Predictive factors for tooth loss in older adults vary according to occlusal support: A 6-year longitudinal survey from the SONIC study
Predictive factors for tooth loss in older adults vary according to occlusal support: A 6-year longitudinal survey from the SONIC study
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老年人牙齿脱落的预测因素因咬合支持而异：SONIC 研究的 6 年纵向调查
DOI：
10.1016/j.jdent.2022.104088
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发表时间：
2022
影响因子：
4.4
通讯作者：
Ikebe K.
中科院分区：
文献类型：
--
作者：
Hitomi S;Hatta K;Murotani Y;Takahashi T;Gondo Y;Kamide K;Masui Y;Ishizaki T;Kabayama M;Ogata S;Matsuda K;Mihara Y;Fukutake M;Hagino H;Higashi K;Akema S;Kitamura M;Murakami S;Maeda Y;Ikebe K.
目的 这项针对 70 岁以上社区老年人的队列研究的目的是调查咬合支持对牙齿脱落的影响，并通过多水平分析确定每个咬合支持类别的牙齿脱落的预测因素。方法参与者为 812 名老年人，他们完成了基线调查和 6 年后的随访调查。 Eichner指数用于评估咬合支撑状态。使用广义估计方程（GEE）逻辑回归分析来检查咬合支撑状态对牙齿缺失的影响，同时调整个体和牙齿水平的各种因素。在每个 Eichner 类别中分别进行了类似的分析，以确定牙齿脱落的预测因素。结果 GEE 显示，咬合支撑的下降会增加牙齿脱落的风险（Eichner A：参考类别，Eichner B：比值比 (OR) = 1.96，p < 0.001，Eichner C：OR = 3.04，p < 0.001）。分层分析表明，无论咬合支撑如何，固定局部义齿的更深的牙周袋和基牙与牙齿脱落显着相关。在 Eichner A 中，相对牙齿的存在有利于保护牙齿，而相邻牙齿的缺失与牙齿缺失没有显着相关。 Eichner B 型患者的对牙与牙齿缺失的风险相关，而 Eichner B 型和 C 型患者的邻牙缺失与牙齿缺失显着相关。结论 咬合支撑的下降会加速牙齿缺失。牙齿脱落的预测因素因咬合支撑状态而异。临床意义咬合支撑是预防牙齿脱落的重要因素。牙列状况（例如缺失邻牙和存在对牙）会增加咬合支持不良的参与者牙齿脱落的风险。牙科人员需要仔细检查牙列状况以评估咬合塌陷的风险。
ObjectivesThe aim of this cohort study among community-dwelling older adults aged over 70 years was to investigate the influence of occlusal support on tooth loss, and to determine predictive factors for tooth loss for each occlusal support category using multilevel analyses.MethodsParticipants were 812 older adults who completed the baseline survey and the follow-up survey 6 years later. The Eichner index was used to evaluate occlusal support status. A generalized estimating equation (GEE) logistic regression analysis was used to examine the influence of occlusal support status on tooth loss while adjusting for various factors at individual and tooth levels. Similar analyses were separately performed in each Eichner class to determine predictive factors for tooth loss.ResultsThe GEE showed that a decline in occlusal support increased the risk of tooth loss (Eichner A: reference category, Eichner B: odds ratio (OR) = 1.96,p< 0.001, Eichner C: OR = 3.04,p< 0.001). Stratified analysis showed that deeper periodontal pockets and abutment teeth for fixed partial dentures were significantly associated with tooth loss, regardless of occlusal support. In Eichner A, the presence of an opposing tooth was advantageous in protecting the tooth, and a missing adjacent tooth was not significantly associated with tooth loss. An opposing tooth was associated with the risk of tooth loss in Eichner B, and a missing adjacent tooth was significantly associated with tooth loss in Eichner B and C.ConclusionsA decline in occlusal support accelerated tooth loss. Predictive factors for tooth loss varied depending on occlusal support status.Clinical SignificanceOcclusal support is an important factor in preventing tooth loss. Dentition conditions such as missing adjacent teeth and the presence of opposing teeth increase the risk of tooth loss in participants with poor occlusal support. Dental personnel need to carefully examine dentition conditions to assess the risk of occlusal collapse.