背景:关于矫形/正畸在治疗JIA相关的牙面畸形中的作用的最新知识是相关的。
目的:本系统综述旨在评估正畸和/或牙颌面骨科治疗幼年特发性关节炎(JIA)牙颌面畸形的证据水平。
方法:截至2024年1月31日,在没有时间或语言限制的情况下搜索了以下数据库(Medline,Embase,Cochrane中央控制试验登记册,Scopus,WebofScience,和拉丁美洲和加勒比健康科学文献)。
方法:纳入标准是关于接受正畸和/或牙面矫形功能矫治器治疗的JIA受试者的研究。
方法:删除重复研究后,数据提取,并根据ROBINS-I指南进行偏倚风险评估。数据提取由两名独立作者进行。
结果:电子数据库搜索在删除重复项后确定了397篇合格文章。在应用预定义的纳入和排除标准之后,剩下11篇文章供列入。两项试验与严重的偏倚风险相关,四项试验存在中等偏倚风险,其他五个呈现低的偏见风险。各种研究小组采用并记录了不同类型的设备和方法的效果。这项研究的异质性不允许进行荟萃分析。此外,在纳入的研究中,观察到治疗目标缺乏一致性.在10项研究中证明了牙面骨科治疗后骨骼的改善,7项研究报告口面体征和症状减少。
结论:在现有文献中,有少量证据表明,牙面骨科可能对JIA的牙面畸形的治疗有益。几乎没有证据表明它可以减少JIA患者的口面体征和症状。根据目前的证据,对于患有JIA相关牙颌面畸形的越来越多的受试者,无法概述骨科治疗的具体方面的临床建议.
背景:PROSPERO(CRD42023390746)。
BACKGROUND: An update on the knowledge regarding the orthopedic/orthodontic role in treating JIA-related dentofacial deformities is relevant.
OBJECTIVE: This systematic review aimed to assess the level of evidence regarding the management of dentofacial deformity from juvenile idiopathic arthritis (JIA) with orthodontics and/or dentofacial orthopedics.
METHODS: The following databases were searched without time or language restrictions up to 31 January 2024 (Medline, Embase, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Latin American and Caribbean Health Sciences Literature).
METHODS: Inclusion criteria were studies dealing with JIA subjects receiving treatment with orthodontic and/or dentofacial orthopedic functional appliances.
METHODS: After the removal of duplicate studies, data extraction, and risk of bias assessment according to ROBINS-I guidelines were conducted. Data extraction was conducted by two independent authors.
RESULTS: The electronic database search identified 397 eligible articles after the removal of duplicates. Following the application of the pre-defined inclusion and exclusion criteria, 11 articles were left for inclusion. Two trials were associated with a severe risk of bias, four trials were at moderate risk of bias, and the other five presented a low risk of bias. Various research groups employed and documented the effects of different types of appliances and methodologies. The study heterogeneity did not allow for meta-analyses. In addition, a lack of uniformity in treatment objectives was observed across the included studies. After treatment with dentofacial orthopedics skeletal improvement was demonstrated in 10 studies, and a decrease in orofacial signs and symptoms was reported in 7 studies.
CONCLUSIONS: Across the available literature, there is minor evidence to suggest that dentofacial orthopedics may be beneficial in the management of dentofacial deformities from JIA. There is little evidence to suggest that it can reduce orofacial signs and symptoms in patients with JIA. Based on current evidence, it is not possible to outline clinical recommendations for specific aspects of orthopedic management in growing subjects with JIA-related dentofacial deformity.
BACKGROUND: PROSPERO (CRD42023390746).