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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(P<0.05);L1-MP、OB、OJ、SNA、SNB、ANB、MP-SN的合并WMD分别为-1.58、0、-0.41、-0.58、0.25、-0.70、0.39,差异均无统计学意义(P>0.05)。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(P<0.05)。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。
Objective To systematically evaluate the position of orthodontics and orthognathic combined orthodontic treatment of skeletal Class Ⅲ malocclusion in 3 years after operation and the stability of the hard tissue. Methods A computer-based search and manual search were combined to find out all the literature of orthodontics and orthognathic surgery in the treatment of severe skeletal class Ⅲ malocclusion. The search date was December, 2013. The literatures were screened strictly according to inclusion criteria and exclusion criteria, and the quality of literature included in the study was evaluated. Meta-analysis or descriptive analysis was performed on the stability of the anterior teeth location and hard tissue-related indices using RevMan5.2 software. Results The study was finally included in four articles, both before and after the control trial, a total of 180 patients, the literature evaluation grade are A. The results of Meta analysis showed that the WMD of U1-SN was 4.29 at 3 years after operation compared with postoperative, with a significant difference (P <0.05); L1-MP, OB, OJ, SNA The combined WMD of SNB, ANB and MP-SN were -1.58,0, -0.41, -0.58,0.25, -0.70,0.39 respectively, with no significant difference (P> 0.05). Descriptive analysis showed that the location of point A was relatively stable at 3 years after operation, with a slight recurrence at point B (P <0.05). Conclusions The location of anterior teeth and the overlays of anterior teeth are relatively stable. There is a slight recurrence of labial protrusion on the anterior teeth. The position of the maxilla remains stable and only a small amount of forward recurrence occurs in the mandible.