背景:文献中没有系统评价和荟萃分析,比较生长患者上颌快速扩张(RME)和上颌缓慢扩张(SME)的患者报告结果指标(PROMs)。
目的:本系统评价的目的是比较RME和SME患者的PROM。
方法:PubMed(MEDLINE)中的电子搜索,科克伦图书馆,Scopus,Embase,WebofScience,并进行了OpenGrey。仅包括RCT。纳入标准是:混合牙列或早期恒牙的生长患者,轻度至中度上颌横向缺损,牙齿拥挤,固定扩张器治疗上颌骨快速和缓慢扩张。使用RoB2评估偏倚风险。已执行GRADE语句。差异的平均值(MD)和风险比(RR)用于数据的汇总。应用了随机效应模型。
结果:最终将两篇共157例患者纳入系统评价和荟萃分析。一篇文章的偏见风险很低,而一个人有偏见的风险,有一些担忧。疼痛的存在较少,虽然没有统计学意义,在SME患者中(RR=2.02,95CI从0.55到7.49,P=0.29,I2=95%,2研究,等级很低)。在治疗的第一周,SME应用的疼痛强度显着降低(合并MD=0.86有利于SME,95CI从0.47到1.26,P<0.0001,I2=6%,2研究,等级中等)。两组在说话难度上无显著差异,吞咽困难,唾液分泌过多,卫生困难,以及患者和父母的满意度。
结论:在治疗的第一周期间,与RME相比,SME的疼痛强度明显降低。在接下来的几周里,两种方案在疼痛方面没有差异.
BACKGROUND: No systematic
review and meta-analysis are present in the literature comparing patient-reported outcome measures (PROMs) in rapid maxillary expansion (RME) versus slow maxillary expansion (SME) in growing patients.
OBJECTIVE: The objective of this systematic
review was to compare PROMs in RME versus SME in growing patients.
METHODS: Electronic search in PubMed (MEDLINE), Cochrane Library, Scopus, Embase, Web of Science, and OpenGrey was conducted. Only RCTs were included. Inclusion criteria were: growing patients in the mixed dentition or early permanent dentition, mild-to-moderate maxillary transverse deficiency, dental crowding, treatment with fixed expanders for rapid and slow maxillary expansion. Risk of bias was assessed using RoB 2. GRADE statement was performed. The mean of the differences (MD) and the risk ratio (RR) were used for the aggregation of data. A random effect model was applied.
RESULTS: Two articles with a total of 157 patients were finally included in the systematic
review and meta-analysis. One article was at low risk of bias, while one was at risk of bias with some concerns. Pain presence was less, though not statistically significant, in SME patients (RR = 2.02, 95%CI from 0.55 to 7.49, P = 0.29, I2 = 95%, 2 studies, GRADE very low). Pain intensity was significantly lower in SME appliance in the first week of treatment (pooled MD = 0.86 favoring SME, 95%CI from 0.47 to 1.26, P < 0.0001, I2 = 6%, 2 studies, GRADE moderate). There were no significant differences between the two groups in difficulty in speaking, difficulty in swallowing, hypersalivation, difficulty in hygiene, and patient and parent satisfaction.
CONCLUSIONS: Pain intensity was significantly lower in SME compared to RME during the first week of treatment. For the following weeks, there were no differences in pain between the two protocols.