title: Systematic review and meta-analysis to determine the proportion of maxillofacial trauma resulting from different etiologies among children and adolescents.
abstract: OBJECTIVE
  This study aimed to determine via systematic review and meta-analysis the proportion of maxillofacial trauma resulting from different etiologies among children and adolescents.
  
  
  METHODS
  A systematic review of articles published from 2006 to 2015 (10 years) in English language was performed. The following databases were used: PubMed/MEDLINE, Scopus, and Web of Science. Observational studies reporting the number of children and/or adolescents who suffered maxillofacial trauma resulting from different etiologies were included. Studies were selected by two independent reviewers (Kappa = 0.737). A proportion meta-analysis using random-effect models was performed to estimate the pooled prevalence and the 95% confidence intervals (CI) using Der-Simonian and Laird weights. Heterogeneity among studies was assessed using the I2statistics.
  
  
  RESULTS
  A total of 27 studies remained after qualitative analysis including 402,339 patients. The male/female ratio ranged from 1.5:1 to 3.5:1. Road traffic accidents corresponded to the main etiology agent of maxillofacial trauma (34%; 95% CI, 25-44), followed by falls (31%; 95% CI, 25-37), violence (11%; 95% CI, 4-19), sports (4%; 95% CI, 3-5), and others (5%; 95% CI, 2-8). Heterogeneity among studies was high, even stratifying by world region. The adapted version of the Newcastle-Ottawa scale for observational studies showed an intermediate score for most of the included studies.
  
  
  CONCLUSIONS
  Results suggest that road traffic accidents represent the main cause of maxillofacial trauma among children and adolescents. However, results should be interpreted with caution due to the high heterogeneity.
authors.affiliation: Department of Social and Preventive Dentistry, Universidade Federal de Minas Gerais - UFMG, R. Prof. Moacir Gomes de Freitas, 688, Belo Horizonte, MG, Brazil.
authors.forename: Kevan Guilherme Nóbrega
authors.initials: KGN
authors.lastname: Barbosa
authors.affiliation: Department of Dentistry, Universidade Estadual da Paraíba - UEPB, Av. das Baraúnas, 351, Campina Grande, PB, Brazil.
authors.forename: Ítalo
authors.initials: Í
authors.lastname: de Macedo Bernardino
authors.affiliation: Department of Dentistry, Universidade Estadual da Paraíba - UEPB, Av. das Baraúnas, 351, Campina Grande, PB, Brazil. davila2407@hotmail.com.
authors.forename: Sérgio
authors.initials: S
authors.lastname: d'Avila
authors.affiliation: Department of Social and Preventive Dentistry, Universidade Federal de Minas Gerais - UFMG, R. Prof. Moacir Gomes de Freitas, 688, Belo Horizonte, MG, Brazil.
authors.forename: Efigênia Ferreira E
authors.initials: EFE
authors.lastname: Ferreira
authors.affiliation: Department of Social and Preventive Dentistry, Universidade Federal de Minas Gerais - UFMG, R. Prof. Moacir Gomes de Freitas, 688, Belo Horizonte, MG, Brazil.
authors.forename: Raquel Conceição
authors.initials: RC
authors.lastname: Ferreira
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D001265:Athletic Injuries / Q000453:epidemiology / Q000209:etiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008446:Maxillofacial Injuries / Q000453:epidemiology* / Q000209:etiology*; D064887:Observational Studies as Topic; D012307:Risk Factors; D014481:United States; D014754:Violence / Q000706:statistics & numerical data
keywords: Adolescent; Child; Etiology; Maxillofacial injuries; Meta-analysis; Review