Ventä Irja, Kylätie Eeva, Hiltunen Kaija
Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, P.O. Box 41, 00014, Helsinki, Finland.
Clin Oral Investig. 2015 Nov;19(8):1785-9. doi: 10.1007/s00784-014-1395-y. Epub 2015 Jan 17.
The objective of this study was to clarify the discrepancy of pathology between earlier and recent studies related to third molars in the elderly persons. Evidence of third molars in the elders is limited. Earlier radiographic studies show rather few pathologic findings related to third molars. Recently, clinical studies have shown totally different numbers for pathology.
Participants were drawn from the population-based Helsinki Aging Study. The study included panoramic radiographs of 293 persons (mean age 79 years, SD ± 3.9 years). We examined the prevalence of third molars and associated pathology and used the chi-squared test to perform the statistical analysis.
Of the whole group of elderly persons, 19% had at least one third molar. The usual dental diseases, caries and periodontal pathology (80 and 33%, respectively), were common in the third molars. The surviving third molar most often appeared in the mandible (P < 0.01), in men (P < 0.05), in the mesioangular position (P < 0.05), and far from the mandibular canal (P < 0.001). Pathology was present in every third molar, although the proportion of serious pathology (i.e., cyst and tumor), accounted for only 2% of third molars.
Although serious pathology related to third molars in the elders is uncommon, universal biofilm diseases (caries and periodontal pathology) widely affect third molars as well as all other teeth.
Because all of the surviving third molars of the elders were diseased, it would be justifiable to extract these teeth at a younger age.
本研究的目的是阐明早期和近期关于老年人第三磨牙的研究在病理学方面的差异。老年人第三磨牙的相关证据有限。早期的影像学研究显示与第三磨牙相关的病理发现相当少。最近,临床研究显示的病理学数据则完全不同。
研究对象来自基于人群的赫尔辛基衰老研究。该研究纳入了293人的全景X线片(平均年龄79岁,标准差±3.9岁)。我们检查了第三磨牙的患病率及相关病理学情况,并使用卡方检验进行统计分析。
在整个老年人群体中,19%的人至少有一颗第三磨牙。常见的牙齿疾病,龋齿和牙周病变(分别为80%和33%),在第三磨牙中很常见。留存的第三磨牙最常出现在下颌骨(P<0.01)、男性(P<0.05)、近中角位(P<0.05),且远离下颌管(P<0.001)。每颗第三磨牙都存在病理学情况,尽管严重病理学情况(即囊肿和肿瘤)仅占第三磨牙的2%。
虽然老年人中与第三磨牙相关的严重病理学情况并不常见,但普遍的生物膜疾病(龋齿和牙周病变)同样广泛影响第三磨牙以及所有其他牙齿。
由于老年人留存的所有第三磨牙都有病变,在较年轻时拔除这些牙齿是合理的。