Affiliation:
1. Stomatological Hospital of Chongqing Medical University; Chongqing Key Laboratory of Oral Disease and Biomedical Sciences; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education , Chongqing , China
2. DDS, Syrian Board in Orthodontics, Specialist Orthodontist, Private Practice , Damascus , Syria
3. CMH Institute of Dentistry Lahore, National University of Medical Sciences , Punjab , Pakistan
4. Private Practice , Worpswede , Germany
Abstract
Summary
Background
Orthodontic space closure of extraction sites can be initiated early, within 1-week post-extraction, or it can be delayed for a month or more.
Objective
This systematic review aimed to evaluate the effect of early versus delayed initiation of space closure after tooth extraction on the rate of orthodontic tooth movement.
Search methods
Unrestricted search of 10 electronic databases was conducted until September 2022.
Selection criteria
Randomized controlled trials (RCTs) investigating the initiation time of space closure of extraction sites in patients undergoing orthodontic treatment were included.
Data collection and analysis
Data items were extracted using a pre-piloted extraction form. The Cochrane’s risk of bias tool (ROB 2.0) and the Grading of Recommendations, Assessment, Development, and Evaluation approach were used for quality assessment. Meta-analysis was undertaken if there are at least two trials reporting the same outcome.
Results
Eleven RCTs met the inclusion criteria. Meta-analysis revealed that early canine retraction resulted in a statistically significant higher rate of maxillary canine retraction when compared to delayed canine retraction [mean difference (MD); 0.17 mm/month, 95% CI: 0.06 to 0.28, P = 0.003, 4 RCTs, moderate quality]. Duration of space closure was shorter in the early space closure group, but not statistically significant (MD; 1.11 months, 95% CI: −0.27 to 2.49, P = 0.11, 2 RCTs, low quality). The incidence of gingival invaginations was not statistically different between early and delayed space closure groups (Odds ratio; 0.79, 95% CI: 0.27 to 2.29, 2 RCTs, P = 0.66, very low quality). Qualitative synthesis found no statistically significant differences between the two groups regarding anchorage loss, root resorption, tooth tipping, and alveolar bone height.
Conclusions
Based on the available evidence, early traction within the first week after tooth extraction has a minimal clinically significant effect on the rate of tooth movement compared to delayed traction. Further high-quality RCTs with standardized time points and measurement methods are still needed.
Registration
PROSPERO (CRD42022346026).
Publisher
Oxford University Press (OUP)
Cited by
3 articles.
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