使用透明调整器提取前膜后的空间封闭:通过元分析进行系统审查
Fernanda Vicioni-Marques1,2, Caio Luiz Bitencourt Reis3,4, Ana Paula Valladares de Almeida1
1School of Dentistry of Ribeirão Preto, Department of Pediatric Dentistry, University of São Paulo, Avenida do café, s/n, São Paulo, 14040-904, Ribeirão Preto, Brazil.
Clinical oral investigations
|September 2, 2025
概括
清晰对齐器治疗 (CAT) 显示出前拔除 (SCaPE) 后间隙关闭的有效性和可预测性有限,通常导致不必要的牙移动. 与CAT相比,固定仪器可以提供更好的控制和结果.
科学领域:
- 牙整形
- 牙科技术
背景情况:
- 清晰对齐器处理 (CAT) 在前膜提取后的空间封闭 (SCaPE) 的有效性和可预测性尚未得到充分证实.
- 在SCaPE的CAT过程中不必要的牙移动需要进一步调查.
研究的目的:
- 系统地审查和评估SCaPE的CAT的有效性,可预测性和对不必要的牙移动的抵抗性.
- 将CAT的结果与预测的移动进行比较,并评估固定设备的潜在优势.
主要方法:
- 包括前后研究和临床试验在内的系统审查,包括到2024年11月进行全面的数据库搜索.
- 使用ROB-2和ROBINS-I工具进行质量评估,并使用Invisalign®系统对预测和实现的牙移动进行元分析.
- 通过标准化的配对差异 (SPD) 估计效果大小,并使用GRADE工具评估95%的预测和置信区间.
主要成果:
- 对510名参与者的14项研究进行了分析,其中10项研究具有高偏差风险.
- 对前牙收缩的CAT效果明显低于预期,导致舌头倾斜和挤出增加.
- 与预测相比,获得的远端犬骨倾斜和半端第一骨倾斜也大于预期,对CAT和固定器件进行比较的证据有限.
结论:
- 由于身体牙运动和定控制的局限性,CAT对SCaPE的有效性和可预测性似乎较低.
- 固定的设备可能优于SCaPE的CAT,尽管证据有限,确定性低至非常低.
- 未来的研究应该集中在增强CAT预测模型和探索辅助使用,以提高SCaPE的疗效.
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