Abstract
Data sources
Medline via PubMed, Scopus and Web of Science databases were searched from January 2003 to March 2015 limited to human studies published in English. Manual searches for the relevant reference lists and a grey literature search via Google Scholar were also conducted.
Study selection
Prospective and retrospective studies about the stability of miniscrew implants (MIs) used for orthodontic anchorage into the posterior buccal region were considered. Two review authors independently assessed titles and abstracts, and evaluated full manuscripts for the meta-analysis.
Data extraction and synthesis
The outcome measure was the success rate of MIs which had to be explicitly reported in order to enable its computation as odds ratios with regards to patient factors (age (years), < 20 vs. ≥ 20; sex, male vs. female; jaw of insertion, maxilla vs. mandible) and MI factors (length, < 8 mm vs. ≥ 1.4 mm; diameter, ≤ 1.4 mm vs. > 1.4 mm). The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). The meta-analysis was expressed as combined OR and heterogeneity was evaluated (Cochran Q and I2). Subgroup meta-analysis was conducted based on study design, study quality and MIs sample size. Publication bias analysis (Begg's and Eggar's tests) and sensitivity analysis were performed.
Results
Seventeen non-randomised studies, five prospective and 12 retrospective, were included. Significantly higher success rates were observed for the maxillary MIs (14 studies odds ratio (OR), 2.32; 95% CI, 1.81-4.08), older patients (six studies OR, 1.59; 95% CI, 1.14-2.22), and for longer MIs (four studies OR, 0.56 (1/0.46= 2.17); 95% CI, 0.26-0.20) and MIs with larger diameter (four studies OR, 0.62 (1/0.62= 1.61); 95% CI, 0.40-0.97), whereas there was no difference observed between male and female patients (13 studies OR, 1.18; 95% CI, 0.92-1.51). All subgroups acquired homogeneity except for the components of study design regarding the jaw of insertion.
Conclusions
The results of this meta-analysis based on non-randomised clinical studies showed that jaw of insertion, age, MI length and MI diameter are critical risk factors to the success of MIs, whereas sex was not influential.
Source of Funding
The Basic Science Research Program of the National Research Foundation of Korea was stated as the source of funding.
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Address for correspondence: Prof. Hoi-Jeong Lim. Department of Orthodontics, School of Dentistry, Dental Science Research Institute, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Korea. E-mail: hjlim@jnu.ac.kr
Hong SB, Kusnoto B, Kim EJ, BeGole EA, Hwang HS, Lim HJ. Prognostic factors associated with the success rates of posterior orthodontic miniscrew implants: A subgroup meta-analysis. Korean J Orthod 2016; 46: 111–126. doi: 10.4041/kjod.2016.46.2.111.
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Afrashtehfar, K. Patient and miniscrew implant factors influence the success of orthodontic miniscrew implants. Evid Based Dent 17, 109–110 (2016). https://doi.org/10.1038/sj.ebd.6401202
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DOI: https://doi.org/10.1038/sj.ebd.6401202