Olley R C, Renton T, Frost P M
Prosthodontics, University of Dundee, Dundee, UK.
KCL Dental Institute, London, UK.
J Oral Rehabil. 2017 Aug;44(8):610-616. doi: 10.1111/joor.12523. Epub 2017 Jun 14.
The shortened dental arch (SDA) provides a cost-effective dentition, considering the population is ageing and retaining teeth for longer. The aims were to observe the reasons and sites of tooth extraction and assess the functional dentition over 15 years in dental practice. Subjects were recruited who required permanent tooth extractions between 2000 and 2015. The reasons for extractions were chosen from twelve extraction codes. Data were also collected for demographics, tooth position, root treated teeth and functional pairs remaining. Patient-centred factors on reasons for tooth extraction and comments on chewing ability and aesthetics following extractions were recorded. Nine hundred and fifty-one teeth were extracted in 900 patients. The mean age was 60 years (SD 20, SE 7, 95% CI 46, 74). Reasons for extraction were periodontal disease (n = 361, 38%), periapical infection (n = 288, 34%) or tooth and tooth-root fractures (15%). Extractions included 201 (21%) second molars, 179 (19%) first molars, 152 (16%) second premolars, 95 (10%) first incisors, 86 (9%) second incisors, 76 (8%) canines and 67 (7%) first premolars. Following extractions, median functional pairs were 12, interquartile range (IQR) 19-7. Individuals with ≥10 functional pairs including anterior teeth (60%, n = 571) had no complaints with chewing ability or aesthetics. They did not require additional prostheses. Periodontal disease and periapical infection were the main causes for the extraction. First and second molars followed by second premolars were the most commonly extracted teeth. This study supports the SDA in creating a cost effective, functional dentition in an aging population, provided remaining teeth and restorations are preserved/maintained, oral health is promoted, and anterior aesthetic tooth replacement is ensured.
考虑到人口老龄化以及牙齿保留时间延长，短牙弓（SDA）提供了一种经济高效的牙列。本研究旨在观察拔牙原因和部位，并评估牙科实践中15年来的功能性牙列情况。招募了2000年至2015年间需要拔除恒牙的受试者。拔牙原因从12个拔牙编码中选取。还收集了人口统计学、牙齿位置、根管治疗牙齿以及剩余功能牙对的数据。记录了以患者为中心的拔牙原因因素以及拔牙后咀嚼能力和美观方面的评价。900名患者共拔除了951颗牙齿。平均年龄为60岁（标准差20，标准误7，95%可信区间46，74）。拔牙原因包括牙周病（n = 361，38%）、根尖感染（n = 288，34%）或牙齿及牙根骨折（15%）。拔牙包括201颗（21%）第二磨牙、179颗（19%）第一磨牙、152颗（16%）第二前磨牙、95颗（10%）第一切牙、86颗（9%）第二切牙、76颗（8%）尖牙和67颗（7%）第一前磨牙。拔牙后，功能牙对的中位数为12，四分位数间距（IQR）为19 - 7。拥有≥10对包括前牙的功能牙对的个体（60%，n = 571）在咀嚼能力或美观方面没有抱怨。他们不需要额外的修复体。牙周病和根尖感染是拔牙的主要原因。第一和第二磨牙，其次是第二前磨牙，是最常拔除的牙齿。本研究支持短牙弓在老年人群中创建具有成本效益的功能性牙列，前提是保留/维护剩余牙齿和修复体，并促进口腔健康，确保前牙的美观修复。
