摘要目的:通过Meta分析与系统综述评价牙周辅助加速成骨正畸用于骨性Ⅲ类患者正畸-正颌联合治疗中牙槽骨形态和牙周软组织的变化。方法:对六个中英文数据库进行文献检索，筛选骨性Ⅲ类患者正颌术前正畸采用牙周辅助加速的成骨正畸(periodontal accelerated osteogenic orthodontics, PAOO)并评价牙周软硬组织变化的纵向研究，对纳入的研究结果(牙槽骨厚度、高度和牙周软组织变化)进行定量和定性分析。结果:本综述共纳入11篇研究。相比于未行PAOO的患者，PAOO治疗后患者下前牙唇侧牙槽骨厚度显著增加(根中部增加1.15 mm， P＝0.02；根尖部增加1.57 mm， P<0.001，根颈部增加0.36 mm， P＝0.26)。PAOO治疗后，患者下前牙唇侧牙槽骨高度无明显下降，但未行PAOO的患者正畸治疗后唇侧牙槽骨高度出现降低，二组唇侧骨吸收高度差平均为2.88 mm( P<0.001)。软组织方面，PAOO术后角化龈宽度显著增加，探诊深度无显著差异，未发生显著的牙龈退缩。 结论:PAOO技术应用于骨性Ⅲ类正畸-正颌联合治疗患者可以增宽角化龈宽度，增加下前牙唇侧根中部和根尖部牙槽骨厚度，较好地维持下前牙唇侧牙槽骨高度及根颈部骨厚度。

abstractsObjective:To evaluate the effect of presurgical periodontally accelerated osteogenic orthodontics (PAOO) on the alveolar bone morphology and periodontal soft tissues in skeletal Class Ⅲ patients through Meta-analysis and systemic review.Methods:A thorough electronic and manual systematic search was conducted in six databases to identify applicable studies for evaluating the effect of PAOO on the periodontal hard and soft tissue in presurgical decompensation for skeletal Class Ⅲ patients. The change of alveolar bone thickness, vertical bone height, and the change of periodontal soft tissue was estimated as the weighted mean differences and standard deviation with confidence intervals using Review Manager.Results:Eleven studies met the inclusion criteria. Labial alveolar bone was thicker in lower anterior teeth with presurgical decompensation using PAOO compared to decompensation without PAOO in skeletal Class Ⅲ patients. The average increase of bone thickness following PAOO on the labial side of lower anterior teeth was 1.15mm at the middle area of the root ( P=0.02), and 1.57 mm ( P<0.001) at the apical area. However, there was no significant bone gain at the cervical area of the labial alveolar bone (average change: 0.36 mm, P=0.26). There was no significant vertical bone loss on the labial side of the lower incisor after PAOO decompensation compared to pre-PAOO. There was much less labial vertical bone loss on the lower anterior teeth in the group of PAOO decompensation than in the group of the regular orthodontic decompensation (mean difference: 2.88 mm, P<0.001). There was a significant improvement in the width of keratinized tissue after the PAOO treatment. No significant change in the probing depth, nor in the gingival recession before and after the PAOO treatment was observed. Conclusions:PAOO technique in presurgical decompensation treatment in skeletal Class Ⅲ patients can increase the width of keratinized tissue and the labial bone thickness of lower anterior teeth at the middle and apical area of the root, while retaining bone thickness and vertical bone level of the labial cervical area.