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Table 1 Summary of characteristics and results of the included studies

From: The effect of pacifier sucking on orofacial structures: a systematic literature review

Study, year

Study design, country

Sample size

Follow-up

Age range (mean ± SD) in months

Characteristics of the control group

Examined orofacial structures

Results: Pacifier group

Results: Control group

Adair et al., 1995 [12]

Cross-sectional study, USA

218

No

24–59 (44 ± 9)

No sucking habits

AOB, PCB, overjet, molar and canine relationship

AOB: 16.7%**, PCB:15%*, overjet (≥ 4 mm): 20%*, class II primary canine relationship: 17.7%*, distal step molar relationship: 9.6%*

AOB: 3.1%, PCB: 5.1%, overjet (≥ 4 mm): 10.2%, class II primary canine relationship: 9.3%, distal step molar relationship: 3.6%

de Sousa et al., 2014 [23]

Cross-sectional study, Brazil

732

No

36–60

No pacifier sucking habits

AOB, PCB

AOB: 38.6.9%***, PCB: 18.2%***, AOB ≥ 36 months pacifier sucking: 73.5% vs < 36 months pacifier sucking: 19.5%***, PCB ≥ 36 months pacifier sucking: 25.5% vs < 36 months pacifier sucking: 15.5%*

AOB: 5.2%, PCB: 5.7%

Dimberg et al., 2010 [24]

Cross-sectional study, Sweden

457

No

36 ± 3

No sucking habits

AOB, PCB, overjet, class II canine relationship

AOB: 66%***, PCB: 25%***, overjet (> 4 mm): 28%***, class II canine relationship: 34%***

AOB: 1%, PCB: 1%, overjet (> 4 mm): 4%, class II canine relationship: 2%

Duncan et al., 2008 [10]

Prospective cohort study, Great Britain

867

0–61 months of age (questionnaire after 15, 24, and 36 months of age, clinical examination after 31, 43, and 61 months of age)

31, 43, and 61

No sucking habits

AOB, PCB, spaced labial segment

Pacifier sucking at 15 months: presence of AOB at 31, 43, and 61 months**, presence of PCB at 31, 43, and 61 months***, spaced upper labial segment at 61 months***, spaced lower labial segment at 31 months***

Pacifier sucking at 24 months: presence of AOB at 31, 43, and 61 months***, presence of PCB at 31, 43, and 61 months***, alignment of the upper labial segment at 43 and 61 months**, alignment of the lower labial segment at 31 months***

Pacifier sucking at 36 months:

presence of AOB at 43 and 61 months***, presence of PCB at 43 and 61 months ***, alignment of the upper labial segment at 61 months***, alignment of the lower labial segment at 43 months***

No data in paper

Facciolli Hebling et al., 2008 [25]

Cross-sectional study, Brazil

728

No

60

No pacifier sucking habits

AOB, PCB

AOB: 81.5%***, PCB: 27.1***

AOB: 11.85%, PCB: 13.73%

Katz and Rosenblatt, 2005 [26]

Prospective cohort study, Brazil

305

1 year

At the beginning average age: 48 ± 5

No sucking habits

AOB

AOB: 72% of the AOB group was pacifier sucking (initial examination) and 59% in the final examination*

AOB: 16% of the AOB group had no sucking habits (initial examination) and 23% in the final examination

Lagana et al., 2013 [27]

Cross-sectional study, Albania

2617

No

84–180

No control group

Molar and canine relationship

Molar and canine relationship: no statistically significant correlation

 

Lima et al., 2016 [15]

Prospective cohort study, Brazil

220

Birth up to the age of 29 ± 2 months; T1: birth, T2: questionnaire after 12–24 months, T3: clinical examination at the age of 24–36 months

24–36 (29 ± 2)

No pacifier sucking habits

AOB, PCB, overjet, molar and canine relationship, deep overbite

AOB: 96.3%**, PCB: 88.9%*, overjet (> 2 mm): 67.5%***, distal step of primary molar: 77.8%***, mesial step of primary molar: 6%***, flush: 85.7%***, deep overbite: 77.8%***

AOB: 3.7%, PCB: 11.1%, overjet (> 2 mm): 32.5%, distal step of primary molar: 22.2%, mesial step of primary molar: 64%, flush: 22.8%, deep overbite: 22.2%

Melsen et al., 1979 [28]

Cross-sectional study, Denmark

723

No

120–132

No sucking habits

AOB, PCB, overjet, molar and canine relationship, swallowing (normal swallow (NSW), tongue-thrust swallow (TTS), teeth-apart swallow (TAS), deep overbite

AOB: 8.5%, NSW: 0.6%, TTS: 34%, TAS: 12.4%, PCB: 14.1%***, NSW: 12.4%, TTS: 14.9%***, TAS: 17.1%*, increased overjet: 23.3%, NSW: 13.9%, TTS: 51.1%, TAS: 26%, bilateral distal occlusion: 41.4%***, NSW: 24.5%, TTS: 74.5%, TAS: 56.3%, mesial occlusion: 1.9%**, NSW: 2.2%**, TTS: 1.1%, TAS: 1.9%, deep overbite: 32%, NSW: 34.1%*, TTS: 22.3%, TAS: 33.5%

AOB: 5.2%, NSW: 1.4%, TTS: 25%, TAS: 9.5%, PCB: 3.1%, NSW: 2.8%, TTS: 0%, TAS: 4.7%, increased overjet: 15.9%, NSW: 7.4%, TTS: 50%, TAS: 38.5%, bilateral distal occlusion: 24%, NSW: 14.9%, TTS: 62.5%, TAS: 38.1%, mesial occlusion: 0%, NSW: 0%, TTS: 0%, TAS: 0%, Deep overbite: 25%, NSW: 22.4%, TTS: 11.7%, TAS: 38.1%

Moimaz et al., 2014 [3]

Prospective cohort study, Brazil

80

Birth up to 30 months of age (questionnaire after 12, 18, and 30 months of age, clinical examination at the 30 months of age

30

No control group

AOB, PCB, overjet, overbite (> 3 mm)

AOB and overjet (> 3 mm): pacifier sucking stop at 12***, 18, and 30***months, PCB: pacifier sucking stop at 12, 18, and 30 months, overbite (> 3 mm): pacifier sucking stop at 12, 18, and 30** months

 

Scavone et al., 2007 [29]

Cross-sectional study, Brazil

366

No

36–72

No pacifier- and finger sucking habits

PCB

PCB: 20.4%**, pacifier sucking until 2 years of age: 17.2%*, pacifier sucking until 4 years of age: 16.9%*, pacifier sucking until 6 years of age: 27.3%**

PCB: 5.2%

Schlomer, 1984 [30]

Cross-sectional study, Germany

582

No

36–72

No sucking habits

AOB, PCB, overjet (no significance data in the study) (no significance data in the study at all)

AOB: 22.8%, PCB: 12.8%, overjet (> 3 mm): 13.2%, pacifier sucking (NUK) stop until 3 years: 3–4 years of age: AOB: 15.2%, PCB: 23.9%, overjet (> 3 mm):10.9%, 5 years of age: AOB: 9.6%, PCB: 11.5%, overjet (> 3 mm): 1.9%, 6 years pf age: AOB: 2.7%, PCB: 10.8%, overjet (> 3 mm): 5.4% (no statistical significance for all mentioned data)

AOB: 2.1%, PCB 0.7%, Overjet (> 3 mm): 12.2%

Tibolla et al., 2012 [31]

Cross-sectional study, Brazil

237

No

36–168: Deciduous: 36–60, Mixed: 72–120, Permanent: 132–168

No pacifier sucking habit

AOB

AOB: 36.5%***, deciduous dentition: 65%***, mixed dentition: 37.3%**, permanent dentition: 23.4%*, > 2 years pacifier sucking vs ≤ 2 years: in deciduous dentition: 83.3% vs. 11.5%***, mixed dentition: 47.6% vs. 11.7***, permanent dentition: 25.9 vs. 9.4%, no or/and only to sleep vs. all the time in deciduous dentition: 17.2% vs. 88.9%***, in mixed dentition: 15.7% vs. 44.4%**, in permanent dentition: 10.7% vs. 25%

AOB: 7.2%, deciduous: 0%, mixed: 11.7%, permanent: 3%

Wagner and Heinrich-Weltzien [16]

Randomized clinical trial, Germany

86

3, 6, 9, and 12 months

16–24 months (20.3)

Weaned of pacifier with a pacifier-associated open bite or overjet ≥ 2 mm

AOB, overjet

Overjet 2.7 ± 0.5 mm, AOB − 1.2 ± 0.3 mm

Overjet 2.4 ± 0.5 mm, AOB − 0.8 ± 0.8 mm

Warren and Bishara, 2002 [32]

Prospective cohort study, USA

372

Birth until 5 years (questionnaire after 3, 6, 9, 12, 20, and 24 months of age, after that yearly, clinical examination: 54–60 months age)

54–60

No control group

AOB, PCB, overjet, molar and canine relationship, vertical overbite, arch width

AOB: 24–36 months pacifier sucking: lower prevalence than < 12 months**, PCB: 24–36 months had a higher prevalence of PCB than ≤24 months**, overjet (≥4 mm): 24–36 months pacifier sucking: lower prevalence than < 12 months, class II canine relationship: 24–36 months pacifier sucking: slightly higher prevalence than < 12 months, arch width and depths measurements: only small differences between < 12 months and 12–36 months pacifier sucking, vertical overbite (mm): not statistically significant between pacifier sucking less than 12 months, 12 to 24 months, and 24 to 36 months.

 

Zimmer et al., 2011 [13]

Prospective cohort study, Germany

121

0–26 months

16 ± 4

No pacifier sucking habit

AOB, overjet

AOB: NUK-group: 38%***, Dentistar group: 5%, overjet (mm): NUK-group: 1.7 ± 1.4, Dentistar group: 1.3 ± 1.0

AOB: 0%, overjet: 1 ± 1 mm

Zimmer et al., 2016 [14]

Prospective cohort study, Germany

121

12 months

20–36

No pacifier sucking habit

AOB, overjet, molar and canine relationship, deep overbite

AOB: NUK-group: 50%, Dentistar group: 6.7%, increased overjet: NUK-group: 19%, Dentistar group: 31.1%**, class II primary canine and molar relationship: NUK-group: 11.1%, Dentistar group: 4.8%, deep overbite: NUK-group: 2.4%, Dentistar group: 6.7%,

AOB: 0%, increased overjet: 5.9%, class II primary canine and molar relationship: 2.9%, deep overbite: 8.9%

  1. AOB anterior open bite, PCB posterior crossbite, NSW normal swallow, TTS tongue-thrust swallow, TAS teeth-apart swallow
  2. *p < 0.05; **p < 0.01; ***p < 0.001