Janket S J, Surakka M, Jones J A, Lam A, Schnell R A, Rose L M, Walls A W G, Meurman J H
Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, USA.
J Dent. 2013 Aug;41(8):740-6. doi: 10.1016/j.jdent.2013.05.009. Epub 2013 Jun 11.
In previous studies, increasing number of teeth predicted better survival and the acute needs for dental treatment predicted mortality. We sought to investigate whether restored dentitions by various removable dental prostheses impact cardiovascular (CVD) longevity.
Kuopio Oral Health and Heart study was initiated as a cross-sectional investigation with 256 subjects with diagnosed coronary artery disease [CAD] and 250 age- and sex-matched controls without CAD in 1995-1996. The mean age of both groups was 61, 30% were females. We appended mortality follow-up records to the baseline data and formulated this 15-year follow-up study. We examined the relationship between various types of dental prostheses and cardiovascular mortality by proportional hazard regression analyses. We also explored their correlation to oral and systemic inflammatory markers such as asymptotic dental score and C-reactive protein.
In a model adjusted for age, sex and smoking, groups having only natural teeth (NT), removable partial denture(s) [PD] and NT, a PD and a full denture [FD], and FD/FD or FD/NT demonstrated the following hazard ratios for mortality (95% confidence interval). NT both arches: 1.00 [reference]; PD and NT: 0.75 [0.22-2.56]; PD and FD: 1.99 [1.05-3.81]; and FD opposed by FD or NT: 1.71 [0.93-3.13], respectively [p for trend=0.05]. Although statistically not significant, those with PD and NT with mean a number of teeth [Nteeth] of 15.4 had better survival compared with those who had all NT [Nteeth=22.5]; while those who had FD and PD [Nteeth=6.5] had shorter longevity than those with FD/FD or FD/NT [Nteeth=3.5].
Although not all subgroups of dental prostheses reached significant relationship with CVD mortality, our study suggests that not only the number [quantity] of remaining teeth but their maintenance [quality] removing potential inflammatory foci, such as pericoronitis or retained root tips, may positively impact on cardiovascular survival.
在以往的研究中，牙齿数量增加预示着更好的生存率，而牙科治疗的迫切需求则预示着死亡率。我们试图研究各种可摘义齿修复的牙列是否会影响心血管疾病（CVD）的寿命。
1995 - 1996年，库奥皮奥口腔健康与心脏研究作为一项横断面调查启动，研究对象包括256名诊断为冠状动脉疾病（CAD）的受试者和250名年龄及性别匹配的无CAD对照者。两组的平均年龄均为61岁，女性占30%。我们将死亡率随访记录附加到基线数据中，并制定了这项为期15年的随访研究。我们通过比例风险回归分析研究了各种类型的义齿与心血管死亡率之间的关系。我们还探讨了它们与口腔和全身炎症标志物（如无症状牙评分和C反应蛋白）的相关性。
在对年龄、性别和吸烟进行校正的模型中，仅拥有天然牙（NT）、可摘局部义齿（PD）和NT、PD和全口义齿（FD）以及FD/FD或FD/NT的组，其死亡率的风险比（95%置信区间）如下。双侧NT：1.00（参考值）；PD和NT：0.75（0.22 - 2.56）；PD和FD：1.99（1.05 - 3.81）；FD与FD或NT相对：1.71（0.93 - 3.13），趋势p值 = 0.05。虽然在统计学上不显著，但平均牙齿数（Nteeth）为15.4的PD和NT组的生存率优于全为NT组（Nteeth = 22.5）；而拥有FD和PD组（Nteeth = 6.5）的寿命比FD/FD或FD/NT组（Nteeth = 3.5）短。
虽然并非所有义齿亚组与CVD死亡率都存在显著关系，但我们的研究表明，不仅剩余牙齿的数量（数量），而且其维护（质量），即消除潜在的炎症病灶，如冠周炎或保留的根尖，可能对心血管生存产生积极影响。
