本文選題：自鎖托槽 + 正畸并發(fā)癥　； 參考：《昆明醫(yī)科大學(xué)》2014年碩士論文

【摘要】：[目的]對(duì)近十年來(lái)自鎖托槽減少青少年患者正畸治療并發(fā)癥的研究進(jìn)行系統(tǒng)評(píng)價(jià),對(duì)該領(lǐng)域存在爭(zhēng)議的相關(guān)研究進(jìn)行Meta分析,得出明確的結(jié)論,并通過(guò)方法學(xué)的質(zhì)量評(píng)估發(fā)現(xiàn)既往研究的不足之處,對(duì)該領(lǐng)域的研究提供新的思路并為臨床矯治提供科學(xué)依據(jù)。 [方法]采用計(jì)算機(jī)檢索PubMed(2003-2013.5), Embase(2003-2013.5), Cochrane Library(2003-2013), CBM(2003-2013.5), CNKI(2003～2013.5), VIP(2003-2013.5)等數(shù)據(jù)庫(kù),根據(jù)納入標(biāo)準(zhǔn)篩選自鎖托槽對(duì)比傳統(tǒng)托槽是否降低青春期錯(cuò)牙合畸形患者正畸治療并發(fā)癥,包括正畸疼痛,牙周損害,牙根吸收的發(fā)生率隨機(jī)對(duì)照試驗(yàn)或半隨機(jī)對(duì)照試驗(yàn)。并對(duì)納入的研究進(jìn)行資料提取與質(zhì)量評(píng)價(jià),運(yùn)用Rev Man5軟件進(jìn)行Meta分析。 [結(jié)果] 1.自鎖托槽與正畸疼痛：本系統(tǒng)評(píng)價(jià)納入8項(xiàng)研究,共381例。Meta分析結(jié)果提示：使用自鎖托槽對(duì)比傳統(tǒng)托槽矯治過(guò)程中疼痛VAS評(píng)分的差異有統(tǒng)計(jì)學(xué)意義,[MD=-0.35,95%CI (-0.92,-0.4) P0.001]。 2.自鎖托槽與牙周損害：本系統(tǒng)評(píng)價(jià)納入6項(xiàng)研究,共168例。Meta分析結(jié)果提示：使用自鎖托槽較傳統(tǒng)托槽在矯治過(guò)程中減輕牙周損害的差異有統(tǒng)計(jì)學(xué)意義。GI[MD=-0.43,95%CI(-0.55,-0.32)P0.00001]; SBI[MD=-0.43,95%CI (-0.59,-0.27) P0.0001]; PLI [MD=-0.72,95%CI (-0.83,-0.60) P0.0001]. 3.自鎖托槽與牙根吸收：本系統(tǒng)評(píng)價(jià)納入4項(xiàng)研究,共218例。Meta分析的結(jié)果提示：使用自鎖托槽矯治后與傳統(tǒng)托槽矯治后對(duì)比,牙根外吸收率的差異無(wú)統(tǒng)計(jì)學(xué)意義,[MD=-0.01,95%CI (-0.21,0.19) P=0.93]。 [結(jié)論]與傳統(tǒng)直絲弓托槽相比較,自鎖托槽減輕了青少年患者在矯治過(guò)程中的疼痛感,減小了對(duì)牙周組織的損害,但在降低牙根吸收程度上并沒(méi)有表現(xiàn)出明顯的優(yōu)勢(shì)。臨床醫(yī)生在選擇托槽時(shí)可以參考本研究結(jié)果。該結(jié)果是否與矯治弓絲的使用、錯(cuò)(?)畸形的類型以及矯治方法等因素相關(guān),還需要大量的隨機(jī)臨床對(duì)照實(shí)驗(yàn)為臨床提供證據(jù)。
[Abstract]:[objective] to evaluate systematically the study of reducing orthodontic treatment complications in adolescent patients by using locking brackets in recent ten years, and to make a Meta analysis of the related research in this field, and to draw a clear conclusion. The shortcomings of previous studies are found through the quality evaluation of methodology, which provides new ideas for the research in this field and provides scientific basis for clinical correction. [methods] A computer-based search was conducted for the databases of PubMedus, Embase, Cochrane Library, Cochrane, CNKI, CNKI, and VIPS, respectively. According to the inclusion criteria, whether self-locking brackets reduced the complications of orthodontic treatment, including orthodontic pain, periodontal damage, and so on, were selected according to the inclusion criteria. Incidence of root resorption: randomized controlled trial or semi-randomized controlled trial. Data extraction and quality evaluation were carried out on the included research, and Meta analysis was carried out by using Rev Man5 software. [results] 1. Self-locking bracket and orthodontic pain: a total of 381 cases of Meta-analysis showed that there was a statistically significant difference in VAS scores between self-locking brackets and orthodontic pain patients compared with traditional brackets. [MD-0.35 ~ 95CI 0.92 ~ 0.92 ~ (-0.4) P0.001]. 2. Self-locking brackets and periodontal damage: a total of 168 cases. Meta-analysis results showed that there were significant differences in reducing periodontal damage with self-locking brackets compared with traditional brackets during orthodontic treatment. GI [MD-0.4395CIC-0.55CI-0.32P0.00001]; SBI [MD-0.43CI-95CI-0.59CI-0.27]; PLI [MD-0.795CI -0.83CI-0.60] P0.0001]. 3. Self-locking brackets and root resorption: four studies were included in this systematic evaluation. The results of meta analysis in 218 cases suggested that there was no significant difference in the extracorporeal absorptivity between self-locking brackets and traditional brackets, [MD-0.01-95CI ~ (-0.21) 0.19] (P _ (0.93)]. [conclusion] compared with the traditional straight wire arch bracket, the self-locking bracket reduces the pain and the damage of periodontal tissue in the treatment of adolescent patients, but it has no obvious advantage in reducing the degree of root resorption. Clinicians can refer to the results of this study when choosing brackets. Whether this result is related to the use of orthodontic wire The types of deformities and methods of correction are related, and a large number of randomized controlled trials are needed to provide evidence for clinical practice.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R783.5

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