Lip incompetence and traumatic dental injuries: a systematic review and meta-analysis

Background/aim Traumatic dental injury is an impact injury to the teeth and/or other hard and soft tissues severity of which can lead to pain, as well as aesthetic, psychological, behavioural and functional problems among children. Lip incompetence directly exposes teeth increasing the risk of traumatic dental injuries. This review aimed to assess the existing evidence regarding association of lip incompetence and dental trauma.Methods The review protocol was registered with PROSPERO with Protocol number: CRD42020163069. Electronic searches of grey literature and three databases were performed. Cross sectional studies conducted between the years 2009-2019 on children aged 0-15 years were selected. Studies were evaluated with the help of NIH quality assessment scale. Data on research question, study population, inclusion and exclusion criteria, sample size justification, exposure and outcome clearly defined and adjustment for confounding variables were assessed. All analyses were performed using Review Manager 5.4.Results The study identified 10,223 articles, 33 were included. Among these 20 identified articles reported 'Good' quality with 13 studies reporting 'Fair' quality post assessment. Subject with lip incompetence were at 2.44 (1.59-3.75) times the risk of developing traumatic injuries during primary dentition. This risk increases to 3.26 (2.21;4.53) times in mixed and permanent dentition. At 12 years of age the OR for dental trauma is 3.77 (2.06;6.91) in subjects with incompetent lips.Conclusions The results confirm the association between lip incompetence and dental trauma.