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首页> 外文期刊>Contemporary Clinical Dentistry >Evaluation of treatment outcomes of en masse retraction with temporary skeletal anchorage devices in comparison with two-step retraction with conventional anchorage in patients with dentoalveolar protrusion: A systematic review and meta-analysis
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Evaluation of treatment outcomes of en masse retraction with temporary skeletal anchorage devices in comparison with two-step retraction with conventional anchorage in patients with dentoalveolar protrusion: A systematic review and meta-analysis

机译：与临时骨架锚固装置的治疗结果评价临时骨架锚固装置与牙齿肺泡突出患者的常规锚定的两步缩回：系统评价与荟萃分析

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Objective: The main objective is to evaluate the effectiveness of en masse retraction with temporary skeletal anchorage devices (TSADs) versus two-step retraction with conventional anchorage (CA) in terms of the skeletal, dental, and soft-tissue variables, as well as the duration of retraction or overall orthodontic treatment. Materials and Methods: An electronic search of PubMed and nine other major databases for prospective, randomized controlled trials (RCTs) and clinical controlled trials (CCTs) was carried out between January 1990 and April 2018. The bibliography in each identified article was checked out. In addition, manual searching was performed in the same time frame in five major orthodontic journals. Adult patients undergoing fixed orthodontic treatment with extraction of maxillary premolars followed by an en masse retraction in the experimental group and two-step retraction of upper anterior teeth in the control group. Methodological index for nonrandomized studies for CCTs and Cochrane's risk of bias tool for RCTs were applied. Results: Four articles (two RCTs and two CCTs) were included in this review and all articles were appropriate for the quantitative synthesis. There was no significant difference between the en masse retraction and two-step retraction groups in terms of SNA, SNB, ANB, and MP-SN angles. Using TSADs gave significantly better results in terms of posterior anchorage and incisors inclination, and greater anterior teeth retraction in comparison with CA (standardized mean difference [SMD] = –3.03 mm, P P = 0.003; SMD = –0.46 mm, P = 0.03, respectively). En masse/TSAD combination caused a significantly greater increase in nasolabial angle, higher decrease in facial convexity angle, and greater lower lip retraction in comparison with two-step/CA combination (weighted mean difference = 4.73°, P = 0.007; P = 0.0435; SMD = –0.95 mm, P = 0.01, respectively). Conclusion: There is weak-to-moderate evidence that using either en masse/TSAD combination or two-step/CA combination would lead to similar skeletal improvement. There is a very weak-to-moderate evidence that using TSADs with en masse retraction would cause better posterior anchorage and incisors inclination, and greater anterior teeth retraction than using CA with two-step retraction. There is weak-to-moderate evidence that using en masse/TSAD combination would lead to a better improvement in the facial profile. According to the quality of evidence, we confirm the need for more well-conducted RCTs in the en masse retraction field.
机译：目的：主要目的是评价临时骨架锚固装置（TSAD）与骨骼，牙科和软组织变量的临时骨架锚固装置（TSAD）的临时骨架锚固装置（TSAD）的有效性与传统锚固（CA）相比，以及缩回或整体正畸治疗的持续时间。材料和方法：在20190年1月至2018年4月之间进行了对预期，随机对照试验（RCTS）和临床对照试验（CCTS）的电子搜索PubMed和九个主要数据库。检查了每个已确定的文章中的参考书目。此外，手动搜索在五个主要正畸期刊中的同一时间框架中进行。成年患者经历固定的正畸治疗，随后在实验组中提取上颌前磨牙，然后在对照组中的上前齿的两步缩回。施用了CCTS和Cochrane对RCTS偏置工具的偏置工具风险的非扫描研究的方法。结果：本综述中包含四种文章（两个RCT和两个CCT），所有物品均适用于定量合成。在SNA，SNB，ANB和MP-SN角度方面，en Masse收缩和两步收缩组之间没有显着差异。使用TSADS在后锚和门牙倾斜方面具有明显更好的结果，与CA相比，更大的前齿缩回（标准化平均值= -3.03mm，PP = 0.003; SMD = -0.46mm，P = 0.03，分别）。 en Masse / Tsad组合导致鼻腔角度显着提高，面部凸起角度较高，与两步/ Ca组合相比，更低的唇缘缩回（加权平均差= 4.73°，p = 0.007; P = 0.0435 ; SMD = -0.95 mm，p = 0.01）。结论：使用EN Masse / Tsad组合或两步/ CA组合会导致类似的骨骼改进，存在弱于中等的证据。存在非常弱的证据，即使用en en masse缩回的Tsads将导致更好的后锚和门牙倾斜度，并且比使用两个步进缩回的CA更大的前齿缩回。有弱于中等的证据，使用EN Masse / TSAD组合将导致面部轮廓更好地改善。根据证据的质量，我们确认了在en Masse Retraction字段中更良好地进行的RCT。

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