正畸正颌联合矫治骨性Ⅲ类错畸形前牙位置及硬组织稳定性系统评价.docVIP

正畸正颌联合矫治骨性Ⅲ类错畸形前牙位置及硬组织稳定性系统评价 　　[摘要] 目的 对正畸正颌联合矫治骨性Ⅲ类错畸形在术后3年前牙位置及硬组织的稳定性进行系统评价。方法 采用计算机检索及手工检索相结合的方式，全面查找研究正畸正颌联合矫治严重骨性Ⅲ类错畸形的所有文献，检索日期截止2013年12月。严格按照纳入标准和排除标准筛选文献，对纳入研究的文献进行质量评价，采用Rev Man5.2软件对前牙位置及硬组织相关指标稳定性进行Meta分析或描述性分析。结果 研究最终纳入4篇文献，均为前后对照试验，共180例患者，文献评价等级均为A。Meta分析结果表明：术后3年与术后相比，U1-SN的合并加权均数差 （WMD）为4.29，差异有统计学意义（P0.05）。描述性分析表明，术后3年A点位置相对稳定，B点较术后有轻微复发（P0.05）。结论 下前牙的位置及前牙覆覆盖较为稳定，上前牙有轻微复发唇倾；上颌骨的位置基本保持稳定，仅下颌骨有少量的向前复发。 　　[关键词] 正畸正颌联合矫治； 骨性Ⅲ类错； 前牙； 硬组织； 稳定性； Meta分析； 系统评价 　　[中图分类号] R 783.5 [文献标志码] A [doi] 10.7518/hxkq.2015.03.011 　　[Abstract] Objective This study aims to analyze the long-term stability of the anterior teeth and hard tissue of skeletal class Ⅲ malocclusion after a three-year orthodontic surgery by systematic review. Methods All studies about skeletal class Ⅲ malocclusion with orthodontic-surgery were searched by computer-based retrieval and manual retrieval； the deadline is December 2013. The literature， filtered according to the inclusion criteria and exclusion criteria， was performed with quality assessment. The same indicators of the anterior location and hard tissue stability were combined and evaluated with meta-analysis and descriptive analysis by Rev Man5.2. Results Four before-and-after comparison study articles with 180 cases were included. The grades of the four literature evaluation were A. The meta-analysis results showed that comparing the three-year post-orthodontic-surgery and post-orthodontic-surgery， the total weighted mean difference （WMD） of U1-SN was 4.29 （P0.05）. The measurement methods of A and B point position were different， hence the qualitative description were as follows： point A remained at a relatively stable position， and point B had some replacement compared with post-operative （P0.05）. Conclusion To the skeletal class Ⅲ malocclusion after three-year orthodontic-surgery， the position of the lower anterior teeth could be kept stable， as well as the overbite and the overjet of the anterior teeth； only the upper inci-