Eficacia de soportes ortodóncicos autoligantes versus convencionales en desarrollo transversal maxilar: una revisión sistemática y metaanálisis
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Introducción: los soportes ortodóncicos de autoligado (SLB) han sido promocionados como superiores a los soportes ortodóncicos convencionales (CB) en el desarrollo del arco maxilar, aunque la evidencia aún es inconsistente. Objetivo: evaluar la eficacia comparativa de los sistemas SLB y CB en los cambios dimensionales del arco maxilar mediante una revisión sistemática y un metaanálisis. Método: se realizó una búsqueda sistemática en PubMed, Scopus y ClinicalKey hasta diciembre de 2024. Se incluyeron ensayos controlados que compararon SLB con CB. Los estudios se evaluaron con las herramientas de Cochrane y JBI. Se empleó un modelo de efectos aleatorios. Resultados: seis estudios cumplieron los criterios (353 participantes). El metaanálisis mostró diferencias significativas a favor de SLB en el ancho intercanino maxilar (DM = 0,83 mm; IC del 95%: 0,33-1,33; p = 0,001), sin diferencias en el ancho intercanino mandibular (DM = -0,38 mm; IC del 95%: -1,17-0,41; p = 0,35). Los SLB demostraron una menor inclinación de los incisivos (DM = -2,28°; IC95% -4,56-0,00; p = 0,05). Conclusiones: los SLB producen una mayor expansión transversal maxilar con menor proclinación. Se requieren estudios longitudinales para evaluar la estabilidad y la costo-efectividad.
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