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Tooth wear prevalence in individuals with Down syndrome: a systematic review

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Abstract

Objectives

This systematic review investigated the prevalence of tooth wear between patients with and without Down syndrome.

Methods

Six databases (Embase, LILACS, Livivo, PubMed, Scopus and Web of Science) and grey literature (Google Scholar, OpenGrey and ProQuest) were searched until March 7, 2022. Observational studies were included to assess the differences in tooth wear prevalence and/or severity in Down syndrome and non-syndromic controls. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations were followed. Three reviewers independently screened studies, extracted data, assessed the methodological quality (Joanna Briggs Institute) and graded the certainty of evidence through the Grading of Recommendations, Assessment, Development, Evaluation (GRADE) approach. Results were summarized through meta-analyses using a random-effects model. The protocol was registered at PROSPERO (CRD42021266997).

Results

Of the 1382 records identified, six cross-sectional studies were included. Individuals with Down syndrome had a higher prevalence and were more likely to have tooth wear than individuals without Down syndrome (44% × 15%; OR = 4.43; 95% CI 3.17–6.18; p < 0.00001; I2 = 8%). Also, the severity of tooth wear was higher in the Down syndrome group (n = 275) compared with the controls (n = 294). The certainty of evidence analysis was very low.

Conclusions

Based on very low certainty of the evidence, patients with Down syndrome had a higher prevalence and likelihood and severity of tooth wear when compared to those without Down syndrome.

Clinical relevance

Screening early tooth wear lesions should be carefully done in the Down syndrome population since its occurrence is remarkable compared to the general population.

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Data availability

Data are available in the manuscript and supplementary file.

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Funding

Thiago Isidro Vieira and Patrícia Pauletto are supported by Coordination for the Improvement of Higher Education Personnel (CAPES), Ministry of Education (Brazil). This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance code 001. Graziela De Luca Canto (Bolsista de Produtividade em Pesquisa 2 from Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq).

Author information

Authors and Affiliations

  1. Centro de Ciências da Saúde – Térreo, Federal University of Paraíba, Campus I - Cidade Universitária, João Pessoa, 58051900, Brazil

    Thiago Isidro Vieira, Yuri Wanderley Cavalcanti, Simone Alves de Sousa & Bianca Marques Santiago

  2. São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo, Brazil

    Luciana Butini Oliveira

  3. Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, Aarhus, Denmark

    Fernando Valentim Bitencourt

  4. Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil

    Graziela De Luca Canto & Patrícia Pauletto

  5. Dentistry School, Universidad de Las Américas (UDLA), Quito, Ecuador

    Patrícia Pauletto

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  1. Thiago Isidro Vieira
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  5. Luciana Butini Oliveira
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Contributions

T.I.V., Y.W.C., S.A.S. and B.M.S. conceptualized the study, collected and analyzed data, wrote the manuscript and approved the final version of the manuscript as submitted. L.B.O., F.V.B., G.D.L.C. and P.P. contributed with the manuscript preparation, analyzed data, critically reviewed and approved the final version of the manuscript as submitted.

Corresponding author

Correspondence to Thiago Isidro Vieira.

Ethics declarations

Registration and protocol

A systematic review protocol based on the PRISMA-P guideline [39] was developed and registered at the PROSPERO database under code CRD42021266997. This systematic review was reported according to PRISMA [40].

Ethical approval

Not applicable.

Competing interests

Thiago Isidro Vieira, Yuri Wanderley Cavalcanti, Simone Alves de Sousa, Bianca Marques Santiago, Luciana Butini Oliveira, Fernando Valentim Bitencourt, Graziela De Luca Canto and Patrícia Pauletto declare no competing interests.

Additional information

Explanations

a. The studies did not identify possible confounding factors, and consequently, there was no adjustment for them in the proper statistical analysis.

b. External validity is compromised since only collaborating individuals and individuals who were members of societies of special needs or participants in special needs schools were examined.

c. The number of participants of the included studies did not reach the optimal information size (OIS) and the confidence interval is large.

d. The number of participants is critical since the sample size of the 3 included studies did not reach the optimal information size (OIS)

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Supplementary information

Appendix 1

Electronic search strategy conducted in March 7, 2022.

Appendix 2

List of unavailable and excluded studies with reasons.

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Vieira, T.I., Cavalcanti, Y.W., de Sousa, S.A. et al. Tooth wear prevalence in individuals with Down syndrome: a systematic review. Clin Oral Invest 27, 943–953 (2023). https://doi.org/10.1007/s00784-022-04856-5

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