title: Is caries a risk factor for dental trauma? A systematic review and meta-analysis.
abstract: OBJECTIVE
  The association between trauma and caries is still controversial in the literature. The aim of this study was to evaluate the possible association between caries and dental trauma through a systematic review with meta-analysis.
  
  
  METHODS
  A systematic literature search was performed in PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library, and Open Grey databases. The MeSH terms used were 'Tooth injuries', 'Tooth fractures', 'Tooth avulsion', 'Tooth movement'; 'Dental caries'; 'DMF index'; and 'Tooth demineralization'. MeSH synonyms, related terms, and free terms were included. The inclusion criteria comprised clinical investigations of subjects with and without caries that had suffered dental trauma. Quality assessment and bias control were carried out. Meta-analysis was performed using the comprehensive meta-analysis software (version 3.2). Heterogeneity was assessed using the I2index, and the odds ratio was also calculated (P < 0.05).
  
  
  RESULTS
  From 1290 abstracts, seven met the inclusion criteria. All studies had high methodological quality and five were included in the meta-analysis. The results demonstrated a positive association (P < 0.001) between dental trauma and dental caries in permanent teeth [OR: 1.490, 95%, CI: 1.209-1.835]. However, for children with primary teeth, the results showed a negative association (P = 0.006) between dental trauma and caries [OR: 0.706, 95%, CI: 0.550-0.906].
  
  
  CONCLUSIONS
  The results demonstrated positive and negative association between the presence of caries and dental trauma in permanent and primary teeth, respectively.
authors.affiliation: Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Thais Rodrigues Campos
authors.initials: TR
authors.lastname: Soares
authors.affiliation: Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Tatiana Kelly da Silva
authors.initials: TK
authors.lastname: Fidalgo
authors.affiliation: Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Andrea Soares
authors.initials: AS
authors.lastname: Quirino
authors.affiliation: Central Library of the Health Science Center - Federal University of Rio de Janeiro, RJ, Brazil.
authors.forename: Daniele Masterson Tavares Pereira
authors.initials: DM
authors.lastname: Ferreira
authors.affiliation: Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Thomaz Kauark
authors.initials: TK
authors.lastname: Chianca
authors.affiliation: Department of Dental Clinic, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Patrícia de Andrade
authors.initials: PA
authors.lastname: Risso
authors.affiliation: Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Lucianne Cople
authors.initials: LC
authors.lastname: Maia
mesh_terms: D003731:Dental Caries / Q000150:complications*; D006801:Humans; D012307:Risk Factors; D018677:Tooth Injuries / Q000209:etiology*
keywords: caries; child; dental trauma; tooth injury