Impactos do uso de aparelhos ortodônticos na qualidade de vida de crianças e adolescentes - revisão sistemática e metanálise

Abstract

Although there are previous systematic reviews on the impact of Oral Health-Related Quality of Life (OHRQoL) in children and adolescents after orthodontic treatment, there is no definition of the magnitude of these impacts during therapy. Therefore, this study aimed to systematically analyze the literature on changes in the quality of life of children and adolescents during orthodontic treatment. JBI guidelines were followed for the elaboration of the review and a protocol was registered in the PROSPERO database. An electronic search was performed in six main databases and two additional databases to partially capture the "grey literature" up to July 2021. The PICO strategy was used to identify randomized or non-randomized clinical trials evaluating OHRQoL before and during the orthodontic treatment of children and adolescents, without restriction of language and year of publication. Two reviewers participated in the selection process, extracted data, and assessed the individual risk of bias of eligible studies. Random-effects meta-analyses were performed to calculate the standardized mean difference in OHRQoL scores one week and one, three, six, and 12 months after initiation of orthodontic treatment. The certainty of evidence was assessed using the GRADE tool. Initially, 2,345 records were located, of which 20 met the eligibility criteria. Nineteen studies had a low risk of bias, and one had a moderate risk. The OHRQoL scores were statistically similar when comparing the time before the start of orthodontic treatment with the other five moments (one week and one, three, six and 12 months) after the start of treatment. Based on evidence rated very low under the GRADE approach, appliance use does not appear to have a significant negative impact during the first year of orthodontic treatment. However, the metaanalytic results suggest that functional limitations in the first three months of treatment may be somewhat more critical for the impact on oral health quality of life and consequent patient adherence to treatment.