Wagner Tassiane P, Costa Ricardo S A, Rios Fernando S, Moura Mauricio S, Maltz Marisa, Jardim Juliana J, Haas Alex N
Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Community Dent Oral Epidemiol. 2016 Aug;44(4):390-9. doi: 10.1111/cdoe.12226. Epub 2016 Mar 8.
To assess the association between gingival recession (GR) and oral health-related quality of life (OHRQoL) in a Brazilian population of adults.
A representative sample from Porto Alegre city was drawn in 2011 using a multistage probability sampling strategy. For this study, 740 individuals, 35-59 years of age and with ≥6 teeth, were included. GR was assessed by two calibrated examiners at four sites in all present teeth. The Oral Health Impact Profile (OHIP-14) was used to assess OHRQoL. OHIP-14 was dichotomized using 'fairly often' as the cutoff point for a negative impact. Multiple logistic regression models were fitted to define which descriptors of GR were associated with the dichotomous outcome of OHIP-14, including dentine hypersensitivity in separate models, adjusting for age, gender, socioeconomic status, smoking, dental care, and missing teeth.
Mean OHIP was significantly higher for individuals with ≥1 tooth with GR ≥2, ≥3, ≥4, and ≥5 mm. Individuals with ≥1 tooth with GR ≥2 mm had approximately two times higher chance of having a negative impact than individuals without GR of this threshold [odds ratio (OR) = 1.99, 95% confidence interval (CI) 1.05-3.78]. When buccal and proximal sites were analyzed separately, the presence of GR was significantly associated with worst quality of life only in anterior and not in posterior teeth. GR in the lower arch had no impact on OHRQoL. GR ≥2 mm affected only physical pain (OR = 2.61; 95% CI 1.06-6.42), whereas GR ≥4 mm affected functional limitation, physical pain, psychological discomfort, physical and psychological disabilities, with ORs ranging from 1.43 to 1.91. Dentine hypersensitivity alone was not associated with OHRQoL, but it modified the association between GR and OHIP when present concomitantly with GR, mainly in buccal sites.
OHRQoL is poorer in this adult population in the presence of GR, mainly in upper and anterior teeth. Dentine hypersensitivity and esthetics were found to be factors linking GR to OHRQoL.
评估巴西成年人群中牙龈退缩(GR)与口腔健康相关生活质量(OHRQoL)之间的关联。
2011年采用多阶段概率抽样策略从阿雷格里港市抽取了一个代表性样本。本研究纳入了740名年龄在35至59岁之间且有≥6颗牙齿的个体。由两名经过校准的检查人员在所有现存牙齿的四个部位评估GR。使用口腔健康影响量表(OHIP - 14)评估OHRQoL。以“相当频繁”作为负面影响的临界点,将OHIP - 14进行二分法处理。拟合多个逻辑回归模型,以确定GR的哪些描述符与OHIP - 14的二分结果相关,在单独的模型中包括牙本质过敏,同时对年龄、性别、社会经济地位、吸烟、牙科护理和缺牙情况进行校正。
对于有≥1颗牙齿GR≥2、≥3、≥4和≥5毫米的个体,平均OHIP显著更高。有≥1颗牙齿GR≥2毫米的个体产生负面影响的几率比未达到该阈值的个体高出约两倍[优势比(OR)= 1.99,95%置信区间(CI)1.05 - 3.78]。当分别分析颊侧和邻面部位时,GR的存在仅在前牙而非后牙中与最差的生活质量显著相关。下牙弓的GR对OHRQoL没有影响。GR≥2毫米仅影响身体疼痛(OR = 2.61;95% CI 1.06 - 6.42),而GR≥4毫米影响功能受限、身体疼痛、心理不适、身体和心理残疾,OR范围为1.43至1.91。单独的牙本质过敏与OHRQoL无关,但当它与GR同时存在时,主要在颊侧部位,会改变GR与OHIP之间的关联。
在该成年人群体中,存在GR时OHRQoL较差,主要表现在上颌和前牙。牙本质过敏和美观被发现是将GR与OHRQoL联系起来的因素。