自锁托槽与传统托槽在非拔牙矫治时牙弓变化比较的Meta分析

发布时间：2018-07-12 10:10

本文选题：自锁托槽 + 托槽　；参考：《暨南大学》2014年硕士论文

【摘要】：目的比较自锁托槽与传统托槽两者在非拔牙矫治牙列轻中度拥挤时上下颌牙弓宽度及前牙唇倾度的变化是否存在差异，为临床应用提供依据。方法采用循证医学系统评价方法，通过计算机检索PubMed、EMBASE、ISI、Cochrane临床对照试验资料库、万方科技期刊全文数据库、中国生物医学文献数据库（CBM）、相关期刊论文（CNKI）、维普中文科技期刊数据库（VIP）及辅以手工检索等方式，全面收集比较自锁托槽与传统托槽在非拔牙矫治时上下颌牙弓宽度及前牙唇倾度变化的文献，检索截止日期至2013年12月31日。由两名评价者按照纳入与排除标准筛选文献、并将纳入的文献进行质量评价及数据资料提取，运用Cochrane协作网Revman5.2软件对其进行Meta分析。结果本研究共纳入符合标准的文献有9篇，包括5篇中文文献，4篇英文文献，共有450例患者（自锁托槽组240例，传统托槽组210例）。Meta分析结果显示在非拔牙矫治病例中： 1、自锁托槽治疗患者的上颌尖牙间距、上颌第一前磨牙间距及上颌第二前磨牙间距的增加值均大于传统托槽，其差异均有统计学意义，，其具体值分别为：[MD=0.30,95%CI(0.04,0.55), P=0.02]，[MD=0.43,95%CI (0.17,0.70),P=0.001]，[MD=0.32,95%CI (0.08,0.56),P=0.008]。 2、自锁托槽与传统托槽相比，上颌第一磨牙间距变化的差异无统计学意义[MD=-0.01,95%CI (-0.25,0.24), P=0.66]。 3、自锁托槽与传统托槽相比，下颌尖牙间距、下颌第一前磨牙间距及下颌第二前磨牙间距变化的差异均无统计学意义，其具体值分别为：[MD=0.02,95%CI (-0.67,0.72), P=0.95]，[MD=0.26,95%CI (-0.62,1.14), P=0.57]，[MD=0.19,95%CI (-0.51,0.88), P=0.52]。 4、自锁托槽与传统托槽相比，下颌磨牙间距变化的差异有统计学意义[MD=0.59,95%CI(0.33,0.84), P＜0.01]。 5、上颌切牙唇倾度的增加量自锁托槽要小于传统托槽，两者比较有统计学上的差异[MD=-3.25,95%CI (-4.99,-1.51), P=0.0003]；下颌切牙唇倾度的增加量自锁托槽与传统托槽无统计学上的差异[MD=-0.44,95%CI (-1.52,0.64), P=0.43]。结论应用自锁托槽和传统托槽行非拔牙矫治牙列拥挤时，自锁托槽组在上颌尖牙区、上颌前磨牙区及下颌磨牙区的牙弓宽度扩大量比传统托槽组要大；在上颌磨牙区、下颌尖牙区、下颌前磨牙区牙弓宽度的变化量二者间无明显差异；无论自锁托槽还是传统托槽在非拔牙矫治时，上下前牙唇倾度均有不同程度的增加，但自锁托槽组的上颌前牙唇倾度增加量要显著小于传统托槽组；下颌前牙唇倾度的增加量与传统托槽相比并无显著差异。
[Abstract]:Objective to compare the changes of the width of upper and lower arch and the degree of labial inclination of anterior teeth between self-locking brackets and traditional brackets in the treatment of mild and moderate crowding of dentition without extraction, so as to provide the basis for clinical application. Methods the database of PubMedus EMBASEI Cochrane clinical controlled trial and the full text database of Wanfang Journal of Science and Technology were searched by Evidence-Based Medicine (EBM) system. Chinese Biomedical Literature Database (CBM), Chinese Journal Full-text Database (CNKI), Weipu Chinese Science and Technology Journal Database (VIP) and manual retrieval, etc. To collect and compare the changes of the width of the upper and lower arch and the labial inclination of the anterior teeth between the self-locking brackets and the traditional brackets during the non-extraction correction, and to search for the deadline from December 31, 2013. The literature was screened by two evaluators according to the inclusion and exclusion criteria, and the quality evaluation and data extraction were carried out. The Meta-analysis was carried out by using Cochrane Cooperative Web Revman 5.2 software. Results A total of 9 articles were included in this study, including 5 articles in Chinese and 4 articles in English. A total of 450 patients (240 cases of self-locking bracket group) were included in this study. The results of Meta-analysis showed that: 1, the increase of maxillary canine spacing, maxillary first premolar distance and maxillary second premolar spacing in patients with self-locking bracket therapy were higher than those in traditional brackets, and the results of meta-analysis showed that: (1) the increase value of maxillary canine space, maxillary first premolar space and maxillary second premolar spacing in patients with self-locking brackets was higher than that in traditional brackets. The differences were statistically significant, and the specific values were as follows: [MDT 0.30C _ (95) CI (0.040.55), P _ (0.02)], [MDO _ (0.439) 95 CI (0.170.70) P _ (0.001)], [MDO _ (0.32) C _ (95) CI (0.080.56) P _ (0.008)]. There was no significant difference in the distance between maxillary first molars [MD-0.01 ~ 95CI (-0.250.24), P _ (0.66)] .3The distance of mandibular canines between self-locking brackets and traditional brackets was higher than that of traditional brackets. There was no significant difference in the distance between the first premolars and the second premolars, and the specific values were: [MDO 0.02 + 95CI (-0.67U 0.72), P < 0.95], [MD0.2695CI (-0.62n 1.14), P0.57], [MD0.19995 CI (-0.51U 0.88), P < 0.52]. There was a significant difference in the distance between mandibular molars [(0.33 卤0.84) CI (0.33 卤0.84), P < 0.01]. 5. The increase of labial inclination of maxillary incisors was smaller than that of traditional brackets, and there was a statistical difference between them [MD-3.2595 CI (-4.99-1.51), P < 0.0003]. There was no statistical difference between self-locking brackets and traditional brackets in the increase of labial inclination of mandibular incisors [MD-0.44 ~ 95CI (-1.52 卤0.64), P _ (0.43)]. Conclusion when self-locking brackets and traditional brackets are used to treat dentition crowding, the arch width in the maxillary canine, maxillary premolar and mandibular molar areas in the self-locking bracket group is larger than that in the traditional bracket group. There was no significant difference in arch width between the maxillary molar region, mandibular canine region and mandibular premolar region. However, the increase of labial inclination in the self-locking bracket group was significantly lower than that in the traditional bracket group, and there was no significant difference between the mandibular anterior tooth labial tilting degree and the traditional bracket group.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5

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