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目的系统评价镍钛拉簧和弹力橡皮链关闭拔牙间隙的有效性和安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、CBM、CNKI和VIP,检索时限截至2012年2月,查找以上述两种方式关闭拔牙间隙的RCT。由两位研究者按照纳入与排除标准独立筛选文献、提取资料并评价纳入研究的方法学质量后,采用RevMan 5.0软件进行Meta分析。结果共纳入4个RCT,122例患者。Meta分析结果显示:镍钛拉簧和弹力橡皮链在关闭拔牙间隙速度上差异有统计学意义[MD=0.30,95%CI(0.17,0.44),P<0.000 1];亚组分析提示,无论是方法学质量较高亚组[MD=0.20,95%CI(0.07,0.34),P=0.003]还是方法学质量较低亚组[MD=0.40,95%CI(0.30,0.50),P<0.000 01],两组在关闭拔牙间隙速度方面差异均有统计学意义。结论当前临床证据表明,镍钛拉簧在关闭拔牙间隙速度方面优于弹力橡皮链,但其远期效果尚需更大样本的随机对照试验进一步验证。
Objective To systematically evaluate the effectiveness and safety of nickel-titanium tension spring and elastic rubber chain in closing the extraction gap. Methods PubMed, EMbase, The Cochrane Library, CBM, CNKI and VIP were searched by computer. The search period was up to February 2012, and the RCTs for closing the tooth gap in the above two ways were searched. After two investigators independently screened the literature for inclusion and exclusion criteria, extracted data, and assessed the quality of the included studies, Meta-analysis was performed using RevMan 5.0 software. Results A total of 4 RCTs were included and 122 patients were included. The results of Meta analysis showed that there was significant difference in the velocity of gap between the nitinol tension and the elastic rubber band in closing the tooth extraction [MD = 0.30,95% CI (0.17,0.44), P <0.0001]. Subgroup analysis indicated that no matter (MD = 0.20, 95% CI (0.07, 0.34), P = 0.003], or a lower subset of methodological quality (MD = 0.40, 95% CI 0.30, 0.50), P < 0.000 01], the two groups in the closure of tooth gap velocity differences were statistically significant. Conclusions The current clinical evidence indicates that NiTi tensile springs are superior to elastic rubber chains in closing the gap speed of extraction, but the long-term effect still needs to be further verified by a larger sample of randomized controlled trials.