Oral alterations in children with microcephaly associated to congenital Zika syndrome: A systematic review and meta-analyses.

AIMS: To synthesize the oral alterations observed in children with microcephaly associated with congenital Zika virus syndrome (CZS), and to compare the oral alterations of these children to a normotypic healthy controls. METHODS AND RESULTS: A search was performed in six electronic databases. Observational studies published that reported oral alterations in children with CZS were selected. Two authors independently extracted data, assessed study quality, using the Joanna Briggs Institute Critical Appraisal Checklist tools, and the certainty of evidence, using Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Twenty-one studies were included in this systematic review and meta-analysis. The pooled crude occurrence showed 88% of increased salivation (95%CI: 82%-94%), 83% of biofilm (95%CI: 75%-91%), and 73% of bruxism (95%CI: 52%-95%). Compared to normotypic controls, children with CZS-associated microcephaly had a higher chance to have difficulty in lip sealing (OR: 18.28; 95%CI: 1.42-235.91), inadequate lingual posture at rest (OR: 13.57; 95%CI: 4.24-43.44), and delayed eruption (OR: 12.92; 95%CI: 3.42-48.78), with very low certainty. CONCLUSION: There are several oral alterations found among children with CZS-associated microcephaly. They are more prone to present some of these alterations, such as difficulty in lip sealing, although with very low certainty of evidence.

Impacto do isolamento social pela pandemia da COVID-19 nas consultas odontopediátricas: uma revisão sistemática e meta-análise / Impact of social isolation caused by the COVID-19 pandemic on pediatric dentistry appointments: a systematic review and meta-analysis

Objetivo: Avaliar estudos que mostraram o impacto do isolamento social pela pandemia da COVID-19 nas consultas odontopediátricas. Métodos: Estudos originais que tenham mostrado o impacto do isolamento social nas consultas de crianças e adolescentes com um(a) odontopediatra foram incluídos. Buscas no Web ofScience, Scopus, Embase e PubMed foram realizadas. A seleção dos estudos foi feita por dois autores. O risco de viés foi avaliado com a escala Universidade de Adelaide. Resultados das meta-análises foram fornecidos em razão de chances (RC) e intervalo de confiança (IC). Resultados:Setecentas e noventa e quatro referências foram avaliadas e quatro estudos foram incluídos. A proporção de consultas realizadas em 2019 (antes da pandemia) para tratamento restaurador (RC = 22,65; IC = 20,57­24,93), extração de dentes (RC = 15,96; IC = 14,78­17,23) e tratamento endodôntico (RC = 9,21; IC = 7,72­10,98) foi significativamente maior que a proporção de consultas realizadas em 2020 (após o início da pandemia). A proporção de pais/responsáveis que não levariam seus(suas) filhos(as) à uma consulta com o odontopediatra foi significativamente maior entre indivíduos com mais medo durante a pandemia (escore 6 a 10) do que entre indivíduos com menos medo durante a pandemia (escore 0 a 5) (RC = 8,41; IC = 5,06­13,98). A proporção de pais/responsáveis que não levariam seus(suas) filhos(as) à uma consulta com o odontopediatra em regiões com mais de 100 casos de COVID-19 foi significativamente maior do que em regiões com até 100 casos (RC = 2,45; IC = 1,55­3,88). A avaliação do risco de viés variou de baixo a alto. Uma limitação dessa revisão foi o número restrito de estudos incluídos. Conclusão: O isolamento social pode ter contribuído para uma redução no número de consultas odontopediátricas devido à insegurança dos pais de levarem seus(suas) filhos(as) ao consultório odontológico. Esses resultados podem ser importantes para os clínicos e os organizadores de serviços de saúde.

Aim: To evaluate studies that showed the impact of social isolation caused by the COVID-19 pandemic on pediatric dentistry appointments. Methods: This work included original studies that have evaluated the impact of social isolation in children's and adolescents' appointments with a pediatric dentist. Searches were conducted in Web of Science, Scopus, Embase, and PubMed databases. Study selection was carried out by two authors. Risk of bias was assessed using the University of Adelaide scale. Results of meta-analyses were provided in odds ratio (OR) and confidence interval (CI). Results: Our study evaluated 794 references, of which four studies were included. The proportion of dental appointments performed in 2019 (before the pandemic) for restorative treatment (OR = 22.65; CI = 20.57­24.93), tooth extraction (OR = 15.96; CI = 14.78­17.23), and endodontic treatment (OR = 9.21; CI = 7.72­10.98) was significantly higher than the proportion of dental appointments performed in 2020 (after the onset of the pandemic). The proportion of parents/guardians who would not take their children to an appointment with a pediatric dentist was significantly higher among individuals who were more afrais during the pandemic (score 6 to 10) than among individuals who were less afraid during the pandemic (score 0 to 5) (OR = 8.41; CI = 5.06­13.98). The proportion of parents/guardians who would not take their children to an appointment with a pediatric dentist in regions with more than 100 cases of COVID-19 was significantly higher than in regions with up to 100 cases (OR = 2,45; CI = 1.55­3.88). Risk of bias assessment ranged from low to high. A limitation of this review was the restricted number of included studies. Conclusion: Social isolation caused a decline in the number of appointments with a pediatric dentist due to parents' insecurity about taking their children to the dental office. These results are important for both dental clinicians and healthcare decision-makers.

Cárie dentária em crianças e adolescentes com Diabetes tipo 1: uma revisão sistemática e meta-análise / Dental caries in children and adolescents with type 1 Diabetes: a systematic review and meta-analysis

Objetivo: O objetivo dessa revisão sistemática e meta-análise foi avaliar estudos que fizeram uma comparação da ocorrência de cárie dentária entre crianças/adolescentes com Diabetes tipo 1 (DM1) e crianças/adolescentes sem essa condição. Métodos:Buscas computadorizadas no Web ofScience, Scopus, Lilacs, PubMed, OpenGrey e Google Scholar foram realizadas até dezembro de 2020. A seleção dos estudos foi feita por dois autores independentemente. Referências que preenchiam os critérios de elegibilidade foram incluídas. O risco de viés foi avaliado com a escala Newcastle Ottawa. Meta-análises foram conduzidas. Diferença média (DM) e intervalos de confiança (IC) foram fornecidos. Resultados: Durante as buscas nas bases de dados, 751 referências foram recuperadas. Após remoção de 102 duplicatas, 649 referências foram avaliadas e 16 estudos foram incluídos nessa revisão sistemática e meta-análise. Os estudos incluídos tiveram resultados discrepantes. Duas meta-análises demonstraram que não houve diferença significativa na média de dentes permanentes com cárie entre crianças/adolescentes com DM1 e crianças/adolescentes sem DM1 (DM = 0,07; IC = -0,68 ­ 0,82) e que não houve diferença significativa na média de superfícies de dentes permanentes com cárie entre crianças/adolescentes com DM1 e crianças/adolescentes sem DM1 (DM = 0,20; IC = -2,22 ­ 2,61). Uma terceira meta-análise revelou que crianças/adolescentes sem DM1 apresentavam uma média de dentes decíduos com cárie significativamente maior do que crianças/adolescentes com DM1 (DM = 0,34; IC = 0,31 ­ 0,37). O maior problema de risco de viés dos estudos foi para a definição dos controles e comparação de casos e controles. Conclusão: A ocorrência de cárie parece ser menor entre crianças/adolescentes com DM1 em comparação a crianças/adolescentes sem DM1.

Aim:The aim of this systematic review and meta-analysis was to evaluate studies in which children/adolescents with type 1 Diabetes (DM1) were compared with children/adolescents without DM1 as regards dental caries. Methods: Electronic searches in Web ofScience, Scopus, Lilacs, PubMed, OpenGrey, and Google Scholar databases were conducted up to December/2020. Study selection was carried out separately by two reviewers. References that met the eligibility criteria were included. Risk of bias was evaluated using the Newcastle Ottawa scale. Meta-analyses were conducted. Mean difference (MD) and confidence intervals (CI) were provided. Results:In the database searches, 751 references were retrieved. Following the removal of 102 duplicates, 649 references were assessed, and 16 studies were included in this systematic review and meta-analysis. Discrepancies in results were found among the included studies. Two meta-analyses demonstrated no significant difference between children/adolescents with DM1 and children/adolescents without DM1 regarding the mean number of permanent teeth with caries (MD = 0.07; CI = -0.68 ­ 0.82), as well as no significant difference between children/adolescents with DM1 and children/adolescents without DM1 with respect to the mean number of permanent tooth surfaces with caries (MD = 0.20; CI = -2.22 ­ 2.61). The third meta-analysis revealed that children/adolescents without DM1 had a significantly higher mean number of primary teeth with caries in comparison to children/adolescents with DM1 (MD = 0.34; CI = 0.31 ­ 0.37). The major issues in the risk of bias assessment were the definition of controls and comparison between cases and controls. Conclusion: The occurrence of caries seems to be lower in children/adolescents with DM1 than in children/adolescents without DM1.