Pahel B T, Vann W F, Divaris K, Rozier R G
1 Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.
2 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
J Dent Res. 2017 Sep;96(10):1115-1121. doi: 10.1177/0022034517716395. Epub 2017 Jun 23.
The emergence of first permanent molars (FPMs) and second permanent molars (SPMs) is an important developmental milestone influencing caries risk and the timing of sealant placement. Emergence times have been shown to vary by sex and race/ethnicity, while recent reports suggest a positive association with adiposity. Amid the changing demographics of the US population and the rising rates of pediatric overweight/obesity, we sought to examine the association of body mass index (BMI) with FPM/SPM emergence in a representative sample of US children and adolescents. We used cross-sectional data from 3 consecutive cycles of the National Health and Nutrition Examination Survey (2009 to 2014). The FPM analysis included ages 4 to 8 y ( n = 3,102 representing ~20 million children), and the SPM analysis included ages 9 to 13 y ( n = 2,774 representing ~19 million children/adolescents). The Centers for Disease Control and Prevention's growth chart data were used to calculate age- and sex-specific BMI percentiles, as measures of adiposity. Initial data analyses relied on descriptive statistics and stratified analyses. We used multivariate methods, including survey linear and ordinal logistic regression and marginal effects estimation to quantify the association between pediatric overweight/obesity and FPM/SPM emergence, adjusting for age, sex, and race/ethnicity. Forty-eight percent of 6-y-olds and 98% of 8-y-olds had all FPMs emerged, whereas SPM emergence varied more. Blacks (vs. whites) and females (vs. males) experienced earlier emergence of FPMs and SPMs. Overweight/obesity was associated with earlier FPM emergence, particularly among black females. Obesity but not overweight was associated with earlier SPM emergence. Overall, overweight/obesity accounted for 6 to 12 mo of dental acceleration. This study's results emanate from the most recent US-representative data and affirm that FPM/SPM emergence varies by race/ethnicity and sex and is positively influenced by BMI. Future research should further elucidate these associations with detailed eruption data and examine the implications of this variation for clinical care.
第一恒磨牙（FPMs）和第二恒磨牙（SPMs）的萌出是影响龋齿风险和窝沟封闭剂放置时机的重要发育里程碑。已有研究表明，萌出时间因性别和种族/族裔而异，而最近的报告显示其与肥胖呈正相关。在美国人口结构不断变化以及儿童超重/肥胖率不断上升的背景下，我们试图在美国儿童和青少年的代表性样本中研究体重指数（BMI）与FPM/SPM萌出之间的关联。我们使用了来自美国国家健康与营养检查调查（2009年至2014年）连续3个周期的横断面数据。FPM分析纳入了4至8岁的儿童（n = 3102，代表约2000万儿童），SPM分析纳入了9至13岁的儿童和青少年（n = 2774，代表约1900万儿童/青少年）。使用美国疾病控制与预防中心的生长图表数据来计算特定年龄和性别的BMI百分位数，作为肥胖程度的衡量指标。初始数据分析依赖于描述性统计和分层分析。我们使用了多变量方法，包括调查线性和有序逻辑回归以及边际效应估计，以量化儿童超重/肥胖与FPM/SPM萌出之间的关联，并对年龄、性别和种族/族裔进行了调整。6岁儿童中有48%、8岁儿童中有98%的FPM已全部萌出，而SPM的萌出差异更大。黑人（与白人相比）和女性（与男性相比）的FPM和SPM萌出更早。超重/肥胖与FPM更早萌出相关，尤其是在黑人女性中。肥胖而非超重与SPM更早萌出相关。总体而言，超重/肥胖导致牙齿萌出提前6至12个月。本研究结果源自最新的美国代表性数据，证实了FPM/SPM萌出因种族/族裔和性别而异，并受到BMI的正向影响。未来的研究应通过详细的萌出数据进一步阐明这些关联，并研究这种差异对临床护理的影响。
