Ati: “Ntuzigere ushidikanya ko itsinda rito ry'abaturage batekereza, bitanze bashobora guhindura isi.Nkako, ni yo yonyine ihari. ”
Inshingano za Cureus nuguhindura uburyo bumaze igihe cyo gutangaza ubuvuzi, aho gutanga ubushakashatsi bishobora kuba bihenze, bigoye, kandi bitwara igihe.
Umubyimba wuzuye mucoperiosteal flap, mop, piezotomy, corticotomy, lllt, prostaglandin, kwihuta kwinyo ryinyo, ortodontike, kutabaga, kubaga
Doaa Tahsin Alfaylani, Mohammad Y. Hajir, Ahmad S. Burhan, Luai Mahahini, Khaldun Darwich, Ossama Aljabban
Tanga iyi ngingo nka: Alfailany D, Hajeer MY, Burhan AS, n'abandi..Umuti 14 (5): e25381.doi: 10.7759 / gukiza.25381
Icyari kigamijwe muri iri suzuma kwari ugusuzuma ibimenyetso bihari byerekana akamaro k'uburyo bwihuse bwo kubaga no kubaga ndetse n'ingaruka zijyanye n'ubu buryo.Ububiko icyenda bwashakishijwe: Cochrane Central Register y Ibigeragezo Byagenzuwe (CENTRAL), EMBASE®, Scopus®, PubMed®, Urubuga rwa siyansi ™, Google ™ Intiti, Urugendo, OpenGrey na PQDT Gufungura pro-Quest®.ClinicalTrials.gov hamwe nu mbuga zishakisha za International Clinical Trials Registry Platform (ICTRP) zasubiwemo kugirango zisuzume ubushakashatsi buriho nubuvanganzo budatangazwa.Ibigeragezo byemewe (RCTs) hamwe nubugenzuzi bwamavuriro (CCTs) byabarwayi barimo kubagwa (tekiniki zitera cyangwa zoroheje cyane) zifatanije nibikoresho gakondo byagenwe kandi ugereranije no kutabaga.Cochrane Risk of Bias (RoB.2) igikoresho cyakoreshejwe mugusuzuma RCT, mugihe igikoresho cya ROBINS-I cyakoreshejwe kuri CCT.
RCT enye na CCT ebyiri (abarwayi 154) zashyizwe muri iri suzuma rifatika.Ibigeragezo bine byagaragaje ko ibikorwa byo kubaga no kubaga bitagize ingaruka zimwe mu kwihutisha amenyo ya ortodontique (OTM).Ibinyuranye, kubaga byagize akamaro muyandi masomo abiri.Urwego rwo hejuru rwa heterogeneité mubushakashatsi burimo rwabujije kugereranya ibisubizo.Ingaruka zavuzwe zijyanye no kubaga no kutabaga ibikorwa byari bisa.
Hariho 'hasi cyane' kugeza 'hasi' ibimenyetso byerekana ko ibikorwa byo kubaga no kutabaga byagize uruhare runini mu kwihutisha amenyo ya ortodontique nta tandukaniro riri mu ngaruka mbi.Ibigeragezo byinshi byujuje ubuziranenge birakenewe kugirango tugereranye ingaruka zo kwihuta muburyo bubiri muburyo butandukanye bwa malocclusion.
Igihe cyo kuvura uburyo ubwo aribwo bwose bwo kuvura ni kimwe mu bintu by'ingenzi abarwayi batekereza igihe bafata icyemezo [1].Kurugero, gukuramo inzoga nyinshi zometseho nyuma yo gukuramo premolars zo hejuru zishobora gufata amezi agera kuri 7, mugihe igipimo cy’amenyo ya bioorthodontique (OTM) kingana na mm 1 ku kwezi, bikavamo igihe cyo kuvura hafi imyaka ibiri [2, 3 ].Kubabara, kutamererwa neza, karies, kugabanuka kwa gingival hamwe no gufata imizi ni ingaruka mbi zongera igihe cyo kuvura imitekerereze [4].Byongeye kandi, impamvu zuburanga n’imibereho itera abarwayi benshi gusaba ko barangiza vuba imiti ya ortodontique [5].Kubwibyo, ortodontiste n’abarwayi bashaka kwihutisha kugenda amenyo no kugabanya igihe cyo kuvura [6].
Uburyo uburyo bwo kugenda bwinyo bwihuta biterwa nigikorwa cyimikorere yibinyabuzima.Ukurikije urugero rwo gutera, ubu buryo bushobora kugabanywamo amatsinda abiri: uburyo bwo kubungabunga ibidukikije (uburyo bw’ibinyabuzima, umubiri, n’ibinyabuzima) hamwe n’uburyo bwo kubaga [7].
Uburyo bwibinyabuzima burimo gukoresha imiti ya farumasi kugirango yongere amenyo mu bushakashatsi bw’inyamaswa no mu bantu.Ubushakashatsi bwinshi bwerekanye imbaraga zirwanya ibyinshi muri ibyo bintu nka cytokine, ibintu bya kirimbuzi kappa-B ligand reseptor / ibikorwa bya kirimbuzi-kappa-B byakira poroteyine (RANKL / RANK), prostaglandine, vitamine D, imisemburo nka hormone ya parathiyide (PTH ).) na osteocalcine, kimwe no guterwa ibindi bintu nka relaxin, ntabwo byagaragaje imbaraga zihuse [8].
Uburyo bw'umubiri bushingiye ku gukoresha imiti ivura ibikoresho, birimo amashanyarazi ataziguye [9], amashanyarazi ya elegitoroniki ya magnetiki [10], kunyeganyega [11], hamwe no kuvura lazeri nkeya [12], byagaragaje ibisubizo bitanga icyizere [8].].Uburyo bwo kubaga bufatwa nkibikoreshwa cyane kandi byemejwe nubuvuzi kandi birashobora kugabanya cyane igihe cyo kwivuza [13,14].Ariko, bashingira kuri "Regional Acceleration Phenomenon (RAP)" kubera ko habaye kwangirika kubagwa kumagufwa ya alveolar bishobora kwihutisha by'agateganyo OTM [15].Muri ubwo buryo bwo kubaga harimo corticotomie gakondo [16,17], kubaga amagufwa ya alveolar interstitial [18], kwihuta kwa osteogenic orthodontique [19], gukurura alveolar [13] no gukwega igihe [20], compression electrotomy [14,21], cortical resection [ 19].22] na microperforation [23].
Isubiramo ryinshi ritunganijwe (SR) ryibigeragezo byateganijwe (RCTs) byasohotse ku kamaro ko gutabara no kubaga mu kwihutisha OTM [24,25].Ariko, ubuhanga bwo kubaga burenze uburyo bwo kubaga ntabwo bwagaragaye.Kubwibyo, iri suzuma ritunganijwe (SR) rigamije gusubiza ikibazo cyingenzi cyisubiramo gikurikira: Ninde ufite akamaro mukwihutisha umuvuduko w amenyo ya ortodontique mugihe ukoresheje ibikoresho bya ortodontique bihamye: uburyo bwo kubaga cyangwa kubaga?
Ubwa mbere, ubushakashatsi bwikigereranyo bwakorewe kuri PubMed kugirango harebwe ko SR zisa kandi no kugenzura ingingo zose zijyanye nayo mbere yo kwandika icyifuzo cya nyuma cya SR.Nyuma, ibigeragezo bibiri bishoboka byaragaragaye kandi birasuzumwa.Kwiyandikisha kuri protocole ya SR mububiko bwa PROSPERO byarangiye (nimero iranga: CRD42021274312).Iyi SR yakozwe hakurikijwe igitabo cyitwa Cochrane Igitabo cy’isuzuma rifatika ry’ibikorwa [26] hamwe n’ibintu byatoranijwe byo gutanga raporo by’amabwiriza ngenderwaho yo gusuzuma no gusesengura Meta (PRISMA) [27,28].
Ubushakashatsi bwarimo abarwayi b’igitsina gabo n’abagore bafite ubuzima buzira umuze, batitaye ku myaka, ubwoko bwa malocclusion, cyangwa ubwoko, nkurikije icyitegererezo cy’abitabiriye amahugurwa, kugereranya, ibisubizo, n’ubushakashatsi bwakozwe (PICOS).Ubundi buryo bwo kubaga (invasive or minimally invasive) kubuvuzi gakondo bwa ortodontique bwatekerejweho.Ubushakashatsi bwarimo abarwayi bahawe imiti ihamye (OT) ifatanije no kutabaga.Izi nkunga zishobora kuba zirimo uburyo bwa farumasi (bwibanze cyangwa sisitemu) hamwe nuburyo bwumubiri (irrasiyo ya laser, amashanyarazi, amashanyarazi ya elegitoroniki (PEMF) hamwe na vibrasiya).
Igisubizo cyibanze cyiki gipimo nigipimo cyo kugenda amenyo (RTM) cyangwa ikindi kintu icyo aricyo cyose gishobora kutumenyesha kubyerekeranye nibikorwa byo kubaga no kubaga.Icyiciro cya kabiri cyarimo ingaruka mbi nkibisubizo byatangajwe n’abarwayi (ububabare, kutamererwa neza, kunyurwa, ubuzima bujyanye n’ubuzima bwo mu kanwa, ingorane zo guhekenya, nubundi bunararibonye), ibisubizo bijyanye na tissue periodontal nkuko byapimwe na index ya periodontal (PI), ingorane , Indangantego ya Gingival (GI), gutakaza umugereka (AT), kugabanuka kwa gingival (GR), ubujyakuzimu bwa pontontal (PD), gutakaza inkunga no kugenda amenyo udashaka (kugoreka, kugoreka, kuzunguruka) cyangwa ihahamuka ryinyo rya iatrogène nko gutakaza amenyo Vitality Imizi.Ibishushanyo mbonera bibiri gusa nibyo byemewe - Ibigeragezo byemewe (RCTs) hamwe na Clinical Trials (CCTs), byanditswe mucyongereza gusa, nta mbogamizi ku mwaka byatangajwe.
Ingingo zikurikira ntizakuweho: ubushakashatsi bwisubireho, ubushakashatsi mu zindi ndimi zitari Icyongereza, ubushakashatsi ku nyamaswa, mu bushakashatsi bwa vitro, raporo y'imanza cyangwa raporo y'uruhererekane rw'imanza, ubwanditsi, ingingo zifite isubiramo n'impapuro zera, ibitekerezo byawe bwite, iburanisha ridafite ingero zavuzwe, oya itsinda rishinzwe kugenzura, cyangwa kuba hari itsinda rishinzwe kutavurwa hamwe nitsinda ryigeragezwa rifite abarwayi batageze ku 10 ryakozwe nuburyo bwanyuma.
Ishakisha rya elegitoronike ryakozwe ku bubiko bukurikira (Kanama 2021, nta gihe ntarengwa, Icyongereza gusa): Igitabo gikuru cya Cochrane cy’ibigeragezo byagenzuwe, PubMed®, Scopus®, Urubuga rwa siyansi ™, EMBASE®, Google ™ Intiti, Urugendo, OpenGrey .Urutonde rwibitabo byingingo zatoranijwe nazo zasuzumwe ibigeragezo byose bishobora kuba bitaraboneka kubushakashatsi bwa elegitoronike kuri interineti.Muri icyo gihe, ubushakashatsi bwakozwe n'intoki bwakorewe mu kinyamakuru cya Angle Orthodontics, Ikinyamakuru cyo muri Amerika cyitwa Ortodontique na Dentofacial Orthopedics ™, Ikinyamakuru cyo mu Burayi cy’imyororokere n’imyororokere n’ubushakashatsi bwa Craniofacial.ClinicalTrials.gov hamwe n’umuryango mpuzamahanga wita ku buzima mpuzamahanga ku rubuga mpuzamahanga rw’ubushakashatsi (ICTRP) bakoze igenzura rya elegitoronike kugira ngo babone ibizamini bitaratangazwa cyangwa ubushakashatsi bwarangiye.Ibisobanuro birambuye kuri e-shakisha ingamba zitangwa mu mbonerahamwe ya 1.
RANKL: ibintu bya kirimbuzi kappa-beta ligand ukora reseptor;RANK: ibintu bya kirimbuzi kappa-beta ligand ukora reseptor
Abashakashatsi babiri (DTA na MYH) bigenga basuzumye ubwigenge bukwiye, kandi mugihe bidahuye, umwanditsi wa gatatu (LM) yatumiwe gufata icyemezo.Intambwe yambere igizwe no kugenzura gusa umutwe na annotation.Intambwe ya kabiri kubushakashatsi bwose kwari ugupima inyandiko yuzuye nkingirakamaro kandi iyungurura kugirango ishyirwemo cyangwa mugihe umutwe cyangwa ibisobanuro bitari bisobanutse kugirango bifashe guca urubanza neza.Ingingo zaraciwe niba zujuje kimwe cyangwa byinshi mubipimo byo gushyiramo.Kubindi bisobanuro cyangwa amakuru yinyongera, nyamuneka andikira umwanditsi bireba.Abanditsi bamwe (DTA na MYH) bakuye mu bwigenge amakuru yavuye mu ndege kandi yateganijwe mbere yo gukuramo amakuru.Iyo abasesenguzi bombi bayoboye batabyumvikanyeho, umwanditsi wa gatatu (LM) yasabwe kubafasha kubikemura.Imbonerahamwe yamakuru yincamake ikubiyemo ibintu bikurikira: amakuru rusange yerekeye ingingo (izina ryumwanditsi, umwaka watangarijwe ninyuma yubushakashatsi);buryo (igishushanyo mbonera, itsinda ryasuzumwe);abitabiriye amahugurwa (umubare w'abarwayi binjijwe, bivuze imyaka n'imyaka)., hasi);Ibikorwa (ubwoko bwibikorwa, aho bikorerwa, ibintu bya tekiniki byuburyo);Ibiranga ortodontike (urugero rwa malocclusion, ubwoko bwimitsi yinyo ya ortodontique, inshuro zo guhindura imitekerereze, igihe cyo kwitegereza);Ingamba zagezweho (ibisubizo byibanze nubwa kabiri byavuzwe, uburyo bwo gupima, no gutanga raporo zerekana itandukaniro rishingiye ku mibare).
Abashakashatsi babiri (DTA na MYH) basuzumye ingaruka zo kubogama bakoresheje igikoresho cya RoB-2 kuri RCT zikomoka [29] hamwe na ROBINS-I ya CCTs [30].Mugihe mutabyumvikanyeho, nyamuneka saba umwe mubanditsi (ASB) kugirango ubone igisubizo.Kubigeragezo byateganijwe, twasuzumye ibice bikurikira nk "" ibyago bike "," ibyago byinshi "cyangwa" ikibazo cyo kubogama ": kubogama guturuka kubikorwa byateganijwe, kubogama bitewe no gutandukana kwateganijwe (ingaruka ziterwa no gutabara; ingaruka za kubahiriza ibikorwa)Muri rusange ibyago byo kubogama kubushakashatsi bwatoranijwe byapimwe kuburyo bukurikira: "Ibyago bike byo kubogama" niba domaine zose zapimwe "ibyago bike byo kubogama";"Impungenge Zimwe" niba byibuze agace kamwe karagaragaye nk "" Impungenge Zimwe "ariko ntabwo" Ibyago Byinshi bya Bias mukarere kamwe, Ibyago Byinshi byo Kubogama: niba byibuze domaine imwe cyangwa nyinshi zapimwe nkibyago byinshi byo kubogama "cyangwa impungenge zimwe hejuru ya domaine nyinshi, bigabanya cyane icyizere mubisubizo.Mugihe, kubigeragezo bidateganijwe, twasuzumye ibice bikurikira nkibishobora kuba bike, bitagereranywa, kandi bishobora guteza akaga: mugihe cyo gutabara (kubogama kubogamye);nyuma yo gutabarwa (kubogama bitewe no gutandukana kubitekerezo byateganijwe; kubogama kubera kubura amakuru; ibisubizo) kubogama kubogamye;gutanga raporo kubogama muguhitamo ibisubizo).Muri rusange ibyago byo kubogama kubushakashatsi bwatoranijwe byapimwe kuburyo bukurikira: "Ibyago bike byo kubogama" niba domaine zose zapimwe "ibyago bike byo kubogama";"Impanuka ziciriritse zo kubogama" niba domaine zose zapimwe nk "ibyago bike cyangwa biciriritse byo kubogama".kubogama ”“ Ibyago bikomeye byo kubogama ”;"Risk Risk of Bias" niba byibuze domaine imwe ihabwa "Risk Risk of Bias" ariko nta Risk Risk of Bias murwego urwo arirwo rwose, "Risk Risk of Bias" niba byibuze domaine imwe ihabwa "Ikibazo gikomeye cyo kwibeshya kuri sisitemu";ubushakashatsi bwafatwaga nk "amakuru yabuze" niba nta kimenyetso cyerekana ko ubushakashatsi "bwagize akamaro kanini cyangwa bugarijwe cyane no kubogama" kandi bukaba bwabuze amakuru mubice bimwe cyangwa byinshi byingenzi bibogamye.Ibimenyetso byizewe byasuzumwe hashingiwe ku mabwiriza ngenderwaho yo gusuzuma, iterambere no gusuzuma (GRADE), ibisubizo byashyizwe mu rwego rwo hejuru, ruciriritse, ruto, cyangwa ruto cyane [31].
Nyuma yubushakashatsi bwa elegitoronike, hamenyekanye ingingo 1972 zose hamwe ni imwe gusa yaturutse ahandi.Nyuma yo gukuraho duplicates, hasubiwemo inyandiko 873 zandikishijwe intoki.Amazina n'ibisobanuro byagenzuwe kugira ngo yemererwe kandi ubushakashatsi ubwo ari bwo bwose butujuje ibyangombwa byujuje ibisabwa bwaranze.Kubera iyo mpamvu, hakozwe ubushakashatsi bwimbitse ku nyandiko 11 zishobora kuba ingirakamaro.Ibigeragezo bitanu byarangiye hamwe nubushakashatsi butanu bukomeje ntabwo bwujuje ibisabwa.Ibisobanuro by'ingingo zitarimo nyuma yo gusuzuma inyandiko yuzuye n'impamvu zo guhezwa zitangwa mumeza kumugereka.Hanyuma, ubushakashatsi butandatu (bine RCT na CCT ebyiri) byashyizwe muri SR [23,32–36].Igishushanyo mbonera cya PRISMA cyerekanwe mubishusho 1.
Ibiranga ibigeragezo bitandatu birimo ibigereranyo bigaragara mu mbonerahamwe ya 2 n'iya 3 [23,32-36].Ikigeragezo kimwe gusa cya protocole cyamenyekanye;reba Imbonerahamwe ya 4 n'iya 5 kubindi bisobanuro kuri uyu mushinga w'ubushakashatsi ukomeje.
RCT: ibizamini byamavuriro byateganijwe;NAC: kugenzura kutihuta;SMD: gushushanya umunwa;MOPs: gutobora mikorobe;LLLT: ubukana buke bwa laser;CFO: ortodontike hamwe na corticotomy;FTMPF: ubunini bwuzuye mucoperiosteal flap;Ikiguzi: ubushakashatsi;umugabo: umugabo;F: igitsina gore;U3: inzoga yo hejuru;ED: ubwinshi bw'ingufu;RTM: umuvuduko wo kugenda amenyo;TTM: igihe cyo kugenda amenyo;CTM: guhunika amenyo;PICOS: abitabiriye, kwitabira, kugereranya, ibisubizo no gushushanya
TADs: igikoresho cy'agateganyo;RTM: umuvuduko wo kugenda amenyo;TTM: igihe cyo kugenda amenyo;CTM: guhunika amenyo;EXP: igerageza;NR: ntabwo byatangajwe;U3: inzoga yo hejuru;U6: umubyimba wo hejuru;SS: ibyuma bidafite ingese;NiTi: nikel-titanium;MOPs: gutobora amagufwa ya mikorobe;LLLT: ubukana buke bwa laser;CFO: ortodontike hamwe na corticotomy;FTMPF: ubunini bwuzuye mucoperiosteal flap
NR: Ntabwo byatangajwe;OMS ICTRP: Shakisha Urubuga rwa OMS Mpuzamahanga Yandika Ibizamini bya Clinical
Iri suzuma ryarimo RCTs zuzuye 23,32–34 na CCTs 35,36 zirimo abarwayi 154.Imyaka iri hagati yimyaka 15 na 29.Ubushakashatsi bumwe bwarimo abarwayi b'igitsina gore gusa [32], mu gihe ubundi bushakashatsi bwarimo abagore bake ugereranyije n'abagabo [35].Hariho abagore benshi kurusha abagabo mu bushakashatsi butatu [33,34,36].Ubushakashatsi bumwe gusa ntabwo bwatanze igabana ry'uburinganire [23].
Bane mu bushakashatsi bwashyizwemo ni ibishushanyo mbonera (SMD) byashushanyije [33-36] naho bibiri byari ibishushanyo mbonera (COMP) (ibyambu bisa kandi byacitsemo ibice) [23,32].Mu bushakashatsi bwakozwe, igishushanyo mbonera cy’itsinda ry’ubushakashatsi cyagereranijwe n’uruhande rudakorera mu yandi matsinda y’ubushakashatsi, kubera ko impande zombi z’amatsinda zitigeze zihuta (gusa kuvura imitekerereze isanzwe) [23,32].Mu zindi nyigo enye, iri gereranya ryakozwe mu buryo butaziguye nta tsinda ryihuta ryihuta [33-36].
Ubushakashatsi butanu bwagereranije kubaga no kuvura umubiri (urugero, kuvura lazeri nkeya {LILT}), naho ubushakashatsi bwa gatandatu bwagereranije kubaga no kwivuza (ni ukuvuga prostaglandine E1).Ibikorwa byo kubaga bitangirira cyane (corticotomy gakondo [33-35], FTMPF yuzuye umubyimba wa mucoperiosteal flap [32]) kugeza kubikorwa byibasiye (inzira ntoya yo gutera {MOPs} [23] hamwe nuburyo bwa piezotomy [36]).
Ubushakashatsi bwose bwabonetse bwarimo abarwayi bakeneye gukuramo kanseri nyuma yo gukuramo premolar [23,32-36].Bose barimo abarwayi bahawe imiti ishingiye ku gukuramo.Canine yakuweho nyuma yo gukuramo premolars yambere yumusaya wo hejuru.Gukuramo byakozwe mugitangira cyo kuvura kugeza birangiye kuringaniza no kuringaniza mubushakashatsi butatu [23, 35, 36] nabandi batatu [32-34].Isuzumabumenyi ryakurikiranwe kuva ku byumweru bibiri [34], amezi atatu [23,36], n'amezi ane [33] kugeza kurangiza gukuramo inzoga [32,35].Mu bushakashatsi bune [23, 33, 35, 36], gupima umuvuduko w’amenyo byagaragaye nk '“umuvuduko w’amenyo” (RTM), naho mu bushakashatsi bumwe, “igihe cyo kugenda amenyo” (CTM) cyagaragajwe nk' “amenyo”. .“Igihe” (TTM).) y'ubushakashatsi bubiri [32,35], bumwe bwasuzumye ibitekerezo bya sRANKL [34].Ubushakashatsi butanu bwakoresheje ibikoresho by'agateganyo bya TAD [23,32–34,36], mu gihe ubushakashatsi bwa gatandatu bwakoresheje inama ihanamye kugira ngo ikosorwe [35].Ku bijyanye n’uburyo bwakoreshejwe mu gupima umuvuduko w’amenyo, ubushakashatsi bumwe bwakoresheje ibyuma bifata ibyuma bifata ibyuma bya interineti [23], ubushakashatsi bumwe bwakoresheje ikoranabuhanga rya ELISA kugira ngo hamenyekane urugero rwa gingival sulcus fluid (GCF) [34], naho ubushakashatsi bubiri bwasuzumye ikoreshwa rya elegitoroniki..itanga Caliper [33,35], mugihe ubushakashatsi bubiri bwakoresheje icyitegererezo cya 3D cyerekanwe kugirango kibone ibipimo [32,36].
Ibyago byo kubogama kugirango bishyirwe muri RCT byerekanwe ku gishushanyo cya 2, kandi muri rusange ibyago byo kubogama kuri buri domeni bigaragara ku gishushanyo cya 3. RCT zose zapimwe nk '"impungenge zishingiye ku kubogama" [23,32-35]."Impungenge zimwe zijyanye no kubogama" ni ikintu cy'ingenzi kiranga RCT.Kubogama kubera gutandukana kubikorwa byari byitezwe (ingaruka zijyanye no gutabara; ingaruka zifatika zo gutabara) niho hakekwa cyane (ni ukuvuga, "impungenge zimwe" zagaragaye 100% mubushakashatsi bune).Ibyago byo kubogama kubushakashatsi bwa CCT bigaragara ku gishushanyo cya 4. Ubu bushakashatsi bwari bufite "ibyago bike byo kubogama".
Igishushanyo gishingiye ku makuru yatanzwe na Abdelhameed na Refai, 2018 [23], El-Ashmawi n'abandi, 2018 [33], Sedky n'abandi, 2019 [34], na Abdarazik n'abandi, 2020 [32].
Kubaga no kwivanga kumubiri: Ubushakashatsi butanu bwagereranije ubwoko butandukanye bwo kubaga hamwe nubuvuzi buke bwa lazeri (LILT) kugirango byihute gukuramo kanseri [23,32–34].El-Ashmawy n'abandi.Ingaruka za "corticotomy gakondo" na "LLT" zasuzumwe muri RCT.Kubijyanye n'umuvuduko wo gukuramo inzoga, nta tandukanyirizo rishingiye ku mibare ryabonetse hagati ya corticotomy na LILI aho ariho hose mu isuzuma (bivuze mm 0.23, 95% CI: -0.7 kugeza 1.2, p = 0 .64).
Turker n'abandi.yasuzumye ingaruka za piezocision na LILT kuri RTM muri cleft TBI [36].Mu kwezi kwa mbere, inshuro zo gukuramo inzoga zo hejuru kuruhande rwa LILI zari hejuru mubarurishamibare kuruta kuruhande rwa piezocision (p = 0.002).Nyamara, nta tandukanyirizo rishingiye ku mibare ryagaragaye hagati y’impande zombi mu mezi ya kabiri n'iya gatatu yo gukuramo inzoga zo hejuru, (p = 0.377, p = 0.667).Urebye igihe cyose cyo gusuzuma, ingaruka za LILI na Piezocisia kuri OTM zari zisa (p = 0.124), nubwo LILI yakoraga neza kuruta uburyo bwa Piezocisia mukwezi kwa mbere.
Abdelhameed na Refai bize ubushakashatsi ku ngaruka za “MOP” ugereranije na “LLLT” na “MOPs + LLLT” kuri RTM mu gishushanyo mbonera cya RCT [23]. Basanze kwiyongera k'umuvuduko wo gukuramo inzoga zo hejuru mu mpande zihuse (“MOPs” kimwe na “LLLT”) ugereranije n'impande zitihuta, hamwe n'imibare itandukanye y'ibarurishamibare mu bihe byose byo gusuzuma (p <0.05). Basanze kwiyongera k'umuvuduko wo gukuramo inzoga zo hejuru mu mpande zihuse (“MOPs” kimwe na “LLLT”) ugereranije n'impande zitihuta, hamwe n'imibare itandukanye y'ibarurishamibare mu bihe byose byo gusuzuma (p <0.05). Они обнаружили ускоренное увеличение скорости ретракции верхних кнаков в боковых сторонах («MOPs», а также «LLLT») по сравнению с неускоренными боковы ретакчим с вический 5). Basanze ubwiyongere bwihuse bwumuvuduko wo gusubira inyuma kuruhande rwa kine yo hejuru (“MOPs” kimwe na “LLLT”) ugereranije no kwihuta kwihuta kuruhande hamwe nibitandukaniro rikomeye ryibarurishamibare mugihe cyose cyo gusuzuma (p <0.05).他们 发现 ， 与 非 侧 侧 M M 加速 侧 “MOP” 和 “LLLT”） 的 上 犬齿 回缩 增加 ， 在 显 着 时间 （p <0.05）。 Basanze, ugereranije n’uruhande rwihuta, amenyo yo hejuru ya kine yo hejuru yihuta (“MOPs” na “LLLT”) yongereye igipimo cyo kugabanuka, kandi hari itandukaniro rikomeye ry’imibare (p <0.05) mugihe cyose cyo gusuzuma . Они обнаружили, что ретракция верхнего клыка б бе вше на стороне аксерерсии («MOPs» и «LLLT») по сравнению со стороной ак аксерерсии со статистически значимой разницей (p <0,05) во висы Yasanze gukuramo ingingo zo hejuru byari hejuru kuruhande hamwe no kwihuta (“MOPs” na “LLLT”) ugereranije kuruhande nta kwihuta hamwe n’itandukaniro rishingiye ku mibare (p <0.05) ku bihe byose byasuzumwe.Ugereranije n’uruhande rutihuta, gukuramo clavicle byihutishijwe inshuro 1,6 na 1.3 kuruhande rwa “SS” na “NILT”.Byongeye kandi, berekanye kandi ko uburyo bwa MOPs bwagize akamaro kuruta uburyo bwa LLLT mu kwihutisha gukuramo clavicles yo hejuru, nubwo itandukaniro ritari rifite imibare.Itandukaniro rinini hamwe n’itandukaniro mubikorwa byakoreshejwe hagati yubushakashatsi bwabanje byabujije guhuza imibare yamakuru [23,33,36].Abdalazik n'abandi.Amaboko abiri ya RCI hamwe nigishushanyo mbonera [32] yasuzumye ingaruka zububiko bwuzuye bwa mucoperiosteal flap (uburebure bwa FTMPF gusa na LLLT) kumitsi yinyo (CTM) nigihe cyo kugenda amenyo (TTM)."Igihe cyo kugenda amenyo" mugihe ugereranije impande zihuta kandi zitihuta, byagaragaye cyane mugihe cyose cyo gukuramo amenyo byagaragaye.Mu bushakashatsi bwose, nta tandukanyirizo rishingiye ku mibare ryari hagati ya “FTMPF” na “LLLT” mu bijyanye no “guhuza amenyo yuzuye” (p = 0.728) n '“igihe cyo kugenda amenyo” (p = 0.298).Mubyongeyeho, "FTMPF" na "LLLT" »irashobora kugera kuri 25% na 20% byihuta OTM.
Seki n'abandi.Ingaruka za "corticotomy gakondo" na "LLT" ku irekurwa rya RANKL mugihe cya OTM muri RCT hamwe na orotomy byasuzumwe kandi bigereranywa [34].Ubushakashatsi bwerekanye ko corticotomy na LILI byombi byongereye RANKL mu gihe cya OTM, byagize ingaruka ku buryo bwo guhindura amagufwa ndetse n’igipimo cya OTM.Itandukaniro ryibihugu byombi ntabwo ryari rifite imibare muminsi 3 na 15 nyuma yo gutabarwa (p = 0.685 na p = 0.400).Itandukaniro mugihe cyangwa uburyo bwo gusuzuma ibyagezweho byabujije gushyira ubushakashatsi bubiri bwabanje muri meta-gusesengura [32,34].
Ibikorwa byo kubaga no gufata imiti: Rajasekaran na Nayak basuzumye ingaruka ziterwa na corticotomy na prostaglandine E1 inshinge kuri RTM nigihe cyo kugenda amenyo (TTM) mumunwa wa CCT [35].Berekanye ko corticotomy yateje imbere RTM kurusha prostaglandine, ifite itandukaniro rinini mu mibare (p = 0.003), kubera ko hagati ya RTM kuruhande rwa prostaglandine yari 0.36 ± 0,05 mm / icyumweru, naho corticotomy yari 0.40 ± 0 .04mm / perimetero.Hariho kandi itandukaniro mugihe cyo kugenda amenyo hagati yuburyo bubiri.Itsinda rya corticotomy (ibyumweru 13) ryagize "igihe cyo kugenda amenyo" mugufi ugereranije na prostaglandine (ibyumweru 15).Kubindi bisobanuro birambuye, incamake y'ibyavuye mu bushakashatsi bivuye mu bushakashatsi nyamukuru bwa buri nyigo yatanzwe mu mbonerahamwe ya 6.
RTM: umuvuduko wo kugenda amenyo;TTM: igihe cyo kugenda amenyo;CTM: guhunika amenyo;NAC: kugenzura kutihuta;MOPs: gutobora amagufwa ya mikorobe;LLLT: ubukana buke bwa laser;CFO: ortodontike hamwe na corticotomy;FTMPF: ubunini bwuzuye mucoperiosteal flap;NR: ntabwo byatangajwe
Ubushakashatsi bune bwasuzumye ibyavuye mu cyiciro cya kabiri [32,33,35,36].Ubushakashatsi butatu bwasuzumye igihombo cy'inkunga [32,33,35].Rajasekaran na Nayak basanze nta tandukanyirizo rishingiye ku mibare riri hagati ya corticotomy na prostaglandine (p = 0.67) [35].El-Ashmawi n'abandi.Nta tandukanyirizo rishingiye ku mibare ryabonetse hagati ya corticotomy n'uruhande rwa LLLT igihe icyo ari cyo cyose cyo gusuzuma (MD 0.33 mm, 95% CI: -1.22-0.55, p = 0.45) [33].Ahubwo, Abdarazik n'abandi.Itandukaniro rishingiye ku mibare ryavuzwe hagati y’amatsinda ya FTMPF na LLLT, hamwe na LLLT itsinda rinini [32].
Ububabare no kubyimba byasuzumwe muri bibiri birimo ibigeragezo [33,35].Nk’uko Rajasekaran na Nayak babitangaza, abarwayi bavuze ko kubyimba byoroheje no kubabara mu cyumweru cya mbere ku ruhande rwa corticotomy [35].Ku bijyanye na prostaglandine, abarwayi bose bagize ububabare bukabije batewe inshinge.Mu barwayi benshi, ubukana buri hejuru kandi bumara iminsi itatu uhereye umunsi batewe inshinge.Ariko, El-Ashmawi n'abandi.[33] yatangaje ko 70% by'abarwayi binubira kubyimba ku ruhande rwa corticotomy, mu gihe 10% bari babyimbye ku ruhande rwa corticotomy no ku ruhande rwa LILI.Ububabare nyuma yo kubagwa bwagaragajwe na 85% by'abarwayi.Uruhande rwa corticotomy rurakomeye.
Rajasekaran na Nayak basuzumye impinduka z'uburebure bw'imisozi n'uburebure bw'imizi kandi basanga nta tandukanyirizo rishingiye ku mibare riri hagati ya corticotomy na prostaglandine (p = 0.08) [35].Ubujyakuzimu bw'ikizamini cya parontontal cyasuzumwe mu bushakashatsi bumwe gusa busanga nta tandukaniro rinini rigaragara riri hagati ya FTMPF na LLLT [32].
Türker n'abandi basuzumye impinduka zabaye muri kineine no mu mfuruka ya mbere basanga nta tandukanyirizo rishingiye ku mibare riri hagati ya kineine n’imfuruka ya mbere hagati ya piezotomy n'uruhande rwa LLLT mu gihe cy'amezi atatu yakurikiranwe [36].
Imbaraga zibimenyetso byerekana imitekerereze idahwitse ningaruka ziva kuri "hasi cyane" kugeza "hasi" ukurikije amabwiriza ya GRADE (Imbonerahamwe 7).Kugabanya imbaraga zibimenyetso bifitanye isano ningaruka zo kubogama [23,32,33,35,36], indirecte [23,32] no kudasobanuka [23,32,33,35,36].
a, g Kugabanya ibyago byo kubogama kurwego rumwe (kubogama bitewe no gutandukana kubikorwa byateganijwe, igihombo kinini cyo gukurikirana) no kugabanya kudasobanuka kurwego rumwe * [33].
c, f, i, j Ibyago byo kubogama byagabanutse kurwego rumwe (ubushakashatsi budateganijwe) kandi intera yamakosa yagabanutse kurwego rumwe * [35].
d Kugabanya ibyago byo kubogama (bitewe no gutandukana kubikorwa byateganijwe) kurwego rumwe, indirecte kurwego rumwe **, no kudasobanuka kurwego rumwe * [23].
e, h, k Kugabanya ibyago byo kubogama (kubogama bifitanye isano na gahunda yo gutoranya ibintu, kubogama bitewe no gutandukana bivuye kubigenewe) kurwego rumwe, indirecteur kurwego rumwe **, no kudasobanuka kurwego rumwe * [32].
CI: intera y'icyizere;SMD: igishushanyo mbonera cy'icyambu;COMP: igishushanyo mbonera;MD: bivuze itandukaniro;LLLT: ubukana buke bwa laser;FTMPF: ubunini bwuzuye mucoperiosteal flap
Habayeho kwiyongera cyane mubushakashatsi ku kwihuta kwimikorere ya ortodontique ukoresheje uburyo butandukanye bwo kwihuta.Nubwo uburyo bwihuse bwo kubaga bwizwe cyane, uburyo butari bwo kubaga nabwo bwabonye inzira mubushakashatsi bwimbitse.Amakuru nibimenyetso byerekana ko uburyo bwihuta buruta ubundi buguma buvanze.
Ukurikije iyi SR, nta bwumvikane hagati y’ubushakashatsi bwiganje ku buryo bwo kubaga cyangwa kubaga mu kwihutisha OTM.Abdelhameed na Refai, Rajasekaran na Nayak basanze muri OTM, kubaga byagize akamaro kuruta kutabagwa [23,35].Ahubwo, Türker n'abandi.Kwivanga kutabaga byagaragaye ko ari byiza kuruta gutabara mu kwezi kwa mbere kwakuwe hejuru ya kineine [36].Icyakora, urebye ibihe byose byageragejwe, basanze ingaruka ziterwa no kubaga no kubaga OTM zisa.Mubyongeyeho, Abdarazik n'abandi, El-Ashmawi n'abandi, na Sedki n'abandi.yavuze ko nta tandukaniro riri hagati yo kubaga no kutabaga mu bijyanye no kwihuta kwa OTM [32-34].