Effectiveness of miniscrew-supported maxillary molar distalization according to temporary anchorage device features and appliance design: systematic review and meta-analysis.

Chiara Ceratti, Marco Serafin, Massimo Del Fabbro, Alberto Caprioglio
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Abstract

Objectives: To evaluate the effectiveness of distalizing maxillary first molars (U6) by temporary anchorage devices (TADs) according to their location (palatal, buccal, and zygomatic), their number, and appliance design.

Materials and methods: An electronic search of maxillary molar distalization with TADs was done through April 2023. After study selection, data extraction, and risk-of-bias assessment, meta-analyses were performed for the extent of distalization, distal tipping, and vertical movement of U6 using the generic inverse variance and random-effects model. The significance level was set at 0.05.

Results: Forty studies met the inclusion criteria: 4 randomized controlled trials (RCTs), 13 prospective studies, and 23 retrospective studies (total of 1182 patients). Distalization of the U6 was not significantly greater (P = .64) by palatal (3.74 mm) and zygomatic (3.68 mm) than by buccal (3.23 mm) TADs. Distal tipping was significantly higher (P < .001) in nonrigid (9.84°) than in rigid (1.97°) appliances. Vertical movement was mostly intrusive and higher but not significantly different (P = .28) in zygomatic anchorage (-1.16 mm).

Conclusions: Distalization of U6 with TADs can be an effective and stable treatment procedure, especially when performed with rigid palatal appliances. However, further RCTs or prospective cohort studies are strongly recommended to provide more clinical evidence.

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根据临时锚定装置的特点和器械设计,小螺钉支持上颌磨牙远端化的有效性:系统综述和荟萃分析。
目的:根据上颌第一磨牙(U6)的位置(腭部、颊部和颧骨)、数量和矫治器设计,评估临时固定器(TADs)对其进行远中的有效性。材料和方法:截至2023年4月,使用TADs对上颌磨牙远端化进行了电子搜索。在研究选择、数据提取和偏倚风险评估后,使用通用逆方差和随机效应模型对U6的远端化程度、远端倾翻和垂直运动进行荟萃分析。显著性水平设定为0.05。结果:40项研究符合纳入标准:4项随机对照试验(RCT)、13项前瞻性研究和23项回顾性研究(共1182名患者)。腭部(3.74 mm)和颧骨(3.68 mm)的U6的畸变并不显著大于颊部(3.23 mm)的TAD(P=.64)。非刚性(9.84°)矫治器的远端倾翻显著高于刚性(1.97°)矫治器(P<0.001)。垂直运动主要是侵入性的,在颧骨固定(-1.16 mm)中较高,但没有显著差异(P=.28)。然而,强烈建议进行进一步的随机对照试验或前瞻性队列研究,以提供更多的临床证据。
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