Son Seung Hyun, Lee Sang-Woo, Chung Gehoon
Department of Oral Physiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
J Dent Sci. 2025 Jan;20(1):310-318. doi: 10.1016/j.jds.2024.07.006. Epub 2024 Jul 16.
BACKGROUND/PURPOSE: Chronic periodontitis and tooth loss contribute to cognitive decline. Since many biological processes are shared by loss of teeth and loss of pulps, this study investigated the potential association between loss of pulp and the development of dementia.
A retrospective cohort analysis was conducted to investigate the association between dental treatment and the development of dementia. The records of dental treatment during the 10 years prior to the first diagnosis of dementia were extracted from the Elderly Cohort Database of the National Health Information Sharing Service of Korea. The independence of dementia compared to the number of pulps or teeth removed was evaluated using the chi-squared test. The subjects were grouped by the number of teeth or pulps treated, and their odds ratio for dementia was calculated.
Analysis of 591,592 sessions for pulpectomy and 710,722 sessions for tooth extraction from 558,147 individuals revealed a significant association with Alzheimer's dementia, but not with vascular or unspecified dementia. The number of dementia patients based on the number of pulps or teeth extracted were significantly different across age groups. The odds ratios demonstrated a tendency to increase with the number of dental treatments and decrease with age at the time of diagnosis of dementia. The number of pulps removed to achieve a notable impact on Alzheimer's dementia was found to be lower than the number of teeth extracted.
The loss of pulp increased incidence of Alzheimer's dementia, with the impact being more pronounced in younger geriatric groups.
背景/目的:慢性牙周炎和牙齿缺失会导致认知能力下降。由于牙齿缺失和牙髓缺失存在许多共同的生物学过程,本研究调查了牙髓缺失与痴呆症发展之间的潜在关联。
进行了一项回顾性队列分析,以研究牙科治疗与痴呆症发展之间的关联。从韩国国家健康信息共享服务的老年队列数据库中提取首次诊断为痴呆症前10年的牙科治疗记录。使用卡方检验评估痴呆症与拔除的牙髓或牙齿数量之间的独立性。根据治疗的牙齿或牙髓数量对受试者进行分组,并计算他们患痴呆症的比值比。
对558,147名个体的591,592次牙髓摘除术和710,722次拔牙记录进行分析,结果显示与阿尔茨海默病痴呆症存在显著关联,但与血管性痴呆症或未明确类型的痴呆症无关。不同年龄组中,根据拔除的牙髓或牙齿数量划分的痴呆症患者数量存在显著差异。比值比显示出随着牙科治疗次数增加而升高,以及随着痴呆症诊断时年龄增加而降低的趋势。发现对阿尔茨海默病痴呆症产生显著影响所需拔除的牙髓数量低于拔牙数量。
牙髓缺失会增加阿尔茨海默病痴呆症的发病率,在年轻老年人群体中影响更为明显。