Prevalência de lesões traumáticas dentoalveolares em serviços odontológicos de urgência: revisão sistemática e meta-análise

Abstract

Traumatic dental injuries (TDI) consist of multiple and acute injuries resulting from abrupt impacts on teeth and their supporting structures. These injuries have a high prevalence reported worldwide and represent a large part of the demand for emergency dental services. However, information on the TDI prevalence rate within emergency dental services is still scattered and fragmented. This study aimed to systematically review the literature and synthesize the information available on this prevalence through meta-analysis, as described in the protocol registered in PROSPERO under code CRD42021243537. A bibliographic search was performed in seven health databases: PubMed; Embase; LILACS; LIVIVO; ScienceDirect; Scopus; and Web of Science. And two other grey literature bases: Google Scholar and OpenGrey. Based on the PICOS strategy, the following specific question for the review was defined: What is the prevalence of TDI in emergency dental services? Studies showing the TDI prevalence rate in emergency dental services, published in the Latin-Roman alphabet, were included. Abstracts, reviews, case reports, protocols, expert opinions, letters, posters, and publications in which the full-text version could not be accessed were excluded. Studies conducted in clinics specializing in dental trauma and in extreme conditions, such as war scenarios and environmental disasters, were also excluded. Of 2464 studies identified by the literature search, 1476 remained after excluding duplicates. Of these, 1329 were excluded by reading the title and abstract. Of the remaining 147 studies, 38 were selected after reading the full text and another 5 works were included through a manual search for the references of the selected publications. The year of publication of the 43 studies ranged from 1984 to 2021. Most studies (30) had a moderate risk of bias according to the Joanna Briggs Institute's checklist for prevalence studies. Prevalence rates ranging from 2% to 69% were observed and the overall prevalence, for the 43 studies included, was 15.4% (11%-21%, i²=100%, CI:95 %). For subgroup analysis, the prevalence of 24% (15%-35%, I²=100%, CI: 95%) was observed for studies that evaluated the age group between 0 and 21. A prevalence of 29% (22%-38%, I²=99%, CI: 95%) was observed for studies conducted in emergency paediatric dental services. Considering that emergency care is a determinant of TDI’s long-term prognosis, knowledge of the prevalence of these injuries among dental emergencies is essential to organize these services and support public policies in this area.