切歯後退時のトルクコントロールのランクと上顎中切歯根の吸収に及ぼす影響の切歯管解剖学的評価-系統的レビュー

The Assessment of the Rank of Torque Control during Incisor Retraction and Its Impact on the Resorption of Maxillary Central Incisor Roots According to Incisive Canal Anatomy-Systematic Review.

抄録

背景:

歯根吸収は矯正治療の合併症のひとつであり、その病因は多様で不明確である。

BACKGROUND: Root resorption is one of the complications of orthodontic treatment, and has a varied and unclear aetiology.

目的:

上切歯の吸収と切歯管との接触、および上切歯の後退とトルクコントロールに関連する矯正治療中の吸収のリスクとの関係を評価すること。

OBJECTIVE: To evaluate the relationship between upper incisor resorption and contact with the incisive canal and the risk of resorption during orthodontic treatment associated with upper incisor retraction and torque control.

検索方法:

PRISMAガイドラインに従い、主要な研究課題をPICOで定義した。科学データベースであるMEDLINE、EMBASE、およびCochrane Central Register of Controlled Trialsを、関連するキーワードで検索した：切歯根管吸収, 鼻口蓋根管吸収, 切歯根管後退, 鼻口蓋根管後退。

SEARCH METHODS: According to PRISMA guidelines, the main research question was defined in PICO. Scientific databases MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched for linking keywords: Resorption of roots incisive canal, Resorption of roots nasopalatine canal, Incisive canal retraction and Nasopalatine canal retraction.

選択基準:

研究数が著しく限られているため、時間フィルターは適用しなかった。英語の出版物を選択した。抄録に記載された情報に基づき、以下の基準に従って論文を選択した：対照臨床前向き試験および症例報告。無作為化臨床試験（RCT）または対照臨床前向き試験（CCT）は見つからなかった。計画した研究のテーマと関係のない論文は除外した。文献を精査し、以下の雑誌を検索した：American Journal of Orthodontics and Dentofacial Orthopedics、International Orthodontics、Journal of Clinical Orthodontics、Angle Orthodontist、Progress in Orthodontics、Orthodontics and Craniofacial Research、Journal of Orofacial Orthopedics、European Journal of Orthodontics、Korean Journal of Orthodontics。

SELECTION CRITERIA: No time filters were applied due to the significantly limited number of studies. Publications in the English language were selected. Based on the information provided in the abstracts, articles were selected according to the following criteria: controlled clinical prospective trials and case reports. No randomised clinical trials (RCTs) or controlled clinical prospective trials (CCTs) were found. Articles unrelated to the topic of the planned study were excluded. The literature was reviewed, and the following journals were searched: American Journal of Orthodontics and Dentofacial Orthopedics, International Orthodontics, Journal of Clinical Orthodontics, Angle Orthodontist, Progress in Orthodontics, Orthodontics and Craniofacial Research, Journal of Orofacial Orthopedics, European Journal of Orthodontics and Korean Journal of Orthodontics.

データ収集と分析:

ROBINS-Iツールを用いて、論文の偏りリスクと質の評価を行った。

DATA COLLECTION AND ANALYSIS: The articles were subjected to risk of bias and quality assessment using the ROBINS-I tool.

結果:

計164人が参加した4つの論文が選択された。すべての研究において、切歯管との接触後に根の長さに差が観察され、これは統計的に有意であった。

RESULTS: Four articles with a total of 164 participants were selected. In all studies, differences in root length were observed after contact with the incisive canal, which was statistically significant.

結論と含意:

切歯根と切歯管の接触は、切歯根の吸収のリスクを増加させる。3D画像を用いた歯列矯正診断では、切歯の解剖学的構造を考慮すべきである。切歯根の移動と範囲を適切に計画し（トルクコントロール）、より大きな角度を内蔵した切歯ブラケットを使用することで、吸収合併症のリスクを低減することができる。登録CRD42022354125。

CONCLUSIONS AND IMPLICATIONS: The contact of incisor roots with the incisive canal increases the risk of resorption of these roots. IC anatomy should be considered in orthodontic diagnosis using 3D imaging. The risk of resorption complications can be reduced by appropriate planning of the movement and extent of the incisor roots (torque control) and the possible use of incisor brackets with built-in greater angulation. Registration CRD42022354125.