Multifactorial risk assessment for survival of abutments of removable partial dentures based on practice-based longitudinal study.
Multifactorial risk assessment for survival of abutments of removable partial dentures based on practice-based longitudinal study.
复制标题
基于实践的纵向研究对可摘局部义齿基台存活的多因素风险评估。
DOI：
10.1016/j.jdent.2013.07.018
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发表时间：
2013
影响因子：
4.4
通讯作者：
Y. Maeda
中科院分区：
文献类型：
--
作者：
S. Tada;K. Ikebe;K. Matsuda;Y. Maeda
目的预测牙体存活是目前循证牙科研究面临的一大挑战。为了防止部分无牙患者的牙齿进一步脱落，评估每颗残牙的个体化风险和收益对临床决策至关重要。虽然有一些报道表明rpd有丧失基牙的风险，但尚无多因素分析探讨基牙丧失原因的报道。这项基于实践的纵向研究的目的是通过多因素风险评估来确定影响RPD基台生存期的预后因素。方法在大阪大学牙科医院为147例患者提供了总共236个新的rpd；对856个rpd基台进行了分析。采用Kaplan-Meier法估计基牙的存活情况。采用Cox比例风险模型进行多变量分析。结果直接基牙5年生存率为86.6%，间接基牙5年生存率为93.1%，非基牙5年生存率为95.8%。多因素分析显示，基牙存活率与冠根比（HR: 3.13）、根管治疗（HR: 2.93）、牙袋深度（HR: 2.51）、基牙类型（HR: 2.19）和咬合支持（HR: 1.90）显著相关。结论基于实践的纵向研究表明，RPD基牙比其他残牙更容易丢失。从多因素危险因素评估中，提出了牙合支持、冠根比、根管治疗、牙袋深度等预后因素。临床意义这些结果可用于评估残牙的个体化风险，预测RPD基台的预后，为临床循证决策提供依据。
ObjectivesPredicting the tooth survival is such a great challenge for evidence-based dentistry. To prevent further tooth loss of partially edentulous patients, estimation of individualized risk and benefit for each residual tooth is important to the clinical decision-making. While there are several reports indicating a risk of losing the abutment teeth of RPDs, there are no existing reports exploring the cause of abutment loss by multifactorial analysis. The aim of this practice-based longitudinal study was to determine the prognostic factors affecting the survival period of RPD abutments using a multifactorial risk assessment.MethodsOne hundred and forty-seven patients had been previously provided with a total of 236 new RPDs at the Osaka University Dental Hospital; the 856 abutments for these RPDs were analyzed. Survival of abutment teeth was estimated using the Kaplan–Meier method. Multivariate analysis was conducted by Cox's proportional hazard modelling.ResultsThe 5-year survival rates were 86.6% for direct abutments and 93.1% for indirect abutments, compared with 95.8% survival in non-abutment teeth. The multivariate analysis showed that abutment survival was significantly associated with crown-root ratio (hazard ratio (HR): 3.13), root canal treatment (HR: 2.93), pocket depth (HR: 2.51), type of abutments (HR: 2.19) and occlusal support (HR: 1.90).ConclusionFrom this practice-based longitudinal study, we concluded that RPD abutment teeth are more likely to be lost than other residual teeth. From the multifactorial risk factor assessment, several prognostic factors, such as occlusal support, crown-root ratio, root canal treatment, and pocket depth were suggested.Clinical significanceThese results could be used to estimate the individualized risk for the residual teeth, to predict the prognosis of RPD abutments and to facilitate an evidence-based clinical decision making.