Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Campus Box 7450, Chapel Hill, NC 27599, USA.
J Am Dent Assoc. 2012 Jun;143(6):566-78. doi: 10.14219/jada.archive.2012.0235.
Tooth loss can be considered a failure of current oral health care strategies. Knowing how soon this failure will occur can help clinicians enhance preventive strategies for preventing tooth loss and minimizing its impact. The authors conducted a study to detail tooth survival patterns in an older cohort.
The authors conducted a retrospective longitudinal study of 491 participants aged 43 to 102 years. They treated the participants' dental conditions before they entered the study. They also collected participants' sociodemographic, medical, functional, cognitive and dental data when they first arrived at the clinic. The authors used Fisher exact tests, χ(2) tests and analysis of variance to examine the association between baseline characteristics and tooth survival. They generated Kaplan-Meier estimates and used Cox proportional hazards regression models to detail tooth survival and associated risk factors.
The authors found that tooth survival patterns differed among participants who had different numbers of carious teeth or retained roots (carious or broken teeth that were missing most of their coronal structures) when they first arrived at the clinic (P < .001) and between participants who wore removable prostheses and those who did not (P = .02). Participants' tooth loss at different times differed by sex, number of medications being taken and number of carious teeth or retained roots. The authors found that after they adjusted for other factors, tooth survival was associated with the number of carious teeth or retained roots (P = .01), as well as the interaction between the number of carious teeth or retained roots and use of prostheses (P = .02).
Caries and the use of removable prostheses synergistically compromised tooth survival in older patients. Patients who wore prostheses and had multiple active carious teeth or retained roots at arrival had the highest risk of losing teeth soon after their existing conditions were treated.
These findings highlight the need for preventing tooth loss in older adults who wear removable prostheses and have poor oral health. Knowing the groups at the highest risk of experiencing tooth loss soon after dental treatment is received can help dentists better target and design preventive strategies.
牙齿缺失可被视为当前口腔保健策略的失败。了解这种失败会多快发生，可以帮助临床医生加强预防策略，以防止牙齿缺失并将其影响降到最低。作者进行了一项研究，详细描述了老年人群中牙齿的存活模式。
作者对 491 名年龄在 43 岁至 102 岁的参与者进行了回顾性纵向研究。他们在参与者进入研究前治疗了他们的牙齿状况。他们还在参与者首次到诊所就诊时收集了参与者的社会人口学、医学、功能、认知和牙科数据。作者使用 Fisher 确切检验、χ(2)检验和方差分析来检查基线特征与牙齿存活之间的关系。他们生成 Kaplan-Meier 估计值，并使用 Cox 比例风险回归模型详细描述牙齿存活及其相关危险因素。
作者发现，在首次就诊时具有不同数量龋齿或残根（缺失大部分冠部结构的龋齿或破损牙齿）的参与者之间，以及佩戴可摘义齿的参与者与不佩戴的参与者之间，牙齿存活模式存在差异（P<0.001）。不同时间参与者的牙齿缺失情况因性别、服用药物的数量以及龋齿或残根的数量而异。作者发现，在调整其他因素后，牙齿存活与龋齿或残根的数量有关（P=0.01），以及龋齿或残根的数量与义齿使用之间的相互作用（P=0.02）。
龋齿和可摘义齿的使用协同损害了老年患者的牙齿存活。在接受现有治疗后不久就出现牙齿缺失风险最高的是佩戴义齿且有多个活跃龋齿或残根的患者。
这些发现强调了需要预防佩戴可摘义齿且口腔健康状况不佳的老年患者牙齿缺失。了解在接受牙科治疗后不久经历牙齿缺失风险最高的群体，可以帮助牙医更好地针对和设计预防策略。
