精密翼治疗骨骼II类生长患者:系统回顾和荟萃分析。

IF 4.8 2区 医学 Q1 Dentistry
Paulo Mecenas, Renata Travassos da Rosa Moreira Bastos, Nathalia Carolina Fernandes Fagundes, David Normando
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引用次数: 0

摘要

背景:骨骼II类错牙合,通常与下颌骨缺陷相关,通常使用功能矫治器治疗。精密翼是一种功能矫治器,通过结合下颌推进和牙齿对齐提供了另一种方法。目的:本系统综述旨在评价精密翼矫治生长患者骨骼ⅱ类错颌合的有效性。入选标准:根据PICOS策略选择评估使用精密翼矫正生长患者骨骼II类错颌的研究。遵循了PRISMA准则。资料来源:截至2025年2月,在七个数据库中进行了不受限制的电子搜索。偏倚风险和结果综合:ROBINS-I工具用于评估非随机研究的偏倚风险(RoB)。进行随机效应荟萃分析,并使用GRADE方法评估证据的确定性。结果:纳入7项研究,并提取资料。使用随机效应荟萃分析计算95%置信区间(ci)的平均差异(md)。研究结果表明,精密翼可以有效地治疗生长患者的骨骼II类错颌畸形,包括牙齿和骨骼的变化。关于骨骼的影响,矢状面变化仅限于下颌骨,且幅度较小,ANB°降低(MD = -0.81;95% CI: -1.04 ~ -0.58;结论:尽管关于这一主题的科学证据有限,但对于骨骼II类错颌畸形的矫正,使用精密翼治疗似乎对下颌生长提供了最小的临床改善。为了获得更多的结论性发现,未来的研究应优先考虑结构良好的随机临床试验,采用标准化的治疗方案、延长随访时间和一致的头侧测量评估方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Precision wings treating skeletal class II in growing patients: a systematic review and meta-analysis.

Background: Skeletal Class II malocclusion, often associated with mandibular deficiency, is commonly treated with functional appliances. Precision Wings are a functional appliance that provides an alternative approach by combining mandibular advancement with dental alignment.

Objective: This systematic review aimed to evaluate the effectiveness of Precision Wings in treating skeletal Class II malocclusion in growing patients.

Eligibility criteria: Studies assessing the correction of skeletal Class II malocclusion in growing patients treated with Precision Wings were selected according to the PICOS strategy. The PRISMA guidelines were followed.

Information sources: Unrestricted electronic searches were conducted across seven databases up to February 2025.

Risk of bias and synthesis of results: The ROBINS-I tool was used to assess the risk of bias (RoB) in non-randomized studies. A random-effects meta-analysis was performed, and the certainty of the evidence was evaluated using the GRADE approach.

Results: Seven studies were included, and data were extracted. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects meta-analysis. The findings suggest that Precision Wings may be effective in treating skeletal Class II malocclusion in growing patients through both dental and skeletal changes. Regarding skeletal effects, sagittal changes were limited to the mandible and were of small magnitude, with a reduction in ANB° (MD = -0.81; 95% CI: -1.04 to -0.58; p < 0.001) occurring exclusively due to an increase in SNB° (MD = 0.55; 95% CI: 0.11 to 0.98; p = 0.01), while no significant changes were observed in SNA° (MD = -0.02; 95% CI: -0.42 to 0.38; p = 0.91). The included studies did not report significant vertical effects. Meta-analyses comparing Precision Wings with other functional appliances were not feasible due to the small number of studies evaluating each comparison and the substantial clinical and methodological heterogeneity across the included studies.

Conclusion: Although the available scientific evidence on this topic is limited, treatment with Precision Wings appears to offer minimal clinical improvement in mandibular growth for the correction of skeletal Class II malocclusion. To obtain more conclusive findings, future research should prioritize well-structured randomized clinical trials with standardized treatment protocols, extended follow-ups, and consistent cephalometric assessment methods.

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来源期刊
Progress in Orthodontics
Progress in Orthodontics Dentistry-Orthodontics
CiteScore
7.30
自引率
4.20%
发文量
45
审稿时长
13 weeks
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
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