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目的:采用Meta分析方法评价正畸正颌联合矫治骨性Ⅲ类错软硬组织的稳定性。方法:计算机检索Cochrane Library、PubM ed、Medline、CNKI、万方等中外文数据库中符合要求的随机对照试验、半随机对照试验、临床病例对照试验的文献,检索日期截止2013-12-31。按照纳入、排除标准,由2名经过系统评价专业培训的研究者对纳入文献进行严格的质量评价,提取中、高等质量文献的数据资料。然后采用RevM an 5.2软件进行Meta分析。结果:最终纳入4篇文献,共178例患者,均为临床病例对照试验(CCT)。Meta分析结果示:硬组织稳定性:SNA(WMD=-0.58,95%CI[-1.18,0.02])、SNB(WMD=0.25,95%CI[-0.42,0.91])、ANB(WMD=-0.70,95%CI[-1.44,0.04])、MP-SN(WMD=0.39,95%CI[-0.25,1.04]),术后与术后3年差异无统计学意义,A点保持相对稳定位置,B点较术后有复发;软组织稳定性:术后与术后3年患者的软组织总体上保持稳定,仅下唇突度术后3年有所增大,显示其有一定的复发。结论:骨性Ⅲ类错患者经正畸联合双颌手术治疗后,软硬组织基本保持了长期的稳定性,仅下颌有一定的向前复发,下唇突度有所增大。
OBJECTIVE: To evaluate the stability of skeletal Class Ⅲ malocclusion by orthodontics and orthognathic surgery combined with Meta analysis. METHODS: Randomized controlled trials, semi-randomized controlled trials, and controlled clinical trials of Cochrane Library, Pubmed, Medline, CNKI and Wanfang were searched by computer. According to the inclusion and exclusion criteria, two researchers trained in systematic evaluation conducted strict quality evaluation of the included documents and extracted data of medium and high-quality literature. Meta-analysis was then performed using RevM an 5.2 software. Results: Four articles were finally included, 178 patients in total, all of which were clinical case-control trials (CCT). Meta-analysis results showed that: Hard tissue stability: SNA (WMD = -0.58,95% CI [-1.18,0.02]), SNB (WMD = 0.25,95% CI [-0.42,0.91]), ANB 0.70, 95% CI [-1.44,0.04]) and MP-SN (WMD = 0.39,95% CI [-0.25,1.04]). There was no significant difference between postoperative and postoperative 3 years Position, B point recurrence than after surgery; soft tissue stability: postoperative and postoperative 3 years in patients with soft tissue remains generally stable, only the lower lip after 3 years of surgery has increased, indicating that it has a certain recurrence. Conclusion: The patients with skeletal Class Ⅲ malocclusion have stable long-term stability after orthodontic and bimaxillary surgery. Only the mandible has some forward recurrence and the lip of the lower lip increases in intensity.