Down Syndrome and its Association with Traumatic Dental Injuries: A Systematic Review and Meta-analysis
Background: Very little is known about the association between traumatic dental injuries (TDI) and Down syndrome (DS) individuals. The aim of this review was to explore the prevalence of TDI among DS individuals and its severity compared to a normal population. Methods: The following databases were searched, without language or date restrictions, between 1900 and November 30, 2021: MEDLINE via PubMed, MEDLINE via OvidSP, Web of Science, CINAHL, Cochrane, and Scopus. A population, exposition, comparison and outcomes (PECO) strategy was performed, which investigated participants with and without DS and their relationship with TDI prevalence. The Joanna Briggs Institute (JBI) checklist was also conducted for quality assessment and bias control. Results: A total of 9,351 eligible articles were identified; 4,014 duplicated studies were eliminated, resulting in 5,337 titles and abstracts. These were then assessed with the inclusion and exclusion criteria, revealing 76 studies eligible for full-text assessment. Consequently, a further 69 were excluded for the reasons that they did not cover TDI or DS, resulting in a total of seven studies included in this review. TDI, class I and II malocclusion associations between both DS and control groups were statistically significant: p=0.005, p=0.05 and p=0.002 respectively. Conclusions: TDI, class I, and class II malocclusion occurrences were more prevalent among DS individuals than healthy controls. Future research may focus on exploring and developing preventive measures that aim at avoiding factors associated with increased TDI among DS individuals, or at least reduce their impact.