Association between malocclusion and dental caries in adolescents: a systematic review and meta-analysis

Aim To evaluate the scientific evidence regarding the association between malocclusion and dental caries in adolescents. Methods Searches were conducted of six electronic databases, complemented by manual searching of the reference lists of the selected articles and grey literature. Two independent reviewers performed the selection of the articles, data extraction and the evaluation of the risks of bias through an assessment of methodological quality. Meta-analysis was performed considering the mean decayed, missing and filled teeth (DMFT) index for caries and the Dental Aesthetic Index (DAI) for malocclusion. Heterogeneity was tested using the I-2 statistic and a random effect model was employed. Summary effect measures were calculated as differences in means. Results The initial search retrieved 2644 studies, only 15 of which were selected for full-text analysis. Four cross-sectional studies were included in the qualitative systematic review. Only one of these studies found no association between malocclusion and dental caries. The meta-analysis of three studies demonstrated that a lower DAI value was significantly associated with a lower mean DMFT index, except for the comparison of DAI 26-30 vs. 31-35. Conclusions Based on the studies analysed, the scientific evidence indicates an association between malocclusion and dental caries.