PDF(Pubmed)
Abstract：
OBJECTIVE: To evaluate the effectiveness of distalizing maxillary first molars (U6) by temporary anchorage devices (TADs) according to their location (palatal, buccal, and zygomatic), their number, and appliance design.
METHODS: An electronic search of maxillary molar distalization with TADs was done through April 2023. After study selection, data extraction, and risk-of-bias assessment, meta-analyses were performed for the extent of distalization, distal tipping, and vertical movement of U6 using the generic inverse variance and random-effects model. The significance level was set at 0.05.
RESULTS: Forty studies met the inclusion criteria: 4 randomized controlled trials (RCTs), 13 prospective studies, and 23 retrospective studies (total of 1182 patients). Distalization of the U6 was not significantly greater (P = .64) by palatal (3.74 mm) and zygomatic (3.68 mm) than by buccal (3.23 mm) TADs. Distal tipping was significantly higher (P < .001) in nonrigid (9.84°) than in rigid (1.97°) appliances. Vertical movement was mostly intrusive and higher but not significantly different (P = .28) in zygomatic anchorage (-1.16 mm).
CONCLUSIONS: Distalization of U6 with TADs can be an effective and stable treatment procedure, especially when performed with rigid palatal appliances. However, further RCTs or prospective cohort studies are strongly recommended to provide more clinical evidence.
METHODS: An electronic search of maxillary molar distalization with TADs was done through April 2023. After study selection, data extraction, and risk-of-bias assessment, meta-analyses were performed for the extent of distalization, distal tipping, and vertical movement of U6 using the generic inverse variance and random-effects model. The significance level was set at 0.05.
RESULTS: Forty studies met the inclusion criteria: 4 randomized controlled trials (RCTs), 13 prospective studies, and 23 retrospective studies (total of 1182 patients). Distalization of the U6 was not significantly greater (P = .64) by palatal (3.74 mm) and zygomatic (3.68 mm) than by buccal (3.23 mm) TADs. Distal tipping was significantly higher (P < .001) in nonrigid (9.84°) than in rigid (1.97°) appliances. Vertical movement was mostly intrusive and higher but not significantly different (P = .28) in zygomatic anchorage (-1.16 mm).
CONCLUSIONS: Distalization of U6 with TADs can be an effective and stable treatment procedure, especially when performed with rigid palatal appliances. However, further RCTs or prospective cohort studies are strongly recommended to provide more clinical evidence.
摘要：
目的：评估通过临时锚固装置（TAD）根据其位置（腭，颊,andzy骨），他们的号码,和电器设计。
方法：直到2023年4月，对TAD的上颌磨牙扩张进行了电子搜索。经过研究选择，数据提取,和偏见风险评估，对远端化程度进行了荟萃分析，远端倾斜,和U6的垂直运动，使用通用逆方差和随机效应模型。显著性水平设定为0.05。
结果：40项研究符合纳入标准：4项随机对照试验，13项前瞻性研究，和23项回顾性研究（共1182例患者）。pal（3.74mm）和zy骨（3.68mm）的U6远大（P=.64）没有明显大于颊（3.23mm）TAD。非刚性（9.84°）的远端倾斜显着高于刚性（1.97°）矫治器（P<.001）。垂直运动大多是侵入性的，并且更高，但没有显着差异（P=.28）。
结论：用TAD治疗U6可能是一种有效且稳定的治疗方法，尤其是用硬腭矫治器进行时。然而,强烈建议进一步的RCT或前瞻性队列研究提供更多的临床证据.
方法：直到2023年4月，对TAD的上颌磨牙扩张进行了电子搜索。经过研究选择，数据提取,和偏见风险评估，对远端化程度进行了荟萃分析，远端倾斜,和U6的垂直运动，使用通用逆方差和随机效应模型。显著性水平设定为0.05。
结果：40项研究符合纳入标准：4项随机对照试验，13项前瞻性研究，和23项回顾性研究（共1182例患者）。pal（3.74mm）和zy骨（3.68mm）的U6远大（P=.64）没有明显大于颊（3.23mm）TAD。非刚性（9.84°）的远端倾斜显着高于刚性（1.97°）矫治器（P<.001）。垂直运动大多是侵入性的，并且更高，但没有显着差异（P=.28）。
结论：用TAD治疗U6可能是一种有效且稳定的治疗方法，尤其是用硬腭矫治器进行时。然而,强烈建议进一步的RCT或前瞻性队列研究提供更多的临床证据.
