Malocclusion is a highly prevalent public health problem, and several studies have shown its negative correlation with quality of life, self-esteem, and social perceptions. However, its association with bullying is still controversial. To evaluate the relationship between malocclusion and bullying in children and adolescents. The databases used for the electronic researches were PubMed, Scopus, Lilacs/BBO, Web of Science, and Cochrane Library. Grey literature was reviewed through Open Grey literature with no language or date restrictions. Selection criteria, based on the PECO strategy, were considered eligible observational studies that included schoolchildren or adolescents (P) with malocclusion (E), compared to those with normal occlusion (C), in which the relationship between malocclusion and bullying was determined (O). Risk of bias evaluation was made for the qualitative synthesis by the Fowkes and Fulton criteria. Data regarding the age of participants and types of malocclusion and of bullying were extracted among other reported data. The quality of the evidence analyzed was evaluated through the GRADE approach. From 2744 articles identified in databases, nine met the eligibility criteria and were included in present systematic review, of which two studies were judged with methodological soundness. The quality of the evidence was classified as very low due to very serious problems for “risk of bias” and “other considerations” and serious problems of “indirectness”. The age of participants ranged from 9 to 34 years considering a cohort study, with a bullying recalling perspective. Malocclusion was both evaluated by researchers and self-reported by participants addressing dentofacial characteristics mostly related to the incisors relationship. All studies evaluated the verbal type of bullying, while 3 also considered physical type. Both types were reported as related to malocclusion, although the results showed that extreme maxillary overjet (> 4 mm, > 6 mm, > 9 mm), extreme deep overbite, and having space between anterior teeth or missing teeth were the types of malocclusion with the strongest relations to bullying. With very low certainty of evidence, the results of this systematic review suggest that conspicuous extreme malocclusion may be related to the occurrence of bullying among children and adolescents.

中文翻译：

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错错与欺凌之间有关系吗？系统的审查。

咬合不良是一个非常普遍的公共卫生问题，一些研究表明，咬合不良与生活质量，自尊和社会观念负相关。但是，其与欺凌的关联仍存在争议。评价儿童和青少年的错牙合和欺凌之间的关系。用于电子研究的数据库是PubMed，Scopus，Lilacs / BBO，Web of Science和Cochrane图书馆。通过开放灰色文献对灰色文献进行了审查，没有语言或日期限制。基于PECO策略的选择标准被认为是合格的观察性研究，包括具有错牙合（E）的中小学生或青少年（P），与具有正常牙合（C）的儿童或青少年（P），其中确定了错牙合与欺凌之间的关系（O ）。根据Fowkes和Fulton标准对定性综合进行偏倚评估风险。在其他报告的数据中，提取了有关参与者的年龄，错牙合和欺凌类型的数据。通过GRADE方法评估了所分析证据的质量。从数据库中确定的2744篇文章中，有9篇符合资格标准，并被包括在当前的系统评价中，其中两项研究在方法上是合理的。由于“偏见风险”和“其他考虑因素”等非常严重的问题以及“间接性”的严重问题，证据的质量被分类为非常低。考虑到队列研究，参与者的年龄从9岁到34岁不等，具有回想起欺负的观点。咬合不均由研究人员评估并且由参与者自我报告，他们主要针对与门牙关系有关的牙面特征。所有研究都评估了欺凌的言语类型，而3项也考虑了欺凌类型。据报道这两种类型均与错牙合有关，尽管结果表明，上颌过度喷射（> 4 mm，> 6 mm，> 9 mm），极深的咬合以及前牙或缺牙之间存在间隔是错牙合的类型。最强的关系就是欺负。在证据的确定性非常低的情况下，本系统评价的结果表明，明显的错牙合可能与儿童和青少年中的欺凌行为有关。所有研究都评估了欺凌的言语类型，而3项也考虑了欺凌类型。据报道这两种类型均与错牙合有关，尽管结果表明，上颌过度喷射（> 4 mm，> 6 mm，> 9 mm），极深的咬合以及前牙或缺牙之间存在间隔是错牙合的类型。最强的关系就是欺负。在证据的确定性非常低的情况下，本系统评价的结果表明，明显的错牙合可能与儿童和青少年中的欺凌行为有关。所有研究都评估了欺凌的言语类型，而3项也考虑了欺凌类型。据报道这两种类型均与错牙合有关，尽管结果表明，上颌过度喷射（> 4 mm，> 6 mm，> 9 mm），极深的咬合以及前牙或缺牙之间存在间隔是错牙合的类型。最强的关系就是欺负。由于证据的确定性非常低，因此本系统综述的结果表明，明显的极端错牙合可能与儿童和青少年中的欺凌行为有关。错牙合类型与欺负关系最密切，前牙之间或牙齿之间有间隔。在证据的确定性非常低的情况下，本系统评价的结果表明，明显的错牙合可能与儿童和青少年中的欺凌行为有关。错牙合类型与欺负关系最密切，前牙之间或牙齿之间有间隔。在证据的确定性非常低的情况下，本系统评价的结果表明，明显的错牙合可能与儿童和青少年中的欺凌行为有关。