Hiltunen Kaija, Vehkalahti Miira M, Peltola Jaakko S, Ainamo Anja
Department of Prosthodontics, Institute of Dentistry, University of Helsinki, Finland.
Int J Prosthodont. 2002 Nov-Dec;15(6):539-43.
The aim of the present 5-year follow-up was to clarify the nature of occlusal support status and radiographic changes in condyles of the elderly, and the association between these two variables.
The present study is part of a comprehensive medical survey of a random sample born in 1904, 1909, and 1914. A total of 364 subjects living in Helsinki participated in the dental part of the examination during 1990 to 1991, and after 5 years a total of 103 were reexamined. Comprehensive data on occlusal support status were available for 94 subjects, and radiographic data were available for 88 subjects. Occlusal support status was assessed on the basis of the Eichner index, radiographic changes were assessed from panoramic radiographs, and symptoms of temporomandibular disorders were assessed using Helkimo's anamnestic index.
The most frequent radiographic finding in the mandibular joint was flattening of the articular surface of the condyle associated with osteoarthrosis, found at baseline in 17% and during follow-up in 13% of the subjects. During the 5-year follow-up, Eichner index for natural dentition remained unaltered in 94% of the subjects and in 85% of the subjects when removable dentures were included. There were no radiographic changes in 92% of the cases. No differences based on age or gender were found. A logistic regression model revealed associations between the selected baseline factors. The odds ratio for baseline Helkimo's anamnestic index was 4.1, 5.7 for Eichner index with the support of removable dentures, and 356 for radiographic findings.
Radiographic changes in condyles of elderly people were small during the 5-year follow-up, but baseline radiographic findings, Helkimo's anamnestic index, and Eichner index with removable dentures were risk factors for radiographic findings at the end of the follow-up.
本次5年随访的目的是明确老年人咬合支持状况的性质、髁突的影像学变化，以及这两个变量之间的关联。
本研究是对1904年、1909年和1914年出生的随机样本进行的综合医学调查的一部分。1990年至1991年期间，共有364名居住在赫尔辛基的受试者参加了牙科检查部分，5年后共有103人接受了复查。94名受试者有关于咬合支持状况的综合数据，88名受试者有影像学数据。根据艾希纳指数评估咬合支持状况，从全景X线片评估影像学变化，使用赫尔基莫问诊指数评估颞下颌关节紊乱症状。
下颌关节最常见的影像学表现是与骨关节炎相关的髁突关节表面变平，在基线时17%的受试者中发现，随访期间13%的受试者中发现。在5年随访期间，94%的天然牙列受试者和包括可摘义齿在内的85%的受试者的艾希纳指数保持不变。92%的病例没有影像学变化。未发现基于年龄或性别的差异。逻辑回归模型显示了所选基线因素之间的关联。基线赫尔基莫问诊指数的优势比为4.1，有可摘义齿支持时艾希纳指数的优势比为5.7，影像学表现的优势比为356。
在5年随访期间，老年人髁突的影像学变化较小，但基线影像学表现、赫尔基莫问诊指数和有可摘义齿时的艾希纳指数是随访结束时影像学表现的危险因素。
