Nóbrega Johnys, Dantas Eugênia, Ferreira-Filho Julio Cesar, Limão Nayara, Rodrigues-de-Melo Ana Carolina, Protásio Ane Polline, Valença Ana Maria, Santiago Bianca
Oral Health Prev Dent. 2017;15(4):329-336. doi: 10.3290/j.ohpd.a38744.
This systematic review sought to determine whether there is consistent evidence of the association between contextual social inequities and the occurrence of dental caries in adolescents.
An electronic survey in ISI Web of Science, SCOPUS, MEDLINE, LILACS, Cochrane Library, and SciELO databases was performed, establishing a specific search strategy in each of them. Only analytical articles in which social indicators were measured at the contextual level published up to December 2015 were included. The risk of bias of studies selected was assessed from parameters suggested by MOOSE (Meta-analysis of Observational Studies in Epidemiology), classifying them in each item as adequate, partially adequate, inadequate and unclear. After evaluation, studies were classified as good (level 1), regular (level 2) or bad (level 3) quality.
Of the 181 articles identified, four met the inclusion and exclusion criteria, and of these, only one showed high risk of bias. Four articles showed significant association between contextual socioeconomic factors and caries. Despite the measurement of different social inequities such as social class and neighbourhood empowerment level, the articles showed significant association between contextual socioeconomic factors and caries.
The scientific evidence that adolescents from areas of higher social inequity are at higher risk for caries is weak, especially considering the small number of existing studies, methodological vulnerabilities and the risk of study bias.
本系统评价旨在确定是否有一致的证据表明背景社会不平等与青少年龋齿的发生之间存在关联。
在科学引文索引（ISI Web of Science）、Scopus、医学文献数据库（MEDLINE）、拉丁美洲和加勒比卫生科学数据库（LILACS）、考克兰图书馆和科学电子图书馆在线数据库（SciELO）中进行了电子检索，在每个数据库中制定了特定的检索策略。仅纳入截至2015年12月发表的、在背景层面测量社会指标的分析性文章。根据流行病学观察性研究的元分析（MOOSE）建议的参数评估所选研究的偏倚风险，将每个项目中的研究分类为充分、部分充分、不充分和不清楚。评估后，将研究分为高质量（1级）、中等质量（2级）或低质量（3级）。
在识别出的181篇文章中，有4篇符合纳入和排除标准，其中只有1篇显示出高偏倚风险。4篇文章显示背景社会经济因素与龋齿之间存在显著关联。尽管测量了不同的社会不平等，如社会阶层和社区赋权水平，但这些文章显示背景社会经济因素与龋齿之间存在显著关联。
来自社会不平等程度较高地区的青少年患龋齿风险更高的科学证据不足，特别是考虑到现有研究数量较少、方法学上的缺陷以及研究偏倚风险。
