Pooled prevalence estimates of malocclusion among Indian children and adolescents: a systematic review and meta-analysis

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Abstract
Objectives: To estimate the pooled prevalence estimates of the malocclusion among child and adolescent population of India. Contents: A comprehensive electronic search was carried to find studies related to assessing malocclusion in Indian children and adolescent population. Indices and classifications considered for pooled analysis were Dental Aesthetic Index, Index of Orthodontic Treatment Needs, Angles classification and terminal plane relationship of primary secondary molars. An eligibility criterion was prepared and quality assessment was done for all the eligible studies. Initial search produced 1090 titles. After removal of duplicates, 850 records were left for further screening. Eighty one articles were found eligible for full text reading. Finally 60 studies were included in this meta-analysis. Pooled prevalence was used to estimate overall effect, with 95% confidence intervals (CI). Statistical difference between the two genders was calculated using chi square test. Summary and outlook: The high prevalence of malocclusion is a public health problem around the world. The current status of burden of malocclusion among Indian children and adolescents is not known. Results of this pooled analysis showed that prevalence of malocclusion among Indian children and adolescents has increased since the last national oral health survey. Prevalence of malocclusion ranged from 28.4% (CI 25.02, 31.9) to 66.7% (CI 50.7, 81.06) depending on the type of index or classification used for recording. Boys recorded higher cumulative prevalence than girls. These findings can be utilized by oral health policy makers to draft measures required for reducing this burden of malocclusion.

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