Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Central Library of the Health Science Center- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Community Dent Oral Epidemiol. 2020 Dec;48(6):447-463. doi: 10.1111/cdoe.12574. Epub 2020 Sep 6.
We sought to revise, qualify and summarize the body of evidence based on current information on the known associations and risk factors for traumatic dental injury (TDI) occurrence with an overview of systematic reviews.
Electronic searches were performed with no language nor date restrictions.According to the PECO strategy, systematic reviews that investigated participants (P) with (E) and without (O) the presentation of factors relating to TDI and these factors' association with TDI episodes (O) as primary or secondary outcomes were included. Quality assessment and bias control were carried out according to the AMSTAR 2 checklist. In cases of systematic review results of discordance, the Jadad decision algorithm was applied.
After titles, abstracts and full texts were read, 19 systematic reviews were included in this overview. Four were classified with critically low, eleven with low and four with moderate methodological quality, respectively. In all studies, 249 cross-sectional, 34 epidemiological surveys, 22 cohort, 9 case-control, 4 longitudinal, 3 ecological and 30 unspecified studies were included. Male gender, child age, greater overjet, inadequate lip coverage, anterior open bite, caries in the permanent dentition, overweight, a previous history of TDI, tongue piercing, the use of alcoholic beverages and participation in sports were all associated with a greater chance of suffering TDI.
Sociodemographic, clinical and environmental factors are associated with a greater chance of TDI occurrence. However, most of the systematic reviews included were of a low quality and may not provide an accurate and comprehensive summary of the available research that addresses the question of interest. Well-designed primary studies on different aspects of TDI are encouraged to provide higher quality scientific evidence.
我们旨在修订、限定并总结当前已知与创伤性牙外伤（TDI）发生相关的关联因素和风险因素的证据体，同时对系统评价进行概述。
无语言和日期限制地进行电子检索。根据 PICO 策略，纳入了调查参与者（P）是否存在（E）和不存在（O）与 TDI 相关的因素以及这些因素与 TDI 发作（O）的关联作为主要或次要结局的系统评价。根据 AMSTAR 2 清单进行质量评估和偏倚控制。在系统评价结果不一致的情况下，应用 Jadad 决策算法。
在阅读标题、摘要和全文后，共纳入 19 篇系统评价进行概述。其中 4 篇被归类为极低质量，11 篇为低质量，4 篇为中质量。在所有研究中，纳入了 249 项横断面研究、34 项流行病学调查、22 项队列研究、9 项病例对照研究、4 项纵向研究、3 项生态学研究和 30 项未明确研究。男性性别、儿童年龄、较大的覆𬌗、唇覆盖不足、前牙开𬌗、恒牙龋齿、超重、既往 TDI 史、舌穿孔、使用酒精饮料和参与体育运动均与 TDI 发生的可能性增加相关。
社会人口学、临床和环境因素与 TDI 发生的可能性增加相关。然而，纳入的大多数系统评价质量较低，可能无法对现有研究提供准确和全面的总结，而这些研究涉及到感兴趣的问题。鼓励开展关于 TDI 不同方面的设计良好的原始研究，以提供更高质量的科学证据。
