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INTRODUCTION: Bruxism is characterised by a repetitive activity in the masticatory muscles that involves teeth clenching or grinding and/or forceful mandibular movements. Its management is typically initiated when individuals start experiencing the adverse effects of the condition. One of the available intervention forms is the administration of botulinum toxin type A (BoNT-A). Numerous systematic reviews have addressed the use of BoNT-A to manage bruxism; however, the results are controversial. The current overview aims to determine BoNT-A's effectiveness for managing bruxism in relation to placebo, the absence of treatment or alternative interventions in the adult population. METHODS AND ANALYSIS: This study will include systematic reviews (SRs), with or without meta-analysis, aiming to evaluate the efficacy of BoNT-A for bruxism in adults. A broad literature search will be carried out on Cochrane Library, EMBASE, LILACS, Livivo, PubMed/MEDLINE, Scopus, Web of Science and the grey literature. Experts in the topic and reference lists of included SRs will also be consulted. The study selection will be conducted in two phases by two independent reviewers. Data collection will be performed by one author and cross-checked by another. The methodological quality of included SRs will be evaluated using AMSTAR-II. A narrative synthesis will be employed as the formal method to combine individual study data. The overlap across studies will be quantified by the corrected covered area and illustrated by the Graphical Representation of Overlap for Overviews. ETHICS AND DISSEMINATION: This overview does not require ethics approval, as it uses secondary data from previously published studies. The results will be disseminated through the publication in a high-impact journal. OSF OF REGISTRATION: DOI: 10.17605/OSF.IO/RB45T.

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OBJECTIVE: This study evaluated the association between sleep bruxism and snoring. Additionally, the associations between sleep bruxism and age, sex, body mass index, sleep structure, sleep quality, and sleepiness were evaluated. METHODS: Adults suspected of having sleep disorders (n = 61) underwent single-night video polysomnography according to the American Academy of Sleep Medicine criteria. Validated questionnaires were used to assess sleepiness and sleep quality, and clinical examinations were performed to document weight and height. Jamovi software was used for statistical analysis. Logistic regression analyses of the different sleep stages-REM sleep, NREM sleep, and total sleep time-were conducted. RESULTS: No association was found between sleep bruxism and snoring (P > 0.31), with a small effect size (V = 0.171). However, the snore index was found to influence the rhythmic masticatory muscle activity index during REM sleep, with an odds ratio of 1.018 (95 % CI: 1.005 to 1.03; P = 0.05). Moreover, logistic regression showed that the desaturation index presented an odds ratio of 5.01 (95 % CI: 0.96 to 26.13; p = 0.056), with a medium effect size (>3.5). Sleep bruxism was not associated with age, sex, body mass index, or other sleep variables. CONCLUSION: Snoring appears to be associated with bruxism during REM sleep. No associations were found between sleep bruxism and sex, age, or body mass index. This lack of association underscores the complexity of sleep bruxism and snoring and highlights the need for further research. Concerning sleep architecture, only desaturation episodes were associated with bruxism during REM sleep. Neither sleep quality nor sleepiness was associated with sleep bruxism.

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Background: COVID-19 presents extrapulmonary manifestations that can aid in the diagnosis. Skin manifestations have been reported but their characteristics are not yet clear. Health professionals need information about its prevalence and main characteristics. Methods: This systematic review followed the PRISMA criteria. The protocol was registered in the PROSPERO (number CRD42020193173). Seven electronic databases and the gray literature were searched independently by two researchers. Observational analytical studies that presented data on the prevalence of skin manifestations in patients aged 19 or older with COVID-19 were included. Prevalence estimates were synthesized through a meta-analysis using random-effects models. Association meta-analysis and comparisons were performed for individual characteristics. Results: We included 31 studies with 10,934 patients, of which 10,121 tested positive for COVID-19. The general prevalence of skin manifestations was 29% (95% CI: 17.0-43.0; I2: 99%), the most in Africa, with a mean duration between 7 and 9 days and the most frequently affecting feet+hands (75%) and the trunk (71%). Patients with mild/moderate COVID-19 had more of chilblain-like+pernio-like lesions (97%) and inflammatory lesions (86%) than patients with severe or critical COVID-19. Manifestations of vascular origin were only in elderly patients and were significant with the severity of COVID-19 (p = 0). Conclusion: The global prevalence of skin manifestations is similar to other signs and symptoms of COVID-19. Skin assessment should be considered when investigating and diagnosing COVID-19 in adult and elderly patients.Systematic review registration: PROSPERO, identifier CRD42020193173, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193173.

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INTRODUCTION: Virtual clinical simulation involves creating and applying scenarios using technology like computers or virtual reality. This method provides a secure experiential learning environment, encouraging active student participation and stimulating clinical, critical and reflective thinking. This article outlines the development of the Evidence and Gap Map, which aims to identify, quantify and visually and interactively classify existing systematic reviews on the effectiveness of virtual clinical simulations in health professional training. METHODS AND ANALYSIS: The Evidence and Gap Map will adhere to the Campbell Collaboration Guidelines. Bibliographic searches in six databases will follow inclusion criteria determined by the Population, Intervention, Comparison, Outcome and Study design strategy. After the initial calibration, two reviewers will independently apply the inclusion and exclusion criteria to the title and abstract of each identified study, with subsequent full reading of the selected articles. The methodological quality of the included systematic reviews will be assessed with the AMSTAR 2 tool. The map will be developed using the EPPI-Mapper software. ETHICS AND DISSEMINATION: There is no requirement for ethical approval for this systematic review. On completion, it will be published in a peer-reviewed academic journal and presented at a conference. This review protocol was registered on the Open Science Framework platform (OSF Associated Project Registration: osf.io/r6wdc and received the following DOI: 10.17605/OSF.IO/R6WDC).

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BACKGROUND: To assess the reporting of the certainty of the evidence using the GRADE approach in systematic reviews of interventions in pediatric dentistry. METHODS: The inclusion criteria were systematic reviews of randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs) in pediatric dentistry that reported the certainty of the evidence through the GRADE approach. Paired independent reviewers screened the studies, extracted data, and appraised the methodological quality using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool. The certainty of the evidence was extracted for each outcome. A descriptive analysis was conducted. RESULTS: Around 28% of pediatric dentistry reviews of interventions used the GRADE approach (n = 24). Twenty reviews reported 112 evidence outcomes from RCTs and 13 from NRSIs using GRADE evidence profile tables. The methodological quality was high (16.7%), moderate (12.5%), low (37.5%), and critically low (33.3%), fulfilling the majority of the AMSTAR 2 criteria. The certainty of the evidence for outcomes generated from RCTs and NRSIs was very low (40.2% and 84.6%), low (33.1% and 7.7%), moderate (17.8% and 7.7%), and high (9.8% and 0.0%). The main reasons to downgrade the certainty were due to (for RCTs and NRSIs, respectively): risk of bias (68.8% and 84.6%), imprecision (67.8% and 100.0%), inconsistency (18.8% and 23.1%), indirectness (17.8% and 0.0%), and publication bias (7.1% and 0.0%). CONCLUSION: The proportion of systematic reviews assessing the certainty of the evidence using the GRADE approach was considered small, considering the total initial number of published pediatric dentistry reviews of intervention. The certainty of the evidence was mainly very low and low, and the main problems for downgrading the certainty of evidence were due to risk of bias and imprecision. REGISTRATION: PROSPERO database #CRD42022365443.

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With the growing popularity of clear aligners, more patients have chosen to use them instead of traditional orthodontic braces to correct their malocclusions. Clear aligners offer distinct advantages over conventional fixed braces, such as limited aesthetic impact, the convenience of easily removing them for meals, improved accessibility for brushing and flossing, and a treatment approach that avoids the use of metal, minimizing potential irritation to the cheeks and gums. Manufacturers point out a disadvantage that can be administered in this type of treatment. Still, to our knowledge, a comprehensive review of the published literature assessing the adverse/negative effects of clear aligners has not yet been conducted. A systematic review, with or without meta-analysis, will be performed. The inclusion criteria will be studies involving individuals using clear aligners and reporting potential adverse/negative effects during or after treatment. No restrictions about time or language will be applied. The studies screening will be conducted in two stages. Two independent reviewers will initially evaluate the title and abstract under the eligibility criteria. Subsequently, the same two reviewers will examine the articles' full text in-depth. The results will be synthesized in the form of a narrative description and incorporate a meta-analysis if justified. Furthermore, we will present details regarding the sample characteristics, intervention, study objectives, methodologies employed, and primary findings. This study aims to investigate the potential adverse effects and their frequency among orthodontic patients wearing clear aligners. Moreover, the outcomes of this review have the potential to illuminate specific inherent limitations of aligner therapy as a comprehensive orthodontic approach.

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A systematic review (SR) requires several steps to be conducted. A major and initial challenge is to formulate a focused research question that may have high scientific relevance to provide evidence-based results and strategies. This narrative mini-review aims to present different categories of systematic reviews currently applied in Head and Neck Cancers (HNC), focusing on the strategies to provide results for evidence-based decision making. The SRs identified were of intervention, diagnostic testing, prognosis, in vitro and in vivo studies, prevalence, and epidemiological studies, and of association and risk factors. Focused questions that define the type of review, whether it is a therapy question (intervention), a question of prevalence or an outcome (prognosis) of disease, are discussed. Additionally, the importance in building interesting research questions and following all proposed steps to produce quality evidence are highlighted. This narrative mini-review may guide future research by showing how to perform and report relevant evidence in terms of HNC.

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Systematic reviews (SRs) of preclinical studies are marked with poor methodological quality. In vitro studies lack assessment tools to improve the quality of preclinical research. This methodological study aimed to identify, collect, and analyze SRs based on cell culture studies to highlight the current appraisal tools utilized to support the development of a validated critical appraisal tool for cell culture in vitro research. SRs, scoping reviews, and meta-analyses that included cell culture studies and used any type of critical appraisal tool were included. Electronic search, study selection, data collection and methodological quality (MQ) assessment tool were realized. Further, statistical analyses regarding possible associations and correlations between MQ and collected data were performed. After the screening process, 82 studies remained for subsequent analysis. A total of 32 different appraisal tools were identified. Approximately 60% of studies adopted pre-structured tools not designed for cell culture studies. The most frequent instruments were SYRCLE (n = 14), OHAT (n = 9), Cochrane Collaboration's tool (n = 7), GRADE (n = 6), CONSORT (n = 5), and ToxRTool (n = 5). The studies were divided into subgroups to perform statistical analyses. A significant association (OR = 5.00, 95% CI = 1.54-16.20, p = 0.008) was found between low MQ and chronic degenerative disorders as topic of SR. Several challenges in collecting information from the included studies led to some modifications related to the previously registered protocol. These results may serve as a basis for further development of a critical appraisal tool for cell culture studies capable of capturing all the essential factors related to preclinical research, therefore enhancing the practice of evidence-based.

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BACKGROUND: Parents believe that teething is associated with signs and symptoms, which may induce them to give medications that could harm their children. Some children may require alleviation of symptoms and overall attention. AIM: To assess parents' beliefs in and attitudes toward teething. DESIGN: Through electronic databases and gray literature, this systematic review identified cross-sectional studies reporting parents' beliefs in, knowledge about, and attitudes toward the signs and symptoms of primary tooth eruption in children aged between 0 and 36 months. Three reviewers independently selected the studies, collected the information, assessed methodological quality, and checked for accuracy with disagreements solved by a fourth reviewer. The Agency of Research and Quality in Health questionnaire for cross-sectional studies was used for quality assessment. Descriptive analysis with median and interquartile ranges was adopted. RESULTS: Twenty-nine studies comprising 10 524 participants from all geographic regions were included. The methodological quality of the studies was moderate. Most parents have beliefs in signs and symptoms during dentition, the most reported symptom being the desire to bite. Oral rehydration was the most exposed attitude in the studies included. Only a small proportion of parents reported no attitude. CONCLUSIONS: The majority of parents believed in at least one sign or symptom associated with teething, and only few of them would do nothing or just wait for the signs or symptoms to pass, with no difference among countries (Protocol doi: 10.17605/OSF.IO/S2KZ3).

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OBJECTIVES: This systematic review investigated the prevalence of tooth wear between patients with and without Down syndrome. METHODS: Six databases (Embase, LILACS, Livivo, PubMed, Scopus and Web of Science) and grey literature (Google Scholar, OpenGrey and ProQuest) were searched until March 7, 2022. Observational studies were included to assess the differences in tooth wear prevalence and/or severity in Down syndrome and non-syndromic controls. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations were followed. Three reviewers independently screened studies, extracted data, assessed the methodological quality (Joanna Briggs Institute) and graded the certainty of evidence through the Grading of Recommendations, Assessment, Development, Evaluation (GRADE) approach. Results were summarized through meta-analyses using a random-effects model. The protocol was registered at PROSPERO (CRD42021266997). RESULTS: Of the 1382 records identified, six cross-sectional studies were included. Individuals with Down syndrome had a higher prevalence and were more likely to have tooth wear than individuals without Down syndrome (44% × 15%; OR = 4.43; 95% CI 3.17-6.18; p < 0.00001; I2 = 8%). Also, the severity of tooth wear was higher in the Down syndrome group (n = 275) compared with the controls (n = 294). The certainty of evidence analysis was very low. CONCLUSIONS: Based on very low certainty of the evidence, patients with Down syndrome had a higher prevalence and likelihood and severity of tooth wear when compared to those without Down syndrome. CLINICAL RELEVANCE: Screening early tooth wear lesions should be carefully done in the Down syndrome population since its occurrence is remarkable compared to the general population.

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INTRODUCTION: This scoping review aimed to determine the frequency of different teaching methodologies, tools and platforms applied in dental education during the COVID-19 pandemic. MATERIALS AND METHODS: The search strategy was performed in six databases and grey literature. A total of 28 questionnaire-based studies were included, without language or time restriction, from 20 different countries. RESULTS: Six thousand five hundred sixty-five participants were assessed: 84% undergraduates, 9% of faculty members, 5% of postgraduate students/residents/trainees and 2% of dental schools/residency programs. The pooled eligible data for teaching methodologies were 62% of a combination of different methods (95% CI, 35.5% to 82.3%), 23% a combination of synchronous and asynchronous formats (95% CI, 8.2% to 50.2%) and 15% for only synchronous lectures (95% CI, 4.3% to 42.2%). The reported tools were laptops (40%), smartphones (40%), tablets (40%), desktops (20%), Blackboard (20%), Respondus Lockdown Browser (20%), eProctor (20%) and PowerPoint (20%). The most used platforms were Zoom (70.6%), Microsoft Teams (23.5%) and Cisco Webex (23.5%). A better time management (17.9%; 95% CI, 7.9% to 35.6%) and the possibility of revision with additional notes (14.3%; 95% CI, 5.7% to 31.5%) was the greatest advantages related to dental e-learning, while the increased levels of anxiety/stress/burnout/exhaustion (35.7%; 95% CI, 21% to 54.2%) and internet connection problems (35.7%; 95% CI, 21% to 54.2%) was the most cited disadvantages. CONCLUSION: This scoping review showed promising blended teaching methodologies, tools and platforms in the dental education profile. The evidence suggests that e-learning technologies can widely contribute to dental education during the COVID-19 pandemic. Therefore, this study makes a major contribution to research by assessing the impact of COVID restrictions on dental education and further studies are needed to identify how restrictions in dental practice will affect future professionals.

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To identify the prevalence of geographic tongue in patients >18 years. A systematic literature review was performed in search of population-based observational studies. Searches were performed using five main databases: Embase, LILACS, PubMed, Scopus and Web of Science; and three gray literature sources: Google Scholar, ProQuest, and OpenGrey. In addition, a manual search in the reference list and consultation with experts on the topic studied were performed. Methodological quality was assessed using the Joanna Briggs Institute's checklist for prevalence studies. Ratio meta-analyses were performed using JAMOVI. Initially, 3046 studies were identified. After a two-phase selection, 11 studies were included for quantitative synthesis. Two studies were classified as of low methodological quality, five studies as of moderate quality, and four as of high quality. Two types of prevalence were analyzed: by period and point. Three studies were included in the period prevalence meta-analysis, and the prevalence was 3% (Confidence interval [CI]: 0.4%-5.5%, n = 9813). Eight studies were included in the point-prevalence meta-analysis, and the prevalence was 3% (CI: -0.2% to 5.5%, n = 10,967). Although there are phases of exacerbation and remission in geographic tongue, prevalence and period prevalence were similar. Approximately one in 30 adults has a geographic tongue.

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OBJECTIVE: This study aimed to analyze the accuracy of artificial intelligence (AI) for orthodontic tooth extraction decision-making. MATERIALS AND METHODS: PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, LIVIVO, Computers & Applied Science, ACM Digital Library, Compendex, and gray literature (OpenGrey, ProQuest, and Google Scholar) were electronically searched. Three independent reviewers selected the studies and extracted and analyzed the data. Risk of bias, methodological quality, and certainty of evidence were assessed by QUADAS-2, checklist for AI research, and GRADE, respectively. RESULTS: The search identified 1810 studies. After 2 phases of selection, six studies were included, showing an unclear risk of bias of patient selection. Two studies showed a high risk of bias in the index test, while two others presented an unclear risk of bias in the diagnostic test. Data were pooled in a random model and yielded an accuracy value of 0.87 (95% CI = 0.75-0.96) for all studies, 0.89 (95% CI = 0.70-1.00) for multilayer perceptron, and 0.88 (95% CI = 0.73-0.98) for back propagation models. Sensitivity, specificity, and area under the curve of the multilayer perceptron model yielded 0.84 (95% CI = 0.58-1.00), 0.89 (95% CI = 0.74-0.98), and 0.92 (95% CI = 0.72-1.00) scores, respectively. Sagittal discrepancy, upper crowding, and protrusion showed the highest ranks weighted in the models. CONCLUSIONS: Orthodontic tooth extraction decision-making using AI presented promising accuracy but should be considered with caution due to the very low certainty of evidence. CLINICAL RELEVANCE: AI models for tooth extraction decision in orthodontics cannot yet be considered a substitute for a final human decision.

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OBJECTIVE: To compare the proportion of young (up to 45 years of age) and older (over 45 years of age) oral squamous cell carcinoma (OSCC) patients who report tobacco and alcohol consumption. METHODS: Observational studies reporting tobacco and alcohol consumption among young and older OSCC patients were selected in a two-phase process. Search strategies were conducted on five main electronic databases and complemented by grey literature. The risk of bias was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data. Synthesis of results was calculated with the software R Statistics version 4.0.2 (The R Foundation). RESULTS: From 6675 records identified, 38 studies met the eligibility criteria and were selected for qualitative synthesis and meta-analysis, encompassing 2439 young and 13,393 older patients. Tobacco smoking was reported by 39.5% (confidence interval (CI) = 31.7% to 47.9%, I2 = 78%) of the young patients and 48.4% (CI = 37.8% to 59.2%, I2 = 94%) of the older patients. Alcohol consumption was reported by 30.9% (CI = 22.7% to 40.5%, I2 = 83%) of the young and 45.8% (CI = 35.6% to 56.5%, I2 = 95%) of the older patients (P < 0.05). CONCLUSION: The comparison in the proportion of individuals reporting tobacco and alcohol consumption demonstrated that these habits were more prevalent in the older group (48.4% and 45.8% respectively) than in the young group (39.5% and 30.9%, respectively). CLINICAL RELEVANCE: As a significant proportion of patients with OSCC reported no habits, novel risk factors for OSCC need to be investigated in further research.

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Introduction The number of systematic reviews (SRs) in dentistry published each year has grown considerably, and they have been essential in clinical decision-making and health policy.Objective The objective is to critically appraise SRs of intervention in dentistry using the 'A Measurement Tool to Assess Systematic Reviews 2' (AMSTAR 2) tool published within one year.Methods A search in the Medline/PubMed database was performed. The SRs were identified in two phases. The first phase identified SRs of interventions in dentistry by title and abstract. In the second phase, the full text was read, applying the eligibility criteria. Three calibrated reviewers methodologically assessed all SRs identified using the AMSTAR 2 tool. Data were analysed descriptively, and SRs were grouped according to methodological quality as moderate/high and low/critically low. A logistic regression model was applied to explore the associations between methodological quality and the study's characteristics.Results Two hundred and twenty-two SRs were included. The methodological quality of the SRs included in this study were: critically low (56.8%), low (27.9%), moderate (14.4%) and high (0.9%), according to AMSTAR 2. There were no statistical differences between moderate/high and low/critically low methodological quality and publication year, continent, journal Impact Factor and dental speciality.Conclusion Less than 1% of recently published SRs in dentistry were classified with high methodological quality. We hope that this study will alert researchers about the need to improve the methodological quality of SRs.

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STUDY OBJECTIVES: To evaluate the available evidence on the putative relationships between sleep bruxism (SB) and, obstructive sleep apnea (OSA) to assess the extent of research on this topic, and to formulate suggestions for future research. METHODS: A scoping review including studies examining temporal and overall association and prevalence of SB and OSA was performed. Six main databases and gray literature were searched. The studies selection was conducted by three independent reviewers. A narrative synthesis of the results was carried out. RESULTS: Thirteen studies in adults and eight studies in children were finally included. The median of concomitant conditions prevalence was 39.3% in adults and 26.1% in children. Marked methodological variability was identified among studies in adults and even more when we compared detection methods in children. No significant association between OSA and SB emerged in most studies in adults, while an association may be possible in children. CONCLUSIONS: Based on the current literature, it is not possible to confirm that there is a relationship between SB and OSA in adults. In patients under pediatric care, although this association seems plausible, there is currently insufficient supportive evidence. Standardized validated methodologies for identifying SB should be consistently used in both populations before reaching any conclusion regarding such association. Furthermore, assessment of shared phenotypes between patients with SB and patients with OSA may reveal new insights that will contribute to personalized approaches aiming to optimize the management of such comorbidities.

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STATEMENT OF PROBLEM: High-performance polymers including polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) have been used as substitutes for metal frameworks in dental prostheses. However, the clinical performance of polymer-based frameworks is still uncertain. PURPOSE: The purpose of this systematic review was to compare the clinical performance of PEEK and PEKK with that of metal frameworks for different dental prostheses. MATERIAL AND METHODS: This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases and non-peer-reviewed literature (without language or follow-up restrictions) were searched for studies conducted before February 2022. Only clinical studies, either randomized clinical trials (RCTs) or nonrandomized clinical trials (N-RCTs), comparing the clinical performance of polymer and metal frameworks were included. The risk of bias and certainty of the evidence were assessed with the RoB 2.0, ROBINS-I, and GRADE. Biologic (plaque and gingival indices, probing depth, bleeding scores, implant stability quotient, marginal bone loss) and mechanical outcomes (ridge base relation, prosthetic marginal gap, and fracture) were assessed. RESULTS: Only 9 studies (7 RCTs and 2 N-RCTs) were included, all with moderate to serious risk of bias and low to very low certainty of evidence. No meta-analysis was possible, but qualitative analysis revealed lower plaque and gingival indices, probing depth, and marginal bone loss, with higher survival rates for implant-supported fixed prostheses and overdentures fabricated with PEEK than for metal frameworks. No significant differences were found between groups for removable partial dentures. The marginal fit of PEEK frameworks was also better for single crowns. Three fractures were reported in the 3 PEKK fixed dental prostheses with cantilevers. CONCLUSIONS: PEEK and PEKK seem to be promising materials for dental prostheses, with acceptable response from the periodontal tissue. However, further well-designed studies are necessary to better understand their clinical and long-term limitations.

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BACKGROUND: The COVID-19 pandemic health crisis has changed household and school routines leaving children and adolescents without important anchors in life. This, in turn, can influence their mental health, changing their behavioral and psychological conditions. AIMS: To systematically review the literature to answer the question: "What is the worldwide prevalence of mental health effects in children and adolescents during the COVID-19 pandemic?". METHODS: Embase, Epistemonikos database, LILACS, PsycINFO, PubMed, Scopus, Web of Science, and World Health Organization Global literature on coronavirus disease were searched. Grey literature was searched on Google Scholar, Grey Literature Report, and Preprint server MedRxiv. Observational studies assessing the prevalence of mental health effects in children and adolescents during the COVID-19 pandemic were included. Four authors independently collected the information and assessed the risk of bias of the included studies. RESULTS: From a total of 11,925 identified studies, 2873 remained after the removal of the duplicated records. Nineteen studies remained after the final selection process. The proportion of emotional symptoms and behavior changes varied from 5.7% to 68.5%; anxiety 17.6% to 43.7%, depression 6.3% to 71.5%, and stress 7% to 25%. Other outcomes such as the prevalence of post-traumatic stress disorder (85.5%) and suicidal ideation (29.7% to 31.3%) were also evaluated. LINKING EVIDENCE TO ACTION: Overall findings showed that the proportion of children and adolescents presenting mental health effects during the COVID-19 pandemic showed a wide variation in different countries. However, there was a trend toward mental health issues. Therefore, policymakers, healthcare planners, youth mental health services, teachers, parents, and researchers need to be prepared to deal with this demand.

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OBJECTIVE: To assess effects of stabilization splints on signs and symptoms of temporomandibular disorders of muscular origin compared to other treatments. METHODS: A search for articles via six electronic databases and gray literature was conducted. The risk of bias was evaluated with the Cochrane Collaboration tool. The Grading of Recommendations Assessment, Development and Evaluation approach determined the certainty of evidence. RESULTS: Ten articles were included. Stabilization splints (n = 160 subjects) were reported to be as effective as other treatments (n = 209 patients) on analyzed outcomes (pressure pain threshold, pain during chewing, mouth opening, spontaneous pain intensity and by palpation). Five studies were judged at low and five at some concerns of risk of bias. The certainty of evidence was very low for all outcomes. CONCLUSION: Positive effect on signs and symptoms of temporomandibular disorders of muscular origin, when managed with stabilization splint, could not be confirmed or refuted.