Prevalence of periodontitis, dental caries, and peri-implant pathology and their relation with systemic status and smoking habits: Results of an open-cohort study with 22009 patients in a private rehabilitation center
Prevalence of periodontitis, dental caries, and peri-implant pathology and their relation with systemic status and smoking habits: Results of an open-cohort study with 22009 patients in a private rehabilitation center
复制标题
DOI：
10.1016/j.jdent.2017.07.013
复制
发表时间：
2017-12-01
影响因子：
4.4
通讯作者：
Malo, Paulo
中科院分区：
文献类型：
--
作者：
Nobre, Miguel de Araujo;Malo, Paulo
目的：这项调查是基于一项为期3年的流行病学监测开放队列研究，旨在了解牙周炎、龋齿和种植体周围病理的患病率，并比较健康和全身性损害患者之间的差异。方法：共观察到22009例患者，包括9035例男性（41.1%）和12974例女性（58.9%），平均年龄为48.5岁（标准差为15.6岁）。计算3种慢性口腔疾病的患病率。通过多变量逻辑回归对每种口腔疾病的健康和全身损害患者进行比较：在一个通用模型和一个针对年龄和性别调整的全身状况特定模型中估计比值比（OR）和95%置信区间（95%CI）。估计全身性疾病的归因分数（两种模型）。结果：牙周炎、龋病和种植体周围病变的患病率分别为17.6%、36.6%和13.9%。在一般模型上，全身损害状态与三种慢性口腔疾病的患病率相关。全身状况特异性模型产生糖尿病[OR = 1.49，95%CI（1.24;1.79）]和HIV + [OR = 4.37，95%CI（1.05;18.24）]作为牙周炎的危险指标;心血管疾病[OR = 1.10，95%CI（1.01;1.20）]、糖尿病[OR = 1.24，95%CI（1.05;1.46）]和神经系统疾病[OR = 1.84，95%CI（1.32;2.57）]作为龋齿的危险指标;吸烟习惯作为三种口腔疾病的危险指标[OR = 1.90，95%CI（1.74;2.07）;龋齿的OR = 1.18，95%CI（1.09;1.27）;种植体周围病变的OR = 1.84，95%CI（1.64;2.07）]。归因分数估计，如果预防暴露于全身条件，牙周炎的潜在减少率为12.2%，龋齿病例的潜在减少率为4.3%;而单独预防暴露于吸烟将导致牙周炎、龋齿和种植体周围病理病例的潜在减少率分别为37%、7%和39%。临床意义：本研究描述了一种流行病学方法的分布和决定因素的三个主要慢性口腔疾病。全身条件和吸烟习惯与口腔疾病患病率的关联突出了一个狭窄的监测system.Conclusions的重要性：本研究报告了一个高患病率的口腔疾病和一个潜在的关联的全身损害状态和吸烟习惯与三种慢性口腔疾病。
Objectives: This investigation, based on a 3-year epidemiological surveillance open cohort study, aimed to provide an insight of the prevalence of periodontitis, dental caries and peri-implant pathology and to compare inferentially between healthy and systemic compromised patients.Methods: A total of 22009 patients were observed consisting in 9035 men (41.1%) and 12974 women (58.9%) with an average age of 48.5 years (standard deviation of 15.6 years). The prevalence of the 3 chronical oral diseases was calculated. The comparison between healthy and systemic compromised patients for each oral disease was performed through multivariate logistic regression: Odds ratios (OR) with 95% confidence intervals (95%CI) were estimated in one general model and one systemic condition specific model adjusted for age and gender. Attributable fractions were estimated for systemic conditions (both models). The level of significance was set at 5%.Results: The prevalence rate of periodontitis, dental caries and peri-implant pathology was 17.6%, 36.6% and 13.9%, respectively. The systemic compromised status was associated with the prevalence of the three chronical oral diseases on the general models. The systemic condition specific models yielded Diabetes [OR = 1.49, 95%CI (1.24;1.79)] and HIV + [OR = 4.37, 95%CI (1.05;18.24)] as risk indicators for Periodontitis; cardiovascular conditions [OR = 1.10, 95%CI (1.01;1.20)], Diabetes [OR = 1.24, 95%CI (1.05;1.46)] and neurologic conditions [OR = 1.84, 95%CI (1.32;2.57)] as risk indicators for dental caries; and smoking habits as a risk indicator for all three oral diseases [OR = 1.90, 95%CI (1.74;2.07) for Periodontitis; OR = 1.18, 95%CI (1.09;1.27) for dental caries; OR = 1.84, 95%CI (1.64;2.07) for peri-implant pathology]. Attributable fractions estimated a potential reduction of 12.2% of Periodontitis, and 4.3% of dental caries cases if the exposure to systemic conditions was prevented; while the prevention of exposure to smoking alone would result in a potential reduction of 37%, 7%, and 39% of Periodontitis, dental caries, and peri-implant pathology cases, respectively.Clinical significance: The present study describes an epidemiological approach to the distribution and determinants of the three principal chronical oral diseases. The association of systemic conditions and smoking habits with oral disease prevalence highlight the importance of a narrow monitoring system.Conclusions: The present study reported a high prevalence for oral disease and a potential association of a systemic compromised status and smoking habits with the three chronical oral diseases.