J Am Dent Assoc. 2017 Aug;148(8):566-574.e6. doi: 10.1016/j.adaj.2017.05.018.
Researchers have purported that breast-feeding can decrease the risk of malocclusions. The authors studied the relationship of breast-feeding on malocclusions in young children by means of conducting a systematic review of association (etiology).
The authors used a 3-step search strategy, including electronic searches. They considered studies whose investigators included healthy children with primary dentition with a history of breast-feeding and in which the study investigators had assessed specific malocclusion outcomes to be eligible for inclusion in this review. The authors considered prospective and retrospective (longitudinal) studies, case-control studies, and analytical cross-sectional studies. Two of the authors, using standardized instruments, independently assessed the methodological quality and extracted data from the included studies. For situations for which there were a sufficient number of studies, the authors conducted meta-analyses using the random-effects model, supplemented with the fixed-effects model in situations for which statistical heterogeneity was 50% or less, assessed using the I statistic.
The authors identified 7 studies that were included in the review. They found that children who had breast-fed suboptimally had an increased risk of developing malocclusions and that a strong and significant association existed between a shorter duration of breast-feeding (less than 12 months) and the development of an anterior open bite (n = 1,875; risk ratio, 3.58; 95% confidence interval, 2.55 to 5.03; P < .00001) and a class II canine relationship (n = 1,203; risk ratio, 1.65; 95% confidence interval, 1.38 to 1.97; P < .00001).
Young children with a history of suboptimal breast-feeding have a higher prevalence and risk ratio for malocclusions. These children have an increased risk of developing a class II canine relationship, posterior crossbite, and anterior open bite.
Dental health care professionals should continue to encourage and promote breast-feeding; however, patients should be aware that children still can develop malocclusions, despite having received optimal breast-feeding, owing to the multifactorial etiology of malocclusions.
研究人员声称母乳喂养可以降低错颌畸形的风险。作者通过系统评价（病因学）研究母乳喂养对幼儿错颌畸形的关系。
作者使用了三步搜索策略，包括电子搜索。他们考虑了将健康儿童的原始牙齿和母乳喂养史纳入研究的研究，并且研究人员评估了特定的错颌畸形结果，以符合本综述的纳入标准。作者认为前瞻性和回顾性（纵向）研究、病例对照研究和分析性横断面研究都是合格的。两位作者使用标准化工具，独立评估了纳入研究的方法学质量并提取了数据。对于有足够数量研究的情况，作者使用随机效应模型进行荟萃分析，并在统计异质性为 50%或更低的情况下，使用 I 统计量补充固定效应模型。
作者确定了 7 项纳入综述的研究。他们发现，母乳喂养不足的儿童发生错颌畸形的风险增加，母乳喂养时间较短（少于 12 个月）与前牙开颌（n=1875；风险比，3.58；95%置信区间，2.55 至 5.03；P<0.00001）和 II 类犬牙关系（n=1203；风险比，1.65；95%置信区间，1.38 至 1.97；P<0.00001）之间存在很强的显著关联。
有母乳喂养不足史的幼儿错颌畸形的患病率和风险比更高。这些儿童患 II 类犬牙关系、后牙反颌和前牙开颌的风险增加。
牙科保健专业人员应继续鼓励和促进母乳喂养；然而，患者应该意识到，尽管接受了最佳的母乳喂养，由于错颌畸形的多因素病因，儿童仍然可能发生错颌畸形。
