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Systematic reviews

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Bite force of children and adolescents: a systematic review and meta-analysis

  • Priya Jayakumar1
  • Gnanasekaran FelsyPremila2,*,
  • MS Muthu3,4,*,
  • Richard Kirubakaran5
  • Noopur Panchanadikar6
  • Sarmad S. Al-Qassar7

1Department of Pediatric and Preventive Dentistry, Sri Ramachandra Institute of Higher Education and Research, 600116 Chennai, India

2Department of Central Research Facility, Faculty of Clinical Research, Sri Ramachandra Institute of Higher Education and Research, 600116 Chennai, India

3Centre for Early Childhood Caries Research (CECCRe), Department of Pediatric and Preventive Dentistry, Sri Ramachandra Institute of Higher Education and Research, 600116 Chennai, India

4Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates

5South Asian Cochrane Network and Centre, Christian Medical College, 632002 Vellore, India

6Disha nursing home, Gulab Nagar, 411043 Pune, India

7Department of Orthodontics (University of Athens), University of Mosul/Collage of Dentistry, 00964 Mosul, Iraq

DOI: 10.22514/jocpd.2023.022 Vol.47,Issue 3,May 2023 pp.39-53

Submitted: 09 August 2022 Accepted: 16 November 2022

Published: 03 May 2023

*Corresponding Author(s): Gnanasekaran FelsyPremila E-mail:
*Corresponding Author(s): MS Muthu E-mail:


This systematic review aimed to assess bite force measurements in children and adolescents and to study the various devices that measure Maximum Voluntary Bite Force (MVBF). This systematic review included observational studies and experimental studies in children and adolescents (upto 19 years of age) which evaluated MVBF using a bite force measuring device. Studies on participants with systemic conditions were excluded. Databases such as PubMed, Embase, LILACS, and the Cochrane library were searched until September 2022, for which screening and quality assessment were performed. Newcastle-Ottawa, modified Newcastle-Ottawa and ROBINS-I tools were used to assess the Risk-of-bias. All observational studies reporting overall bite force values of participants were included for meta-analyses. A total of 8864 participants (3491 males and 3623 females) were included from 61 studies. Meta-analyses were conducted to evaluate mean average bite force value for each included dentition using R software v2.4-0. Estimation was done to derive an average BF value for variables such as age (dentition), gender, side, site, device and ethnicity. MVBF values were reported as mean average in the form of MLN with 95% CI (Confidence Interval). Using a random-effects model, 29 forest plots were generated. I2 values varied between 90% and 100%. Bite force ranged from 246.22 N (220.47; 274.98) to 311.72 N (255.99; 379.59) and 489.35 N (399.86; 598.87) in primary, mixed, and permanent dentitions, respectively. Six different sites for recording bite force and 11 different types of devices were reported with portable occlusal bite force gauge being the most common device. Outcomes of this review provide useful baseline reference values of bite force for clinicians and researchers.


Bite force; Children; Device; Dentition; Occlusion

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Priya Jayakumar,Gnanasekaran FelsyPremila,MS Muthu,Richard Kirubakaran,Noopur Panchanadikar,Sarmad S. Al-Qassar. Bite force of children and adolescents: a systematic review and meta-analysis. Journal of Clinical Pediatric Dentistry. 2023. 47(3);39-53.


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