Department of Oral Function and Prosthetic Dentistry, College of Dental Science, Radboud University Nijmegen Medical Centre, Philips van Leydenlaan 25, 6525 EX Nijmegen, The Netherlands.
Health Qual Life Outcomes. 2010 Nov 5;8:126. doi: 10.1186/1477-7525-8-126.
It is increasingly recognized that the impact of disease on quality of life should be taken into account when assessing health status. It is likely that tooth loss, in most cases being a consequence of oral diseases, affects Oral Health-Related Quality of Life (OHRQoL). The aim of the present study is to systematically review the literature and to analyse the relationship between the number and location of missing teeth and oral health-related quality of life (OHRQoL). It was hypothesized that tooth loss is associated with an impairment of OHRQoL. Secondly, it was hypothesized that location and distribution of remaining teeth play an important role in this.
Relevant databases were searched for papers in English, published from 1990 to July 2009 following a broad search strategy. Relevant papers were selected by two independent readers using predefined exclusion criteria, firstly on the basis of abstracts, secondly by assessing full-text papers. Selected studies were grouped on the basis of OHRQoL instruments used and assessed for feasibility for quantitative synthesis. Comparable outcomes were subjected to meta-analysis; remaining outcomes were subjected to a qualitative synthesis only.
From a total of 924 references, 35 were eligible for synthesis (inter-reader agreement abstracts κ = 0.84 ± 0.03; full-texts: κ = 0.68 ± 0.06). Meta-analysis was feasible for 10 studies reporting on 13 different samples, resulting in 6 separate analyses. All studies showed that tooth loss is associated with unfavourable OHRQoL scores, independent of study location and OHRQoL instrument used. Qualitative synthesis showed that all 9 studies investigating a possible relationship between number of occluding pairs of teeth present and OHRQoL reported significant positive correlations. Five studies presented separate data regarding OHRQoL and location of tooth loss (anterior tooth loss vs. posterior tooth loss). Four of these reported highest impact for anterior tooth loss; one study indicated a similar impact for both locations of tooth loss.
This study provides fairly strong evidence that tooth loss is associated with impairment of OHRQoL and location and distribution of tooth loss affect the severity of the impairment. This association seems to be independent from the OHRQoL instrument used and context of the included samples.
人们越来越认识到，在评估健康状况时，应考虑疾病对生活质量的影响。牙齿缺失（通常是口腔疾病的后果）很可能会影响口腔健康相关生活质量（OHRQoL）。本研究的目的是系统地回顾文献，并分析缺失牙的数量和位置与口腔健康相关生活质量（OHRQoL）之间的关系。我们假设牙齿缺失与 OHRQoL 的损害有关。其次，我们假设剩余牙齿的位置和分布在这方面起着重要作用。
使用广泛的搜索策略，在英语数据库中搜索了 1990 年至 2009 年 7 月期间发表的论文。两位独立的读者使用预定义的排除标准，首先根据摘要，其次根据全文论文选择相关论文。选择的研究根据使用的 OHRQoL 工具进行分组，并评估定量综合的可行性。可比结果进行荟萃分析；其余结果仅进行定性综合。
从总共 924 条参考文献中，有 35 条符合综合条件（摘要读者间一致性κ=0.84±0.03；全文：κ=0.68±0.06）。有 10 项研究报告了 13 个不同样本，有 6 项独立分析结果，可进行荟萃分析。所有研究均表明，牙齿缺失与不利的 OHRQoL 评分有关，与研究地点和使用的 OHRQoL 工具无关。定性综合表明，所有 9 项研究均表明，目前存在的牙合对数量与 OHRQoL 之间可能存在关系，均报告了显著的正相关。有 5 项研究分别提供了有关牙齿缺失位置（前牙缺失与后牙缺失）与 OHRQoL 的数据。其中 4 项研究报告了前牙缺失的影响最大；一项研究表明，两个位置的牙齿缺失的影响相似。
本研究提供了相当有力的证据，证明牙齿缺失与 OHRQoL 的损害有关，且牙齿缺失的位置和分布会影响损害的严重程度。这种关联似乎独立于使用的 OHRQoL 工具和纳入样本的背景。
