2种上颌快速扩弓器临床效果的Meta分析

目的:比较牙支持式及混合支持式扩弓器进行上颌快速扩弓的临床效果.方法:计算机检索PubMed、Cochrane Library、EMbase、CBM、中国知网、维普、万方数据库,收集所有比较牙支持式及混合支持式扩弓器进行上颌快速扩弓的文献,检索时限均从建库至2015-10-31.按照纳入、排除标准,由2位研究者评价纳入研究的质量并提取资料后,采用RevMan 5.3软件进行Meta分析.结果:共纳入研究8篇,患者206例.Meta分析结果显示,牙支持式及混合支持式扩弓器相比,两者在扩弓矫治前后右侧第一磨牙倾斜角度变化[MD=-1.62,95％CI(-3.18,-0.07)]、第一前磨牙间距变化[SMD=-0.86,95％CI(-1.47,0.25)]、牙槽突倾斜角变化[SMD=-0.86,95％CI(-1.10,-0.20)]方面的差异有统计学意义.在扩弓矫治前后第一磨牙间距变化[SMD=-0.08,95％CI(-0.61,0.45)]、左侧第一磨牙倾斜角度变化[MD=-1.12,95％CI(-2.57,0.33)]、上颌骨横向宽度变化[SMD=-0.30,95％ CI(-1.08,0.47)]方面的差异无统计学意义.结论:牙支持式及混合支持式扩弓器对上颌牙弓的扩张效果相当,牙支持式扩弓器会造成更多的第一磨牙及牙槽突倾斜.

Meta-analysis of clinical effects of two kinds of rapid maxillary expanders

Objective:To compare the clinical effects of rapid maxillary expansion between tooth-borne and hybrid-borne expanders.Methods:PubMed,Cochrane Library,EMbase,CBM,CNKI,VIP and WanFang Data were searched from the date of their establishment to October 31,2015,to find clinical trials about comparison of rapid maxillary expansion by tooth tissue-borne versus hybrid-borne expanders.The quality of the included studies was evaluated by 2 independent reviewers,and Meta-analysis was performed by using RevMan 5.3 software.Results:8 articles with 206 cases were included.The results of Meta-analysis showed that:there were significant differences between the 2 groups in the changes of the right first molar dental inclination [MD =-1.62,95 ％ CI (-3.18,-0.07)],inter first premolar width [SMD =-0.86,95％ CI(-1.47,0.25)] and molar alveolar inclination [SMD =-0.86,95％ CI(-1.10,-0.20)].There was no significant difference between the 2 groups in the changes of inter first molar ~dth [SMD =-0.08,95％ CI (-0.6l,0.45)],the left first molar dental inclination [MD =-1.12,95％ CI(-2.57,0.33)],maxillary width [SMD =-0.30,95％ CI(-1.08,0.47)].Conclusion:The effect between tooth-borne and hybrid-borne expanders in the expansion of maxillary dental arch is similar.However,tooth-borne expanders may cause greater inclination of first molar and alveolar process.