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Hao C, Hao Y, Lou X, Wang X, Liu W, Zhou H, Ban X, Wu W, Wang X, Wang X. Secular trends of dental caries and association with nutritional status: a retrospective analysis of 16,199 Chinese students from three successive national surveys from 2010 to 2019. Front Public Health 2024; 12:1379767. [PMID: 38841684 PMCID: PMC11150691 DOI: 10.3389/fpubh.2024.1379767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction The prevalence of dental caries (DC) among students in developing countries has increased at an alarming rate, and nutritional status has been shown to be associated with DC in children and adolescents with inconsistent conclusions. We aimed to understand the trends of DC prevalence in students aged 7, 9, 12, and 14 years and to explore the relationship between DC prevalence and nutritional status. Methods We recruited 16,199 students aged 7, 9, 12, and 14 years in China by multi-stage, stratified, random sampling methods from 2010 to 2019. Permanent caries were measured using the Decay, Loss, and Filling (DMF) index and prevalence rate. Deciduous caries were measured using the decay, loss, and filling (dmf) index and prevalence rate. Nutritional status was assessed using body mass index (BMI) and hemoglobin levels. Logistic regression analysis was used to assess the association between nutritional status and the DC prevalence in children and adolescents, incorporating information concerning family-related factors. Results The results indicated that DC prevalence increased from 39.75% in 2010 to 53.21% in 2019 in Henan province, with deciduous teeth and permanent teeth being 45.96 and 27.18%, respectively, in 2019. The total caries rate decreased with age (p < 0.05), and the caries rate of girls was higher than that of boys in 2019 (55.75% vs. 50.67%) (p < 0.001). The prevalence of dental caries among primary and secondary school students in areas with medium economic aggregate was the highest, followed by cities with the best economic development level, and cities with low economic levels have a lower prevalence of dental caries. The dental caries prevalence was negatively correlated with body mass index. In the fully adjusted model, underweight children had a higher caries prevalence (OR = 1.10, 95%CI: 0.86-1.41). Children with anemia had a higher prevalence of dental caries (OR = 1.18, 95%CI: 0.98-1.42). Conclusion The DC prevalence of students in Henan Province was high, with a tendency to increase. Females, young individuals, and those with a higher economic level showed a positive correlation with the prevalence of caries. In the process of economic development, particular attention should be paid to early childhood caries prevention. Nutritional status should be taken seriously among children and adolescents, and the oral health system should be improved to keep pace with economic development.
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Affiliation(s)
- Changfu Hao
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yudan Hao
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaomin Lou
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaolin Wang
- Department of Pediatrics, Luohe Central Hospital, Luohe, China
| | - Weiping Liu
- Department of Pediatrics, Luohe Central Hospital, Luohe, China
| | - Huijun Zhou
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaolei Ban
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wencan Wu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xuejie Wang
- Department of Child Rehabilitation, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xian Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
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Pizzi JF, Carrada CF, Zeferino MVDS, Doriguêtto PVT, Abreu LG, Scalioni FAR, Devito KL, Ribeiro RA. Overweight/obesity and dental caries in Brazilian children and adolescents: a systematic review and meta-analysis. Braz Oral Res 2024; 38:e015. [PMID: 38477801 PMCID: PMC11376620 DOI: 10.1590/1807-3107bor-2024.vol38.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/13/2023] [Indexed: 03/14/2024] Open
Abstract
This review aimed to assess the association between overweight/obesity and dental caries in Brazilian children/adolescents. Searches were performed in the Web of Science, Scopus, Cochrane, PubMed, Embase and SciELO, Lilacs and Open Grey literature databases up to June 2022. The Joanna Briggs Institute checklist for analytical cross-sectional studies, the checklist for cohort studies, and the checklist for case-control studies were used. A total of 41 publications were included, and 15 meta-analyses were performed. The authors analyzed the differences in weighted mean difference (MD) and odds ratios (OR), and their corresponding confidence intervals (CI) (95%) for dental caries among eutrophic and obese and/or overweight children/adolescents. Meta-analyses showed that there was no association between overweight and/or obesity and dental caries in Brazilian children/adolescents for most anthropometric reference curves using BMI (Body Mass Index). A greater experience of dental caries was associated with well-nourished adolescents in permanent dentition, compared with obese individuals in the same dentition, as classified by the CDC 2000 curve (OR = 2.53, 95% CI;1.49-4.29; p = 0.0006; I2 = 0%) in dichotomous outcome studies, and (MD = 0.61, 95%CI: 0.08-1.15; p = 0.02; I2 = 0%) in continuous studies. The strength of the evidence of the results was classified as very low, low or moderate. It was concluded that there is no association between overweight and/or obesity and dental caries in Brazilian children/adolescents for most anthropometric reference curves using BMI. A greater experience of dental caries was associated with well-nourished adolescents in permanent dentition, compared with obese individuals in the same dentition, as classified by the CDC 2000 curve.
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Affiliation(s)
- Julia Faria Pizzi
- Universidade Federal de Juiz de Fora - UFJF, School of Dentistry, Juiz de Fora, MG, Brazil
| | - Camila Faria Carrada
- Faculdade de Ciências Médicas e da Saúde - Suprema, School of Dentistry, Department of Paediatric Dentistry, Juiz de Fora, MG, Brazil
| | | | | | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG, Schoool of Dentistry, Department of Oral Health for Children and Adolescents, Belo Horizonte, MG, Brazil
| | - Flávia Almeida Ribeiro Scalioni
- Universidade Federal de Juiz de Fora - UFJF, School of Dentistry, Department of Social and Paediatric Dentistry; Juiz de Fora, MG, Brazil
| | - Karina Lopes Devito
- Universidade Federal de Juiz de Fora - UFJF, School of Dentristry, Department of Dental Clinic, Juiz de Fora, MG, Brazil
| | - Rosangela Almeida Ribeiro
- Universidade Federal de Juiz de Fora - UFJF, School of Dentistry, Department of Social and Paediatric Dentistry; Juiz de Fora, MG, Brazil
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Ciężki S, Odyjewska E, Bossowski A, Głowińska-Olszewska B. Not Only Metabolic Complications of Childhood Obesity. Nutrients 2024; 16:539. [PMID: 38398863 PMCID: PMC10892374 DOI: 10.3390/nu16040539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
The increasing incidence of obesity in the pediatric population requires attention to its serious complications. It turns out that in addition to typical, well-known metabolic complications, obesity as a systemic disease carries the risk of equally serious, although less obvious, non-metabolic complications, such as cardiovascular diseases, polycystic ovary syndrome, chronic kidney disease, asthma, thyroid dysfunction, immunologic and dermatologic conditions, and mental health problems. They can affect almost all systems of the young body and also leave their mark in adulthood. In addition, obesity also contributes to the exacerbation of existing childhood diseases. As a result, children suffering from obesity may have a reduced quality of life, both physically and mentally, and their life expectancy may be shortened. It also turns out that, in the case of obese pregnant girls, the complications of obesity may also affect their unborn children. Therefore, it is extremely important to take all necessary actions to prevent the growing epidemic of obesity in the pediatric population, as well as to treat existing complications of obesity and detect them at an early stage. In summary, physicians treating a child with a systemic disease such as obesity must adopt a holistic approach to treatment.
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Affiliation(s)
- Sebastian Ciężki
- Department of Pediatrics, Endocrinology, and Diabetology with Cardiology Division, Medical University of Bialystok, 15-274 Białystok, Poland
| | - Emilia Odyjewska
- Department of Pediatrics, Endocrinology, and Diabetology with Cardiology Division, Medical University of Bialystok, 15-274 Białystok, Poland
| | - Artur Bossowski
- Department of Pediatrics, Endocrinology, and Diabetology with Cardiology Division, Medical University of Bialystok, 15-274 Białystok, Poland
| | - Barbara Głowińska-Olszewska
- Department of Pediatrics, Endocrinology, and Diabetology with Cardiology Division, Medical University of Bialystok, 15-274 Białystok, Poland
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Bhoopathi V, Tripicchio G. Childhood dental caries and obesity: Opportunities for interdisciplinary approaches to prevention. Obes Sci Pract 2024; 10:e740. [PMID: 38332757 PMCID: PMC10851802 DOI: 10.1002/osp4.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/08/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024] Open
Abstract
Dental caries and obesity are prevalent and preventable chronic childhood diseases. Evidence shows a strong connection between these two diseases, with overlapping common risk factors, including diet as a key driver of risk. Dental professionals are well-positioned to perform nutritional counseling and obesity prevention in dental clinic settings, but training and clinical integration remain key challenges. This paper highlights the potential for leveraging the common risk factor approach (CRFA) framework and its principles to reduce the impact of childhood dental caries and obesity. Strategies and methods are provided to integrate meaningful didactic and clinical training experiences in dental academia, and the need to include effective and evidence-based nutritional counseling techniques in dental settings is also described. Additionally, the potential for integrating CRFA and engaging health care providers across the spectrum of care, including primary care settings, to reduce the prevalence of these diseases in pediatric populations is highlighted. Finally, the authors propose future directions for multidisciplinary research to advance the scientific knowledge in this area and to inform effective and comprehensive interventions for dental settings.
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Affiliation(s)
- Vinodh Bhoopathi
- Section of Public and Population HealthDivision of Oral and Systemic Health SciencesUniversity of California at Los Angeles School of DentistryLos AngelesCaliforniaUSA
| | - Gina Tripicchio
- Center for Obesity Research and EducationTemple University School of Public HealthPhiladelphiaPennsylvaniaUSA
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Ramirez I, Alves DE, Kuchler PC, Madalena IR, de Lima DC, Barbosa MCF, Oliveira MAHDM, Thedei Júnior G, Baratto-Filho F, Küchler EC, de Oliveira DSB. Geographic Information Systems (GIS) to Assess Dental Caries, Overweight and Obesity in Schoolchildren in the City of Alfenas, Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032443. [PMID: 36767807 PMCID: PMC9915223 DOI: 10.3390/ijerph20032443] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 05/15/2023]
Abstract
Childhood-related obesity and overweight are increasing concerns for the health and well-being of children. Dental caries (decay) is the most prevalent oral disease during childhood, and several studies have suggested that nutritional status and dental caries are associated in children. Therefore, this study aimed to determine the geographic distribution of childhood overweight/obesity and dental caries in a medium-sized Brazilian city. This cross-sectional study was conducted with 269 children of both genders enrolled in four public schools in the city of Alfenas. The children were clinically examined to assess cavitated dental caries and nutritional status (overweight and obesity). In addition, the GIS was used for the geospatial clustering analyses. A heat map was created by the Kemel method to estimate the concentration of the outcomes. The cavitated dental caries and overweight/obesity were also pointed out by dots on the map. However, of the 269 children, 118 were boys (43.87%) and 151 were girls (56.13%). One hundred fifty-seven children (58.4%) were classified as having "non-cavitated caries," while 112 (41.6%) were classified as having "cavitied caries." In the nutritional status assessment, 204 children (75.84%) were classified as "eutrophic," while 65 children (24.16%) were classified as "overweight/obesity," A geographical correlation of dental caries with overweight/obesity may exist in the northeast and southwest areas. In conclusion, a geographical concordance between the dental caries and the occurrence of overweight/obesity among the schoolchildren from Alfenas may exist in some areas. Future studies are necessary.
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Affiliation(s)
- Iago Ramirez
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas 37130-001, Brazil
| | - Diego Escobar Alves
- Institute of Geography, Department of Physical Geography, Rio de Janeiro State University (UERJ/IGEOG/DGF), Rua São Francisco Xavier, 524, Maracanã, Rio de Janeiro 25550-013, Brazil
| | - Patrick Calvano Kuchler
- Institute of Geography, Department of Physical Geography, Rio de Janeiro State University (UERJ/IGEOG/DGF), Rua São Francisco Xavier, 524, Maracanã, Rio de Janeiro 25550-013, Brazil
| | - Isabela Ribeiro Madalena
- Department of Biomaterials, University of Uberaba, Uberaba 35430-026, Brazil
- Department of Dentistry, University of Joinville Region, Joinville 89219-710, Brazil
- School of Dentistry, Presidente Tancredo de Almeida Neves University Center, São João del Rei 66645-057, Brazil
| | - Daniela Coelho de Lima
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas 37130-001, Brazil
| | | | | | | | - Flares Baratto-Filho
- Department of Dentistry, University of Joinville Region, Joinville 89219-710, Brazil
- School of Dentistry, Tuiuti University from Parana, Curitiba 82010-210, Brazil
| | - Erika Calvano Küchler
- Department of Biomaterials, University of Uberaba, Uberaba 35430-026, Brazil
- School of Dentistry, Tuiuti University from Parana, Curitiba 82010-210, Brazil
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Abstract
Childhood obesity is, according to the WHO, one of the most serious challenges of the 21st century. More than 100 million children have obesity today. Already during childhood, almost all organs are at risk of being affected by obesity. In this review, we present the current knowledge about diseases associated with childhood obesity and how they are affected by weight loss. One major causative factor is obesity-induced low-grade chronic inflammation, which can be observed already in preschool children. This inflammation-together with endocrine, paracrine, and metabolic effects of obesity-increases the long-term risk for several severe diseases. Type 2 diabetes is increasingly prevalent in adolescents and young adults who have had obesity during childhood. When it is diagnosed in young individuals, the morbidity and mortality rate is higher than when it occurs later in life, and more dangerous than type 1 diabetes. Childhood obesity also increases the risk for several autoimmune diseases such as multiple sclerosis, Crohn's disease, arthritis, and type 1 diabetes and it is well established that childhood obesity also increases the risk for cardiovascular disease. Consequently, childhood obesity increases the risk for premature mortality, and the mortality rate is three times higher already before 30 years of age compared with the normal population. The risks associated with childhood obesity are modified by weight loss. However, the risk reduction is affected by the age at which weight loss occurs. In general, early weight loss-that is, before puberty-is more beneficial, but there are marked disease-specific differences.
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Affiliation(s)
- Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Pernilla Danielsson
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Emilia Hagman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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Sabharwal A, Stellrecht E, Scannapieco FA. Associations between dental caries and systemic diseases: a scoping review. BMC Oral Health 2021; 21:472. [PMID: 34563194 PMCID: PMC8466895 DOI: 10.1186/s12903-021-01803-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 09/01/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The objective of this study was to evaluate and present evidence from animal and human clinical studies on associations between dental caries and systemic diseases, and to suggest potential mechanisms that might explain such associations. METHODS An electronic search was conducted of PubMed, Embase and Cochrane Central Register of Controlled Trials for articles published from 2010 to 2020 in the English language. From the initial search, 404 full-text studies were assessed for eligibility. After excluding studies for technical and study limitations, a total of 67 studies were included in the summary tables and additional studies were included in the review to support evidence. RESULTS Few systemic disease and conditions were found to be clinically meaningfully associated with caries experience. Best evidence from human and animal studies described association between metabolic diseases and dental caries. Several interesting animal studies were noted that could generate clinical hypotheses and further investigations in rodent models for cardiovascular injury and hyperglycemia. Inadequate data was found to suggest any modifications to current clinical practice or prevention guidelines. CONCLUSIONS Limited clinical evidence was found connecting several systemic diseases and dental caries. Inadequate data was found to suggest any modifications to current clinical practice or prevention guidelines. CLINICAL SIGNIFICANCE Understanding of associations between dental caries and systemic diseases play a crucial role in the treatment planning and education of the dental patient.
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Affiliation(s)
- Amarpreet Sabharwal
- Division of Periodontics, Schulich School of Medicine and Dentistry, DSB 0156A, Western University, 1151 Richmond St., London, ON N6A 5C1 Canada
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, 3435 Main St., Buffalo, NY 14214 USA
| | - Elizabeth Stellrecht
- Health Sciences Library University at Buffalo, 3435 Main St., Buffalo, NY 14214 USA
| | - Frank A. Scannapieco
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, 3435 Main St, Buffalo, NY 14214 USA
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Differences between Obese and Non-Obese Children and Adolescents Regarding Their Oral Status and Blood Markers of Kidney Diseases. J Clin Med 2021; 10:jcm10163723. [PMID: 34442019 PMCID: PMC8397190 DOI: 10.3390/jcm10163723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 01/05/2023] Open
Abstract
(1) Background: A rarely discussed effect of obesity-related glomerulopathy (ORG) may slowly lead to irreversible glomerular damage and the development of chronic kidney disease. These patients need to undertake medical care, but whether they should be included in intensive oral care is still not mandatory. The study aimed to assess a relationship between renal, metabolic, and oral health indicators among pediatric patients affected by simple obesity. (2) Methods: 45 children and adolescents with simple obesity hospitalized (BMI 34.1 ± 4.8 kg/m2, age 15.4 ± 2.3) and compared with 41 aged-matched healthy controls (BMI 16.4 ± 2.4 kg/m2, age 15.4 ± 2.7). Echocardiography, 24-h ambulatory blood pressure monitoring, ultrasound exam with Doppler, and laboratory tests including kidney and metabolic markers were performed. Oral status was examined regarding the occurrence of carious lesions using decay missing filling teeth (DMFT), gingivitis as bleeding on probing (BOP), and bacterial colonization as plaque control record (PCR). (3) Results: The strongest correlation was revealed between BMI and concentration of uric acid, cystatin C, GFR estimated by the Filler formula (r = 0.74; r = 0.48; r = -0.52), and between oral variables such as PCR and BOP (r = 0.54; r = 0.58). Children and adolescents with obesity demonstrated untreated dental caries, less efficient in plaque control and gingivitis. (4) Conclusions: No specific relation to markers of kidney disease were found; however, more frequent gingivitis/bacterial colonization and significant differences in oral status between obese and non-obese patients were revealed. Susceptibility to inflammation may be conducive to developing metabolic syndrome and kidney damage in the form of obesity-related glomerulopathy and contribute to future dental caries. Uric acid seems to indicate metabolic syndrome and cardiovascular complications (LVMI > 95 percentiles). Cystatin C and uric acid might aspire to be early markers of kidney damage leading to obesity-related glomerulopathy.
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Paszynska E, Dmitrzak-Węglarz M, Perczak A, Gawriolek M, Hanć T, Bryl E, Mamrot P, Dutkiewicz A, Roszak M, Tyszkiewicz-Nwafor M, Slopien A. Excessive Weight Gain and Dental Caries Experience among Children Affected by ADHD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165870. [PMID: 32823570 PMCID: PMC7460135 DOI: 10.3390/ijerph17165870] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/28/2020] [Accepted: 08/11/2020] [Indexed: 02/07/2023]
Abstract
In recent years, attention has been paid to the co-occurrence of attention deficit hyperactivity disorder (ADHD) and obesity, but results in relation to dental caries outcomes differ. The study was conducted to determine obesity/overweight and dental caries in children suffering from ADHD and to draw comparisons with non-ADHD children. A total of 119 children under 11 years old (8.2 ± 1.2) were enrolled into a cross-sectional study: those with confirmed ADHD (n = 39), and healthy controls (n = 80). The behavioral evaluation included a parent interview directed at sweetened food/drink habits. The clinical evaluation included physical measurements (height, waist, hip circumference, body weight, body mass index (BMI), and dental examination (International Caries Detection and Assessment System—ICDAS). Results showed a higher prevalence of abnormal body weight, hip circumference, and BMI, and a higher frequency of caries (84.6%) in the ADHD group. Significant caries differences for primary (ICDAS 0, 1, 2, 5, 6 scores) and permanent teeth (ICDAS 1, 3 scores) were recorded. The questionnaire pinpointed interplays between sugar consumption and tooth decay, especially for primary dentition. It can be concluded that the consumption of sweetened foods/drinks among ADHD children may lead to an increased rate of overweight, but may also affect oral health. Limiting sugar consumption might be one of the important elements in prevention programmes against dental caries and overweight/obesity.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan 60-812, Poland; (A.P.); (M.G.)
- Correspondence:
| | - Monika Dmitrzak-Węglarz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poznan 60-806, Poland;
| | - Aleksandra Perczak
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan 60-812, Poland; (A.P.); (M.G.)
| | - Maria Gawriolek
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan 60-812, Poland; (A.P.); (M.G.)
| | - Tomasz Hanć
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Poznan 61-614, Poland; (T.H.); (E.B.); (P.M.)
| | - Ewa Bryl
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Poznan 61-614, Poland; (T.H.); (E.B.); (P.M.)
| | - Paula Mamrot
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Poznan 61-614, Poland; (T.H.); (E.B.); (P.M.)
| | - Agata Dutkiewicz
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznan 60-572, Poland; (A.D.); (M.T.-N.); (A.S.)
| | - Magdalena Roszak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan 60-806, Poland;
| | - Marta Tyszkiewicz-Nwafor
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznan 60-572, Poland; (A.D.); (M.T.-N.); (A.S.)
| | - Agnieszka Slopien
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznan 60-572, Poland; (A.D.); (M.T.-N.); (A.S.)
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