary interest
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
