PDF(Pubmed)
Abstract：
BACKGROUND: The use of clear aligners is becoming more common for aesthetic orthodontic treatment, but there are still concerns about how they affect mastication biomechanics in the short and long term. The clear aligners treatment (CAT) mechanism changes the position of the mandible and maxilla, especially impacting the masseter muscle. Surface electromyography (sEMG) proves to be a useful method to evaluate masticatory muscle activity (MMA).
OBJECTIVE: To analyze the effect of clear aligners treatment on alterations in masticatory muscles (masseter, temporalis) using surface electromyography.
METHODS: Five databases (PubMed, Web of Science, SCOPUS, Cochrane Library, and Google Scholar) were searched up to March 2024.
METHODS: Studies in which MMA was evaluated after the installation of orthodontic clear aligners.
METHODS: Screening, data extraction, and quality assessments were performed by four investigators independently. The data, which evaluated temporalis and masseter muscle characteristics during CAT using surface electromyography, was extracted, and the quality of the studies was evaluated. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS).
RESULTS: Six studies (two prospective cohort studies, three observational longitudinal studies, and one observational longitudinal case-control study) with low and moderate risk of bias were included in the qualitative synthesis. Six of these were also included in the meta-analysis. Our study investigated the dynamics of masseter and temporalis muscle activity during CAT. The results show that during maximal voluntary clenching, the masseter muscle demonstrated a significant initial increase (P < .05) followed by a subsequent non-significant decrease. It also showed that submaximal voluntary clenching consistently exhibited a significant reduction in muscle activity throughout the study period (P < .01). Assessment of muscle activity at the mandibular resting position revealed a variety of responses, with some participants showing a significant increase while others exhibited non-significant changes (P < .05, P > .05, respectively). However, the meta-analysis showed a non-significant difference in measuring masseter and temporalis muscles activity during CAT.
CONCLUSIONS: Based on existing evidence, it is reasonable to conclude that CAT affected MMA. During maximal voluntary clenching, masseter muscle activity initially increased but later decreased, while temporalis muscle activity showed mixed results. Submaximal voluntary clenching revealed a consistent decrease in muscle activity over time. Mandibular resting position assessments showed both increases and no significant changes in muscle activity. However, the existing literature is insufficient to draw concrete conclusions; therefore, well-conducted further research is needed to confirm this statement.
BACKGROUND: This systematic review and meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42024522231).
OBJECTIVE: To analyze the effect of clear aligners treatment on alterations in masticatory muscles (masseter, temporalis) using surface electromyography.
METHODS: Five databases (PubMed, Web of Science, SCOPUS, Cochrane Library, and Google Scholar) were searched up to March 2024.
METHODS: Studies in which MMA was evaluated after the installation of orthodontic clear aligners.
METHODS: Screening, data extraction, and quality assessments were performed by four investigators independently. The data, which evaluated temporalis and masseter muscle characteristics during CAT using surface electromyography, was extracted, and the quality of the studies was evaluated. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS).
RESULTS: Six studies (two prospective cohort studies, three observational longitudinal studies, and one observational longitudinal case-control study) with low and moderate risk of bias were included in the qualitative synthesis. Six of these were also included in the meta-analysis. Our study investigated the dynamics of masseter and temporalis muscle activity during CAT. The results show that during maximal voluntary clenching, the masseter muscle demonstrated a significant initial increase (P < .05) followed by a subsequent non-significant decrease. It also showed that submaximal voluntary clenching consistently exhibited a significant reduction in muscle activity throughout the study period (P < .01). Assessment of muscle activity at the mandibular resting position revealed a variety of responses, with some participants showing a significant increase while others exhibited non-significant changes (P < .05, P > .05, respectively). However, the meta-analysis showed a non-significant difference in measuring masseter and temporalis muscles activity during CAT.
CONCLUSIONS: Based on existing evidence, it is reasonable to conclude that CAT affected MMA. During maximal voluntary clenching, masseter muscle activity initially increased but later decreased, while temporalis muscle activity showed mixed results. Submaximal voluntary clenching revealed a consistent decrease in muscle activity over time. Mandibular resting position assessments showed both increases and no significant changes in muscle activity. However, the existing literature is insufficient to draw concrete conclusions; therefore, well-conducted further research is needed to confirm this statement.
BACKGROUND: This systematic review and meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42024522231).
摘要：
背景：在美学正畸治疗中，使用清晰的矫正器变得越来越普遍，但人们仍然担心它们在短期和长期内如何影响咀嚼生物力学。明确的对齐治疗（CAT）机制改变下颌骨和上颌骨的位置，尤其是对咬肌的影响.表面肌电图（sEMG）被证明是评估咀嚼肌活动（MMA）的有用方法。
目的：分析透明矫正器治疗对咀嚼肌改变的影响（咬肌，颞肌）使用表面肌电图。
方法：五个数据库(PubMed，WebofScience,Scopus,科克伦图书馆,和谷歌学者)被搜索到2024年3月。
方法：在安装正畸透明矫正器后评估MMA的研究。
方法：筛选，数据提取,质量评估由4名研究者独立进行.数据，使用表面肌电图评估CAT期间的颞肌和咬肌特征，被提取，并对研究的质量进行了评估。使用纽卡斯尔-渥太华量表（NOS）评估偏倚风险。
结果：六项研究（两项前瞻性队列研究，三项观察性纵向研究，定性综合中纳入了一项观察性纵向病例对照研究）。其中六个也包括在荟萃分析中。我们的研究调查了CAT期间咬肌和颞肌活动的动力学。结果表明，在最大自愿紧握期间，咬肌表现出显著的初始增加(P<.05),随后无显著下降。它还表明，在整个研究期间，次最大的自愿握紧始终表现出肌肉活动的显着减少（P<0.01）。评估下颌静息位置的肌肉活动显示出多种反应，一些参与者表现出显着增加，而另一些参与者表现出无显着变化（分别为P<.05，P>.05）。然而,荟萃分析显示CAT期间测量咬肌和颞肌活动的差异无统计学意义。
结论：根据现有证据，得出CAT影响MMA的结论是合理的。在最大的自愿紧握期间，咬肌活动最初增加，但后来减少，而颞肌活动表现出混合的结果。次最大自愿握紧显示肌肉活动随时间持续减少。下颌静息位置评估显示肌肉活动既增加又无明显变化。然而,现有文献不足以得出具体的结论；因此，需要进行良好的进一步研究来证实这一说法。
背景：本系统评价和荟萃分析已在国际前瞻性系统评价注册（PROSPEROCRD42024522231）中注册。
目的：分析透明矫正器治疗对咀嚼肌改变的影响（咬肌，颞肌）使用表面肌电图。
方法：五个数据库(PubMed，WebofScience,Scopus,科克伦图书馆,和谷歌学者)被搜索到2024年3月。
方法：在安装正畸透明矫正器后评估MMA的研究。
方法：筛选，数据提取,质量评估由4名研究者独立进行.数据，使用表面肌电图评估CAT期间的颞肌和咬肌特征，被提取，并对研究的质量进行了评估。使用纽卡斯尔-渥太华量表（NOS）评估偏倚风险。
结果：六项研究（两项前瞻性队列研究，三项观察性纵向研究，定性综合中纳入了一项观察性纵向病例对照研究）。其中六个也包括在荟萃分析中。我们的研究调查了CAT期间咬肌和颞肌活动的动力学。结果表明，在最大自愿紧握期间，咬肌表现出显著的初始增加(P<.05),随后无显著下降。它还表明，在整个研究期间，次最大的自愿握紧始终表现出肌肉活动的显着减少（P<0.01）。评估下颌静息位置的肌肉活动显示出多种反应，一些参与者表现出显着增加，而另一些参与者表现出无显着变化（分别为P<.05，P>.05）。然而,荟萃分析显示CAT期间测量咬肌和颞肌活动的差异无统计学意义。
结论：根据现有证据，得出CAT影响MMA的结论是合理的。在最大的自愿紧握期间，咬肌活动最初增加，但后来减少，而颞肌活动表现出混合的结果。次最大自愿握紧显示肌肉活动随时间持续减少。下颌静息位置评估显示肌肉活动既增加又无明显变化。然而,现有文献不足以得出具体的结论；因此，需要进行良好的进一步研究来证实这一说法。
背景：本系统评价和荟萃分析已在国际前瞻性系统评价注册（PROSPEROCRD42024522231）中注册。
