| Background: Malocclusion is a common oral disease in schoolchildren.A large number of studies have shown that the long-term effects of malocclusion will have many negative effects on children’s aesthetical appearance,psychosocial well-being and interpersonal communication.There are many reports about the prevalence of malocclusion in China,however,the prevalence of malocclusion reported in different countries and different years has shown substantially variable,and a comprehensive epidemiology of malocclusion in mixed dentition remains poorly described across China.Therefore,it is necessary to conduct a meta-analysis and systematic review to explore the epidemiological characteristics of malocclusion among Chinese schoolchildren and to provide data for the allocation of dental medical resources and policy development.Objective: This study aims to estimate the overall prevalence of malocclusion among Chinese schoolchildren and to describe its epidemic characteristics,which provides a scientific basis for the prevention and treatment of malocclusion.Methods: Literature search methods included searching original articles in 7 English and Chinese electronic databases until January 2020.The search was supplemented by hand searching to identify relevant surveys.Searching for articles was conducted by two researchers based on pre-established inclusion and exclusion criteria,and the quality of the literature was evaluated by STROBE.Subsequently,two independent researchers extracted data from the final included articles with a pre-determined data collection form.Data analysis were performed by STATA 12.0 and RevMan 5.3 software.Results: Altogether 42 eligible studies were included in this systematic review,which contained a total of 134,548 sample sizes and 60,249 cases.The pooled national prevalence for malocclusion was 49.75%(95%CI: 44.13%-55.36%).For the Angle classification,the overall prevalence rates were 30.56%(95%CI:26.47%-35.48%),10.71%(95%CI:8.26%-14.53%)and 5.66%(95%CI:3.85%-7.41%)for Angle I,Angle II and Angle III malocclusion,respectively.The result of subgroup analysis shown that boys 48.72%(95%CI:39.39%-58.33%)had a significant higher prevalence compared with girls 46.52%(95%CI:37.50%-55.36%).Moreover,deep overbite 18.03%(95%CI:14.53%-21.88%),deep overjet 13.04%(95%CI: 9.91%-18.03%)and crowding 13.04%(95%CI: 8.26%-18.70%)were shown to be the most common types of malocclusion.When stratified by urban and rural,the overall rates of urban and rural were 50.25%(95%CI:45.36%-55.36%)and 46.24%(95%CI:35.06%-57.63%)respectively.And more importantly,an obvious ascending trend for malocclusion in mixed-dentition across mainland China was observed over time,the overall prevalence rates were 42.53%(95%CI: 29.08%-57.45%),47.64%(95%CI: 42.53%-53.05%)and 60.16%(95%CI:54.55%-65.40%)for≤1999,2000-2009,≥2010 years,respectively.Conclusions: Nearly half of the schoolchildren in mainland China suffer from one or more malocclusions,and an ascending trend were observed.Among them,Angle Ⅰ malocclusion and deep overbite are the most common malocclusion types.At the same time,we found that the prevalence of boys is higher than that of girls,urban areas are higher than that of rural areas,and there are still some areas lack relevant basic survey data,highlighting the need for proactive interventions of malocclusion at an early age.The health policymakers should draw up a better prevention and treatment plan and improve people’s awareness of oral health prevention. |
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