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Abstract：
BACKGROUND: This review aims to compare the effectiveness of en masse and two-step retraction methods during orthodontic space closure regarding anchorage preservation and anterior segment retraction and to assess their effect on the duration of treatment and root resorption.
METHODS: An electronic search for potentially eligible randomized controlled trials and prospective controlled trials was performed in five electronic databases up to July 2017. The process of study selection, data extraction, and quality assessment was performed by two reviewers independently. A narrative review is presented in addition to a quantitative synthesis of the pooled results where possible. The Cochrane risk of bias tool and the Newcastle-Ottawa Scale were used for the methodological quality assessment of the included studies.
RESULTS: Eight studies were included in the qualitative synthesis in this review. Four studies were included in the quantitative synthesis. En masse/miniscrew combination showed a statistically significant standard mean difference regarding anchorage preservation - 2.55 mm (95% CI - 2.99 to - 2.11) and the amount of upper incisor retraction - 0.38 mm (95% CI - 0.70 to - 0.06) when compared to a two-step/conventional anchorage combination. Qualitative synthesis suggested that en masse retraction requires less time than two-step retraction with no difference in the amount of root resorption.
CONCLUSIONS: Both en masse and two-step retraction methods are effective during the space closure phase. The en masse/miniscrew combination is superior to the two-step/conventional anchorage combination with regard to anchorage preservation and amount of retraction. Limited evidence suggests that anchorage reinforcement with a headgear produces similar results with both retraction methods. Limited evidence also suggests that en masse retraction may require less time and that no significant differences exist in the amount of root resorption between the two methods.
METHODS: An electronic search for potentially eligible randomized controlled trials and prospective controlled trials was performed in five electronic databases up to July 2017. The process of study selection, data extraction, and quality assessment was performed by two reviewers independently. A narrative review is presented in addition to a quantitative synthesis of the pooled results where possible. The Cochrane risk of bias tool and the Newcastle-Ottawa Scale were used for the methodological quality assessment of the included studies.
RESULTS: Eight studies were included in the qualitative synthesis in this review. Four studies were included in the quantitative synthesis. En masse/miniscrew combination showed a statistically significant standard mean difference regarding anchorage preservation - 2.55 mm (95% CI - 2.99 to - 2.11) and the amount of upper incisor retraction - 0.38 mm (95% CI - 0.70 to - 0.06) when compared to a two-step/conventional anchorage combination. Qualitative synthesis suggested that en masse retraction requires less time than two-step retraction with no difference in the amount of root resorption.
CONCLUSIONS: Both en masse and two-step retraction methods are effective during the space closure phase. The en masse/miniscrew combination is superior to the two-step/conventional anchorage combination with regard to anchorage preservation and amount of retraction. Limited evidence suggests that anchorage reinforcement with a headgear produces similar results with both retraction methods. Limited evidence also suggests that en masse retraction may require less time and that no significant differences exist in the amount of root resorption between the two methods.
摘要：
背景：这篇综述旨在比较正畸间隙闭合过程中整体和两步回缩方法在支抗保留和前节回缩方面的有效性，并评估其对治疗持续时间和牙根吸收的影响。
方法：截至2017年7月，在五个电子数据库中对可能符合条件的随机对照试验和前瞻性对照试验进行了电子搜索。研究选择的过程，数据提取,质量评估由两名评审员独立进行.除了在可能的情况下对汇总结果进行定量综合外，还进行了叙述性审查。使用Cochrane偏倚风险工具和纽卡斯尔-渥太华量表对纳入研究的方法学质量进行评估。
结果：本综述的定性综合纳入了8项研究。在定量合成中包括四项研究。与两步式/常规锚固组合相比，整体/微型组合在锚固保留方面显示出统计学上显着的标准平均差异-2.55mm（95％CI-2.99至-2.11）和上切牙回缩量-0.38mm（95％CI-0.70至-0.06）。定性合成表明，整体回缩比两步回缩需要更少的时间，而根部吸收量没有差异。
结论：在空间闭合阶段，整体和两步回缩方法均有效。在锚固保护和缩回量方面，整体/微型机组组合优于两步式/常规锚固组合。有限的证据表明，使用头帽进行锚固加固可以在两种缩回方法中产生相似的结果。有限的证据还表明，整体回缩可能需要更少的时间，并且两种方法之间的牙根吸收量没有显着差异。
方法：截至2017年7月，在五个电子数据库中对可能符合条件的随机对照试验和前瞻性对照试验进行了电子搜索。研究选择的过程，数据提取,质量评估由两名评审员独立进行.除了在可能的情况下对汇总结果进行定量综合外，还进行了叙述性审查。使用Cochrane偏倚风险工具和纽卡斯尔-渥太华量表对纳入研究的方法学质量进行评估。
结果：本综述的定性综合纳入了8项研究。在定量合成中包括四项研究。与两步式/常规锚固组合相比，整体/微型组合在锚固保留方面显示出统计学上显着的标准平均差异-2.55mm（95％CI-2.99至-2.11）和上切牙回缩量-0.38mm（95％CI-0.70至-0.06）。定性合成表明，整体回缩比两步回缩需要更少的时间，而根部吸收量没有差异。
结论：在空间闭合阶段，整体和两步回缩方法均有效。在锚固保护和缩回量方面，整体/微型机组组合优于两步式/常规锚固组合。有限的证据表明，使用头帽进行锚固加固可以在两种缩回方法中产生相似的结果。有限的证据还表明，整体回缩可能需要更少的时间，并且两种方法之间的牙根吸收量没有显着差异。
