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Observational studies published that reported oral alterations in children with CZS were selected. Two authors independently extracted data, assessed study quality, using the Joanna Briggs Institute Critical Appraisal Checklist tools, and the certainty of evidence, using Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Twenty\u2010one studies were included in this systematic review and meta\u2010analysis. The pooled crude occurrence showed 88% of increased salivation (95%CI: 82%\u201394%), 83% of biofilm (95%CI: 75%\u201391%), and 73% of bruxism (95%CI: 52%\u201395%). Compared to normotypic controls, children with CZS\u2010associated microcephaly had a higher chance to have difficulty in lip sealing (OR: 18.28; 95%CI: 1.42\u2013235.91), inadequate lingual posture at rest (OR: 13.57; 95%CI: 4.24\u201343.44), and delayed eruption (OR: 12.92; 95%CI: 3.42\u201348.78), with very low certainty.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>There are several oral alterations found among children with CZS\u2010associated microcephaly. They are more prone to present some of these alterations, such as difficulty in lip sealing, although with very low certainty of evidence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/scd.12761","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T08:44:33Z","timestamp":1659343473000},"page":"184-198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Oral alterations in children with microcephaly associated to congenital Zika syndrome: A systematic review and meta\u2010analyses"],"prefix":"10.1111","volume":"43","author":[{"given":"Leni Ver\u00f4nica de Oliveira","family":"Silva","sequence":"first","affiliation":[{"name":"Department of Oral Surgery Pathology and Clinical Dentistry School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte  Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula","family":"Hermont","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte  Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela Queiroz","family":"Magnani","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Dentistry School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte  Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina Castro","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte  Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cristina","family":"Borges\u2010Oliveira","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Dentistry School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte  Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41426-018-0069-2"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00562-6"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00080-5"},{"key":"e_1_2_10_5_1","unstructured":"BRASIL.Minist\u00e9rio da Sa\u00fade. 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