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中华口腔医学研究杂志(电子版) ›› 2022, Vol. 16 ›› Issue (01) : 41 -48. doi: 10.3877/cma.j.issn.1674-1366.2022.01.007

Meta分析

压电骨皮质切开术在正畸中加速牙移动临床效果Meta分析
宋雯璐1, 李京1, 李国英1, 段俨芳1, 狄心声1, 胥欣2,()   
  1. 1. 潍坊医学院,潍坊 261053
    2. 潍坊医学院,潍坊 261053;潍坊医学院附属医院,潍坊 261000
  • 收稿日期:2021-11-18 出版日期:2022-02-01
  • 通信作者: 胥欣

Clinical effect of piezocision on accelerating tooth movement in orthodontics: A Meta-analysis

Wenlu Song1, Jing Li1, Guoying Li1, Yanfang Duan1, Xinsheng Di1, Xin Xu2,()   

  1. 1. Weifang Medical University, Weifang 261053, China
    2. Weifang Medical University, Weifang 261053, China; Affiliated Hospital of Weifang Medical University, Weifang 261000, China
  • Received:2021-11-18 Published:2022-02-01
  • Corresponding author: Xin Xu
  • Supported by:
    The National Undergraduate Science and Technology Innovation Fund Project(S202010438025); Key Research and Development Plan of Shandong Province(2019GSF111067); Weifang Medical Science and Technology Development Plan Project(2021YX047)
引用本文:

宋雯璐, 李京, 李国英, 段俨芳, 狄心声, 胥欣. 压电骨皮质切开术在正畸中加速牙移动临床效果Meta分析[J/OL]. 中华口腔医学研究杂志(电子版), 2022, 16(01): 41-48.

Wenlu Song, Jing Li, Guoying Li, Yanfang Duan, Xinsheng Di, Xin Xu. Clinical effect of piezocision on accelerating tooth movement in orthodontics: A Meta-analysis[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2022, 16(01): 41-48.

目的

评价压电骨皮质切开术在正畸治疗中加速牙齿移动的临床效果。

方法

根据Cochrane Handbook规范化要求,分别在中国知网(CNKI)、万方、维普、Cochrane Library、PubMed、Embase、Web of Science、ClinicalTrials.gov等数据库,以"Piezosurgery" "Orthodontics" "Tooth Movement Techniques"等主题词及其下位词,以及"加速牙齿移动" "骨皮质切开术" "超声骨刀" "正畸"为检索关键词进行检索,将检索时间限定为2009年1月至2021年6月。由3名成员进行独立标准化检索,根据预先制定标准对检索获得的文献进行筛选、偏倚风险评估和数据搜集。由于研究之间存在异质性,选择随机效应模型,选择RevMan 5.3软件对纳入文献进行Meta分析。

结果

最终纳入临床随机对照试验4篇,其中共有57例受试者。Meta分析结果示,压电骨皮质切开术后第1个月和第3个月的移动速率与常规正畸治疗相比差异无统计学意义,第2个月移动速率提高0.48毫米/月,差异有统计学意义[WMD = 0.48,95%CI(0.36,0.59),P<0.001]。压电骨皮质切开术后前2个月尖牙移动速率提高0.52毫米/月,差异具有统计学意义[WMD = 0.52,95%CI(0.45,0.59),P<0.001],研究之间异质性高(I2 = 69%)。

结论

压电骨皮质切开术可以在术后第2个月加快尖牙移动的速度,但是这种操作在临床上起到的效果并不显著,且术后第1个月和第3个月对牙齿移动速率可能无影响。

Objective

To evaluate the clinical effect of Piezocision on accelerating tooth movement in orthodontic treatment.

Methods

According to the standardization requirements of Cochrane Handbook, we browsed the CNKI, Wanfang, Weipu, Cochrane Library, PubMed, Web of Science, Embase, ClinicalTrials.gov and other databases. The MeSH "Piezosurgery" "Orthodontics" and "Tooth Movement Techniques" and their subordinate words were adopted as the search keywords and the search time limit was from January 2009 to June 2021. Three members conducted independent standardized searching, assessed the risk of bias and extracted data according to the inclusion and exclusion criteria. On the basis of heterogeneity, a random effect model was selected, and the data were analyzed by RevMan 5.3 software.

Results

A total of four randomized controlled trials were finally included, with 57 patients in the Meta-analysis. The Meta-analysis showed that there was no statistically significant difference in canine retraction movement rate at the first month and third month after operation, but there was significant difference in canine retraction movement rate at the second month [WMD = 0.48, 95%CI (0.36, 0.59) , P<0.001]. There was significant difference in canine retraction movement rate within two months after operation [WMD = 0.52, 95%CI (0.45, 0.59) , P<0.001], where the heterogeneity was high, I2 = 69%.

Conclusions

Piezocision may accelerate the movement of canine retraction in the second month after operation, but the clinical effect of this operation was not obvious, whereas it may have no effect on the rate of tooth movement in the first and third month.

图1 压电骨皮质切开术在正畸中加速牙移动临床效果Meta分析的文献检索策略
图2 压电骨皮质切开术在正畸中加速牙移动临床效果Meta分析的文献筛选流程图
表1 压电骨皮质切开术在正畸中加速牙移动临床效果Meta分析的纳入文献特征
作者 年份 国家 研究类型 参与人数 年龄(岁) 畸形类型 材料 干预措施 结局指标 随访
Abbas等[13] 2016 埃及 自身对照实验,RCT n = 10 15 ~ 25 安氏二类1分类伴轻度拥挤或不拥挤 托槽:Roth 0.022英寸
弓丝:0.016英寸× 0.022英寸
不锈钢弓丝
镍钛封闭螺旋弹簧压力:150 g
干预:邻间垂直骨皮质切口
1.尖牙移动速率
2.支抗丧失
3.牙周健康
4.牙根吸收
总随访期:尖牙回缩开始后3个月内
回访周期:每2周进行1次回访
Raj等[14] 2020 印度 自身对照实验,RCT n = 20(女14例、男6例) 23.18 ± 1.41 安氏二类错畸形 弓丝:0.016英寸× 0.022英寸
不锈钢弓丝
镍钛封闭螺旋弹簧压力:150 g
干预:长度10 mm,深度3 mm的邻间垂直骨皮质切口
1.尖牙和磨牙的移动速率
2.牙周指数
3.牙槽骨水平
4.牙根吸收情况
总随访期:7个月
回访周期:手术后1、3、6个月进行牙周评估,每2周进行一次尖牙回缩检查
Aksakalli等[15] 2016 土耳其 自身对照实验,RCT n = 10(女6例、男4例) 16.3 ± 2.4 安氏二类错畸形 托槽:Roth 0.22英寸
弓丝:0.016英寸× 0.022英寸
不锈钢弓丝
弹性链压力:150 g
干预:2个长度10 mm,深度3 mm的邻间垂直骨皮质切口
1.尖牙和磨牙移动速率
2.尖牙横向变化
3.牙龈指数
回访周期:每2周进行1次回访
Alfawal等[16] 2018 希腊 自身对照实验,RCT n = 18(女11例、男7例)失访1例 18.70 ± 3.6 安氏二类错畸形 托槽:MBT 0.22英寸
弓丝序列:根据拥挤程度选择0.014英寸镍钛弓丝或者0.016英寸镍钛弓丝,0.016英寸× 0.022英寸,0.017英寸×0.025英寸镍钛弓丝,0.019英寸×0.025英寸不锈钢弓丝
镍钛封闭螺旋弹簧压力:150 g
干预:2个长度10 mm,深度3 mm的邻间垂直骨皮质切口
1.尖牙移动速率
2.支抗丧失
3.尖牙旋转和回缩的持续时间
回访周期:每2周进行1次回访
记录尖牙回缩开始后1个月(T1)、2个月(T2)、3个月(T3)、4个月(T4)的测量数据
表2 压电骨皮质切开术在正畸中加速牙移动临床效果Meta分析的文献方法质量评价
表3 压电骨皮质切开术在正畸中加速牙移动临床效果Meta分析的文献偏倚风险总结
图3 压电骨皮质切开术后第1 ~ 2个月尖牙移动速率(毫米/月)的Meta分析结果
图4 压电骨皮质切开术后第3个月尖牙移动速率(毫米/月)的Meta分析结果
表4 GRADE方法对压电骨皮质切开术加速牙移动临床效果Meta分析的证据质量评价总结
[1]
Long H,,Pyakurel U,,Wang Y,et al. Interventions for accelerating orthodontic tooth movement:A systematic review[J]. Angle Orthod201383(1):164-171. DOI:10.2319/031512-224.1.
[2]
杨雨虹,唐倩.牙周辅助加速成骨正畸治疗技术[J/OL].中华口腔医学研究杂志(电子版)201711(1):49-52. DOI:10.3877/cma.j.issn.1674-1366.2017.01.010.
[3]
Wang Y,,Zhang H,,Sun W,et al. Macrophages mediate corticotomy-accelerated orthodontic tooth movement[J]. Sci Rep20188(1):16788. DOI:10.1038/s41598-018-34907-5.
[4]
邵淇,康非吾.手术方法加速正畸牙移动的研究进展[J].口腔生物医学202112(3):201-204. DOI:10.3969/j.issn.1674-8603.2021.03.013.
[5]
Dibart S,,Sebaoun JD,,Surmenian J. Piezocision:A minimally invasive,periodontally accelerated orthodontic tooth movement procedure[J]. Compend Contin Educ Dent200930(6):342-344,346,348-350.
[6]
艾琦,王银龙,徐建光,等.压电骨皮质切开术加速正畸牙移动的临床效果研究[J].中国美容医学201827(6):112-115. DOI:10.15909/j.cnki.cn61-1347/r.002447.
[7]
Yavuz MC,,Sunar O,,Buyuk SK,et al. Comparison of piezocision and discision methods in orthodontic treatment[J]. Prog Orthod201819(1):44. DOI:10.1186/s40510-018-0244-y.
[8]
Gibreal O,,Hajeer MY,,Brad B. Efficacy of piezocision-based flapless corticotomy in the orthodontic correction of severely crowded lower anterior teeth:A randomized controlled trial[J]. Eur J Orthod201941(2):188-195. DOI:10.1093/ejo/cjy042.
[9]
付腾飞.微骨穿孔在加速正畸牙齿移动中作用的研究[D].西安:中国人民解放军空军军医大学,2018.
[10]
Tunçer NI,,Arman-Özçirpici A,,Oduncuoglu BF,et al. Efficiency of piezosurgery technique in miniscrew supported en-masse retraction:A single-centre,randomized controlled trial[J]. Eur J Orthod201739(6):586-594. DOI:10.1093/ejo/cjx015.
[11]
Keser EI,,Dibart S. Sequential piezocision:A novel approach to accelerated orthodontic treatment[J]. Am J Orthod Dentofacial Orthop2013144(6):879-889. DOI:10.1016/j.ajodo.2012.12.014.
[12]
李雪迎. Meta分析研究设计中的PICOS原则[J].中国介入心脏病学杂志201624(11):611. DOI:10.3969/j.issn.1004-8812.2016.11.005.
[13]
Abbas NH,,Sabet NE,,Hassan IT. Evaluation of corticotomy-facilitated orthodontics and piezocision in rapid canine retraction[J]. Am J Orthod Dentofacial Orthop2016149(4):473-480. DOI:10.1016/j.ajodo.2015.09.029.
[14]
Raj SC,,Praharaj K,,Barik AK,et al. Retraction with and without piezocision-facilitated orthodontics:A randomized controlled trial[J]. Int J Periodontics Restorative Dent202040(1):e19-e26. DOI:10.11607/prd.3968.
[15]
Aksakalli S,,Calik B,,Kara B,et al. Accelerated tooth movement with piezocision and its periodontal-transversal effects in patients with classⅡ malocclusion[J]. Angle Orthod201686(1):59-65. DOI:10.2319/012215-49.1.
[16]
Alfawal AMH,,Hajeer MY,,Ajaj MA,et al. Evaluation of piezocision and laser-assisted flapless corticotomy in the acceleration of canine retraction:A randomized controlled trial [J]. Head Face Med201814(1):4. DOI:10.1186/s13005-018-0161-9.
[17]
Chung B,,Pandis N,,Scherer RW,et al. CONSORT extension for within-person randomized clinical trials[J]. J Dent Res202099(2):121-124. DOI:10.1177/0022034519891953.
[18]
Pandis N,,Chung B,,Scherer RW,et al. CONSORT 2010 statement:Extension checklist for reporting within person randomised trials[J]. Br J Dermatol2019180(3):534-552. DOI:10.1111/bjd.17239.
[19]
Barlow M,,Kula K. Factors influencing efficiency of sliding mechanics to close extraction space:A systematic review[J]. Orthod Craniofac Res200811(2):65-73. DOI:10.1111/j.1601-6343.2008.00421.x.
[20]
Tominaga JY,,Ozaki H,,Chiang PC,et al. Effect of bracket slot and archwire dimensions on anterior tooth movement during space closure in sliding mechanics:A 3-dimensional finite element study[J]. Am J Orthod Dentofacial Orthop2014146(2):166-174. DOI:10.1016/j.ajodo.2014.04.016.
[21]
Wilcko WM,,Wilcko T,,Bouquot JE,et al. Rapid orthodontics with alveolar reshaping:Two case reports of decrowding[J]. Int J Periodontics Restorative Dent200121(1):9-19.
[22]
Wilcko WM,,Ferguson DJ,,Bouquot JE,et al. Rapid orthodontic decrowding with alveolar augmentation:Case report[J]. World Journal of Orthodontics20034(3):197-205.
[23]
Wilcko MT,,Wilcko WM,,Bissada NF. An evidence-based analysis of periodontally accelerated orthodontic and osteogenic techniques:A synthesis of scientific perspectives[J]. Semin Orthod200814(4):305-316. DOI:10.1053/j.sodo.2008.07.007.
[24]
韩正强,李宁,陈曦. Piezocision法辅助正畸牙移动局部加速现象的研究进展[J].医学综述201521(8):1404-1406. DOI:10.3969/j.issn.1006-2084.2015.08.022.
[25]
Patterson BM,,Dalci O,,Papadopoulou AK,et al. Effect of piezocision on root resorption associated with orthodontic force:A microcomputed tomography study[J]. Am J Orthod Dentofacial Orthop2017151(1):53-62. DOI:10.1016/j.ajodo.2016.06.032.
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