Abstract：
To evaluate the treatment effects and post-treatment stability of the maxillary total arch distalization using TADs during the non-extraction treatment of class II malocclusions.
Study involved an electronic search followed by hand searching for randomized and non-randomized clinical studies about maxillary total arch distalization using TADs. After data extraction and risk of bias assessment, meta-analysis was performed for dental, skeletal and soft tissue changes using the Generic-inverse variance approach by use of the mean difference and random-effect model.
In total, 1788 articles were identified, 88 full texts were screened and 22 studies were found eligible; 17 of them were included in the quantitative analysis. The means of distalization/distal tipping of the maxillary first molar were 4mm/3.17° in adults, 3.95mm/1.61° in adolescents after treatment with the Modified C-Palatal plate (MCPP), while they were 2.44mm/2.91° with the inter-radicular mini-screws. Both MCPP\'s treatment in adults and inter-radicular mini-screws resulted in significant intrusion of U6 (1.64 and 0.75mm, respectively), while insignificant extrusion of U6 was resulted in adolescents treated by MCPP. MCPP appliances resulted in palatal inclination/extrusion of maxillary incisors U1 (6.77°/2mm in adults, 7.46°/3.14mm in adolescents). In contrast, inter-radicular mini-screws resulted in less palatal less amount of palatal inclination/insignificant intrusion of U1 (2.42°/0.14mm). MCPP treatment also resulted in significant changes in the skeletal measurements (SNA, ANB, occlusal and mandibular planes). Insignificant differences were found between subgroups in the retraction amount of maxillary incisors, as well as the upper and lower lips. In the follow-up of adolescents treated with MCPP, a significant amount of mesial movement, mesial tipping, and extrusion (2.94mm, 2.84°, and 3.94mm, respectively) was found. However, skeletal and occlusal corrections of the Class II relationship were maintained.
Maxillary total arch distalization using TADs can be an effective and stable treatment procedure. However, RCTs or prospective cohort studies are highly recommended to establish a clinical evidence regarding their efficiency.
Study involved an electronic search followed by hand searching for randomized and non-randomized clinical studies about maxillary total arch distalization using TADs. After data extraction and risk of bias assessment, meta-analysis was performed for dental, skeletal and soft tissue changes using the Generic-inverse variance approach by use of the mean difference and random-effect model.
In total, 1788 articles were identified, 88 full texts were screened and 22 studies were found eligible; 17 of them were included in the quantitative analysis. The means of distalization/distal tipping of the maxillary first molar were 4mm/3.17° in adults, 3.95mm/1.61° in adolescents after treatment with the Modified C-Palatal plate (MCPP), while they were 2.44mm/2.91° with the inter-radicular mini-screws. Both MCPP\'s treatment in adults and inter-radicular mini-screws resulted in significant intrusion of U6 (1.64 and 0.75mm, respectively), while insignificant extrusion of U6 was resulted in adolescents treated by MCPP. MCPP appliances resulted in palatal inclination/extrusion of maxillary incisors U1 (6.77°/2mm in adults, 7.46°/3.14mm in adolescents). In contrast, inter-radicular mini-screws resulted in less palatal less amount of palatal inclination/insignificant intrusion of U1 (2.42°/0.14mm). MCPP treatment also resulted in significant changes in the skeletal measurements (SNA, ANB, occlusal and mandibular planes). Insignificant differences were found between subgroups in the retraction amount of maxillary incisors, as well as the upper and lower lips. In the follow-up of adolescents treated with MCPP, a significant amount of mesial movement, mesial tipping, and extrusion (2.94mm, 2.84°, and 3.94mm, respectively) was found. However, skeletal and occlusal corrections of the Class II relationship were maintained.
Maxillary total arch distalization using TADs can be an effective and stable treatment procedure. However, RCTs or prospective cohort studies are highly recommended to establish a clinical evidence regarding their efficiency.
摘要：
目的评价在II类错牙合非拔牙治疗过程中使用TAD进行上颌全弓扩张的治疗效果和治疗后稳定性。
研究涉及电子搜索，然后手动搜索有关使用TAD的上颌全弓扩张的随机和非随机临床研究。经过数据提取和偏差风险评估，对牙科进行了荟萃分析，通过使用平均差和随机效应模型，使用广义逆方差方法进行骨骼和软组织变化。
总共，1788篇文章被确认，筛选了88篇全文，发现22篇研究合格；其中17篇纳入定量分析。成人上颌第一磨牙的扩张/远端倾斜方式为4mm/3.17°，改良C-腭板（MCPP）治疗后青少年的3.95mm/1.61°，而它们是2.44毫米/2.91°，与神经根之间的微型螺钉。MCPP在成人中的治疗和神经根间微型螺钉均导致U6明显侵入（1.64和0.75mm，分别)，而在接受MCPP治疗的青少年中，U6的挤出不明显。MCPP矫治器导致上颌切牙U1的腭倾斜/挤压（成人为6.77°/2mm，青少年7.46°/3.14mm)。相比之下,神经根间微型螺钉可减少pal倾角/U1的侵入量（2.42°/0.14mm）。MCPP治疗也导致骨骼测量的显著变化(SNA，ANB,咬合和下颌平面）。上颌切牙的回缩量在亚组之间无显著差异，以及上唇和下唇。在接受MCPP治疗的青少年的随访中，大量的中间运动，中等小费，和挤压(2.94mm，2.84°,和3.94毫米，分别)被发现。然而,维持了II类关系的骨骼和咬合校正。
使用TAD的上颌全弓扩张可以是有效且稳定的治疗程序。然而,强烈建议RCT或前瞻性队列研究以建立有关其有效性的临床证据。
研究涉及电子搜索，然后手动搜索有关使用TAD的上颌全弓扩张的随机和非随机临床研究。经过数据提取和偏差风险评估，对牙科进行了荟萃分析，通过使用平均差和随机效应模型，使用广义逆方差方法进行骨骼和软组织变化。
总共，1788篇文章被确认，筛选了88篇全文，发现22篇研究合格；其中17篇纳入定量分析。成人上颌第一磨牙的扩张/远端倾斜方式为4mm/3.17°，改良C-腭板（MCPP）治疗后青少年的3.95mm/1.61°，而它们是2.44毫米/2.91°，与神经根之间的微型螺钉。MCPP在成人中的治疗和神经根间微型螺钉均导致U6明显侵入（1.64和0.75mm，分别)，而在接受MCPP治疗的青少年中，U6的挤出不明显。MCPP矫治器导致上颌切牙U1的腭倾斜/挤压（成人为6.77°/2mm，青少年7.46°/3.14mm)。相比之下,神经根间微型螺钉可减少pal倾角/U1的侵入量（2.42°/0.14mm）。MCPP治疗也导致骨骼测量的显著变化(SNA，ANB,咬合和下颌平面）。上颌切牙的回缩量在亚组之间无显著差异，以及上唇和下唇。在接受MCPP治疗的青少年的随访中，大量的中间运动，中等小费，和挤压(2.94mm，2.84°,和3.94毫米，分别)被发现。然而,维持了II类关系的骨骼和咬合校正。
使用TAD的上颌全弓扩张可以是有效且稳定的治疗程序。然而,强烈建议RCT或前瞻性队列研究以建立有关其有效性的临床证据。
