微创骨皮质切开加速牙移动的临床效果及安全性的Meta分析

目的系统评价颌骨微创骨皮质切开加速牙移动的临床效果及安全性。 方法检索PubMed、Embase、Cochrane Library、Web of Science、中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方、维普资讯等数据库，检索时间限定至2019年2月。由2位研究者独立使用标准化方法从符合纳入标准的文献中提取相关数据并进行质量学评价。根据各研究间的异质性，采用固定或随机效应模型计算效应合并值的加权均数差（WMD）和相应的95%可信区间（95% CI）进行分析。采用Stata 11.0软件对资料进行Meta分析。 结果最终共纳入9篇文献（5篇随机对照临床试验、4篇临床对照试验），包括171例受试者。Meta分析结果显示：行颌骨微创骨皮质切开后上颌尖牙移动的差异有统计学意义[WMD = 0.36，95% CI（0.19，0.53）]；治疗完成时间差异有统计学意义[WMD = -5.41，95% CI（-6.63，-4.18）]；切开前后上颌第一磨牙位置差异无统计学意义[（WMD = -0.41，95% CI（-0.88，0.06）]；切开前后尖牙根尖吸收风险差异无统计学意义[WMD = -0.20，95% CI（-0.48，0.88）]。 结论颌骨微创骨皮质切开法能加速早期牙移动，缩短治疗时间；上颌第一磨牙近中移位不明显，尖牙根尖吸收风险未增加。

The clinical effect and risk of minimally invasive corticotomy in the acceleration of tooth movement: a Meta-analysis

ObjectiveThis Meta-analysis was performed to examine the clinical effect and risk of minimally invasive corticotomy in the acceleration of orthodontic tooth movement. MethodsLiterature was searched in some databases such as PubMed, Embase, Cochrane Library, Web of Science, CNKI, CBM, Wanfang and CQVIP. The search was limited to literature before February, 2019. Data were extracted and quality assessed independently and in duplicate by two researchers. The weighted mean difference (WMD) and 95% confidence intervals (CIs) were used to pool results using a fixed or random effects model according to heterogeneity. The Meta-analysis was performed using Stata software (version 11.0) . ResultsA total of 9 studies (5 randomized controlled trials and 4 clinical controlled trials) with 171 patients were included in this Meta-analysis. Our Meta-analysis yielded a statistically significant pooled difference in canine retraction [WMD = 0.36, 95% CI (0.19, 0.53) ] and overall treatment time [WMD = -5.41, 95% CI (-6.63, -4.18) ]. However, the result of the mesial movement of first molar showed no statistically significant difference [WMD = -0.41, 95% CI (-0.88, 0.06) ]. The risk of canine root resorption did not show significant changes [WMD = -0.20, 95% CI (-0.48, 0.88) ]. ConclusionsThe current study demonstrated that minimally invasive corticotomy could accelerate the orthodontic tooth movement at early stage and shorten the treatment time. The mesial movement of the first molar was not obvious. It did not increase the risk of canine root resorption.