Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata City, Niigata, Japan.
Community Dent Oral Epidemiol. 2012 Apr;40(2):154-63. doi: 10.1111/j.1600-0528.2011.00648.x. Epub 2011 Nov 1.
To appropriately explore risk factors for tooth loss operating at the tooth-level, subject-related factors and a hierarchical data structure have to be considered. The purpose of this study was to evaluate tooth-related and subject-related risk factors affecting tooth loss.
A 10-year longitudinal survey was carried out on 286 elderly subjects. At baseline, the prosthodontic status and abutment function of the 5574 teeth were recorded. Tooth loss was defined as the main outcome variable, and a multilevel logistic regression model considering subject and tooth levels was applied.
Tooth loss was found in 75% of subjects and most frequently in molars. A multivariable, multilevel logistic regression revealed that the following tooth-related variables were significantly related to tooth loss over 10 years: maxillary teeth, multirooted teeth, single crowns, abutment teeth for a fixed/removable partial denture (FPD/RPD), and periodontally involved teeth. Among them, single crowns, abutment teeth for an FPD, and teeth with severe periodontal disease at baseline had the highest odds of 5.1, 6.0, and 7.1, respectively.
The findings of this study suggest that tooth loss is the result of complex interactions of tooth-related factors. Several tooth-related variables including multirooted teeth, abutments, and single crowns were found to be possible risk factors for tooth loss. Thus, these findings confirm and underline the potential benefit of minimizing prosthetic treatment of molars.
要恰当地探讨在牙级别上起作用的牙齿缺失的风险因素，必须考虑与个体相关的因素和分层数据结构。本研究的目的是评估影响牙齿缺失的与牙齿相关的和与个体相关的风险因素。
对 286 名老年受试者进行了为期 10 年的纵向研究。在基线时，记录了 5574 颗牙齿的修复体状况和基牙功能。牙齿缺失被定义为主要结局变量，并应用了考虑个体和牙齿水平的多级逻辑回归模型。
75%的受试者出现了牙齿缺失，且最常发生在磨牙。多变量、多级逻辑回归显示，以下与牙齿相关的变量与 10 年内的牙齿缺失显著相关：上颌牙齿、多根牙、单冠、固定/可摘局部义齿（FPD/RPD）的基牙、牙周病受累牙。其中，单冠、FPD 的基牙和基线时患有严重牙周病的牙齿的优势比最高，分别为 5.1、6.0 和 7.1。
本研究的结果表明，牙齿缺失是牙齿相关因素复杂相互作用的结果。一些与牙齿相关的变量，包括多根牙、基牙和单冠，被认为是牙齿缺失的可能风险因素。因此，这些发现证实并强调了尽量减少磨牙修复治疗的潜在益处。
