Malocclusion in individuals with Autism Spectrum Disorder (ASD): review systematic and meta-analysis
Bibliographic record
Abstract
Malocclusion is the third most prevalent oral condition worldwide. Individuals with autism spectrum disorder (ASD) may have parafunctional oral habits that may act as important causal factors for malocclusions. Literature is still controversial about the higher occurrence of malocclusion in individuals with ASD compared to those without ASD. The aim of this systematic review and meta-analysis was to assess the prevalence of malocclusion in individuals with ASD and to compare malocclusion characteristics between individuals with and without ASD. This systematic review was registered in PROSPERO (CRD42019151794). Epidemiologic studies that evaluated malocclusion clinically in individuals with ASD and/or measured malocclusion in individuals with or without ASD were included. The search was conducted on PubMed, Scopus, Web of Science, Cochrane, Scielo and Lilacs electronic databases. The identified studies were selected and assessed by two researchers independently. The risk of bias was analyzed using the Newcastle Ottawa scale according to the study design. The meta-analysis included the pooled prevalence and 95% confidence interval (CI 95%) of malocclusion characteristics among individuals with ASD. The pooled odds ratio (OR) and 95% CI were estimated to assess the relationship between ASD and malocclusion. Of the 2522 articles identified, 15 studies were included. Regarding the quality of studies, no articles were considered to be of high quality.. The meta-analyses of prevalence and association included 12 and 6 articles, respectively. The prevalence of Class I, II and III in individuals with ASD was 39%, 22% and 8%, respectively. The most prevalent malocclusion characteristic was increased maxillary overjet (39%, 95%CI 23-54) and crowding (38%, 95%CI 22-53%). Individuals with ASD had a 53% greater odds (OR 1.53; 95%CI 1.06-2.21) of increased maxillary overjet, and had 73% higher odds (OR 1.73; 95%CI 1.03 -2.90) of deep bite than those without ASD. Furthermore, individuals with ASD had 20% greater odds (OR 1.20; 95%CI 1.03-1.39) of having at least one type of malocclusion when compared with those without ASD. The available evidence suggests that individuals with ASD are more likely to have malocclusion than individuals without ASD. These findings indicate the importance of a multidisciplinary team in the health care of individuals with ASD as well as the need of providing more guidance for these individuals to prevent and reduce harmful oral habits, with the aim of preventing malocclusion.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.023 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.027 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".