自锁托槽对减少青少年患者正畸并发症的系统评价研究

发布时间：2018-05-18 12:45

本文选题：自锁托槽 + 正畸并发症　；参考：《昆明医科大学》2014年硕士论文

【摘要】：[目的]对近十年来自锁托槽减少青少年患者正畸治疗并发症的研究进行系统评价,对该领域存在争议的相关研究进行Meta分析,得出明确的结论,并通过方法学的质量评估发现既往研究的不足之处,对该领域的研究提供新的思路并为临床矫治提供科学依据。 [方法]采用计算机检索PubMed(2003-2013.5), Embase(2003-2013.5), Cochrane Library(2003-2013), CBM(2003-2013.5), CNKI(2003～2013.5), VIP(2003-2013.5)等数据库,根据纳入标准筛选自锁托槽对比传统托槽是否降低青春期错牙合畸形患者正畸治疗并发症,包括正畸疼痛,牙周损害,牙根吸收的发生率随机对照试验或半随机对照试验。并对纳入的研究进行资料提取与质量评价,运用Rev Man5软件进行Meta分析。 [结果] 1.自锁托槽与正畸疼痛：本系统评价纳入8项研究,共381例。Meta分析结果提示：使用自锁托槽对比传统托槽矫治过程中疼痛VAS评分的差异有统计学意义,[MD=-0.35,95%CI (-0.92,-0.4) P0.001]。 2.自锁托槽与牙周损害：本系统评价纳入6项研究,共168例。Meta分析结果提示：使用自锁托槽较传统托槽在矫治过程中减轻牙周损害的差异有统计学意义。GI[MD=-0.43,95%CI(-0.55,-0.32)P0.00001]; SBI[MD=-0.43,95%CI (-0.59,-0.27) P0.0001]; PLI [MD=-0.72,95%CI (-0.83,-0.60) P0.0001]. 3.自锁托槽与牙根吸收：本系统评价纳入4项研究,共218例。Meta分析的结果提示：使用自锁托槽矫治后与传统托槽矫治后对比,牙根外吸收率的差异无统计学意义,[MD=-0.01,95%CI (-0.21,0.19) P=0.93]。 [结论]与传统直丝弓托槽相比较,自锁托槽减轻了青少年患者在矫治过程中的疼痛感,减小了对牙周组织的损害,但在降低牙根吸收程度上并没有表现出明显的优势。临床医生在选择托槽时可以参考本研究结果。该结果是否与矫治弓丝的使用、错(?)畸形的类型以及矫治方法等因素相关,还需要大量的随机临床对照实验为临床提供证据。
[Abstract]:[objective] to evaluate systematically the study of reducing orthodontic treatment complications in adolescent patients by using locking brackets in recent ten years, and to make a Meta analysis of the related research in this field, and to draw a clear conclusion. The shortcomings of previous studies are found through the quality evaluation of methodology, which provides new ideas for the research in this field and provides scientific basis for clinical correction. [methods] A computer-based search was conducted for the databases of PubMedus, Embase, Cochrane Library, Cochrane, CNKI, CNKI, and VIPS, respectively. According to the inclusion criteria, whether self-locking brackets reduced the complications of orthodontic treatment, including orthodontic pain, periodontal damage, and so on, were selected according to the inclusion criteria. Incidence of root resorption: randomized controlled trial or semi-randomized controlled trial. Data extraction and quality evaluation were carried out on the included research, and Meta analysis was carried out by using Rev Man5 software. [results] 1. Self-locking bracket and orthodontic pain: a total of 381 cases of Meta-analysis showed that there was a statistically significant difference in VAS scores between self-locking brackets and orthodontic pain patients compared with traditional brackets. [MD-0.35 ~ 95CI 0.92 ~ 0.92 ~ (-0.4) P0.001]. 2. Self-locking brackets and periodontal damage: a total of 168 cases. Meta-analysis results showed that there were significant differences in reducing periodontal damage with self-locking brackets compared with traditional brackets during orthodontic treatment. GI [MD-0.4395CIC-0.55CI-0.32P0.00001]; SBI [MD-0.43CI-95CI-0.59CI-0.27]; PLI [MD-0.795CI -0.83CI-0.60] P0.0001]. 3. Self-locking brackets and root resorption: four studies were included in this systematic evaluation. The results of meta analysis in 218 cases suggested that there was no significant difference in the extracorporeal absorptivity between self-locking brackets and traditional brackets, [MD-0.01-95CI ~ (-0.21) 0.19] (P _ (0.93)]. [conclusion] compared with the traditional straight wire arch bracket, the self-locking bracket reduces the pain and the damage of periodontal tissue in the treatment of adolescent patients, but it has no obvious advantage in reducing the degree of root resorption. Clinicians can refer to the results of this study when choosing brackets. Whether this result is related to the use of orthodontic wire The types of deformities and methods of correction are related, and a large number of randomized controlled trials are needed to provide evidence for clinical practice.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5

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