Lichota D
Zakładu Stomatologii Zachowawczej, Pomorskiej Akademii Medycznej w Szczecinie.
Ann Acad Med Stetin. 1998;44:263-83.
The aim of the paper has been to provide objective data comparable to world literature, on the status of masticatory organ in the population of adults aged 35-44 years in Poland. As many as 1380 subjects were studied in 9 voivodeships with due consideration to three inhabited environments: big town, small town and village. The studies were performed in artificial lighting, using a probe and dental mirror, on the basis of methodology found in the WHO instruction of 1986 (Fig. 1.). The status of periodontium and the therapeutic requirements in that respect were assessed by resorting to CPITN index and WHO 621 periodontologic probe. The data concerning the status of dentition reveal a high frequency of caries, claiming 99.8%, as well as high intensity of caries expressed by mean number of DMF equal to 18.6. Despite the fact that the provided index values are comparable to values reached by the majority of developed countries, in case of Polish population aged 35-44 years there is, unlike those countries, very unfavourable distribution for components of D, M and F. The highest value (10.5) is requested by the mean number of missing teeth (M), by mean number of carious teeth (D) with 4.1, while, unfortunately, the lowest being the mean number of filled teeth (F), which is hardly 4.0. So high means of numbers for missing teeth and carious ones indicate that despite the low percentage of toothless subjects in the studied population (1.0%), it will be impossible to reach the 4th health target launched by WHO in the year 2000, it means a 50% reduction in the number of toothless subjects aged 35-44 years. It is evident from data concerning the status of dentition that in the oral cavity of each subject studied there were on the average 21 teeth whereof only 37.2% were made up of healthy teeth. The presence of healthy teeth was recorded more frequently in mandible than in maxilla and most frequently these were incisors and lower canines. Missing teeth (regardless of cause) were disclosed more frequently in maxilla than in mandible. The analysis of the missing teeth according to individual group of teeth reveals their very unfavourable distribution primarily in the lateral segments, it means in zone of support of the masticatory organ. That results in its far reaching consequences with regard to parodontial diseases and temporo-mandibular joints. The established results of studies covering parodontium disclose that it is unrealistic to achieve the 2nd periodontological target of health fixed by WHO for the year 2000, assuming that 75.0% of population aged 35-44 years should possess at least 3 healthy sextants, while deep periodontal pockets (6 mm) were detected in 15.0% of the examined subjects. The poor status of parodontal health is accompanied by colossal need of treatment in this respect. Almost 100% of subjects required instructions with regard to brushing as well as professional procedure in removing dental deposits, whereas 15.0% of the studied demanded specialistic periodontal treatment. The health status of parodontium and the therapeutic demands in this respect for Polish population are also unfavourable against the background of the population residing in the developed countries. The considerable dental losses revealed in the investigation exerted an influence on the prosthetic state of requirements closely related to the above finding. The analysis of data points to high percentages of persons not using removable dentures, particularly the lower ones. It was simultaneously noted that women were more frequent users of movable dentures both upper and lower. No therapeutic requirements involving the upper removable denture were evidenced in a higher percentage of the studied subjects than in the case of lower movable dentures. More persons asked for partial upper denture than lower. As concerns complete denture the situation is found to be reversed. It appears from the data concerning the temporo-mandible joints that in 70.6% of
本文旨在提供与世界文献可比的客观数据,以了解波兰35 - 44岁成年人咀嚼器官的状况。在9个省对多达1380名受试者进行了研究,充分考虑了三种居住环境:大城市、小镇和村庄。研究在人工照明下进行,使用探针和牙镜,依据1986年世界卫生组织指南中的方法(图1)。通过采用社区牙周指数(CPITN)和世界卫生组织621牙周探针评估牙周状况及相关治疗需求。关于牙列状况的数据显示,龋齿发生率很高,达99.8%,且以平均龋失补牙数(DMF)等于18.6表示的龋齿严重程度也很高。尽管所提供的指数值与大多数发达国家的数值相当,但对于波兰35 - 44岁的人群而言,与这些国家不同的是,龋失补牙(D、M和F)各组成部分的分布非常不利。平均缺失牙数(M)最高,为10.5,平均龋牙数(D)为4.1,而不幸的是,平均补牙数(F)最低,仅为4.0。如此高的缺失牙数和龋牙数意味着,尽管在所研究人群中无牙受试者的比例较低(1.0%),但要实现世界卫生组织在2000年提出的第四个健康目标,即35 - 44岁无牙受试者数量减少50%是不可能的。从牙列状况的数据可以明显看出,在所研究的每个受试者口腔中平均有21颗牙齿,其中只有37.2%是健康牙齿。在下颌比在上颌更常记录到健康牙齿的存在,且最常见的是切牙和下颌尖牙。上颌比下颌更常发现缺失牙(无论原因)。根据个别牙组对缺失牙进行的分析表明,它们的分布非常不利,主要集中在外侧段,即咀嚼器官的支持区域。这对牙周疾病和颞下颌关节产生了深远影响。关于牙周组织的研究既定结果表明,要实现世界卫生组织为2000年设定的第二个牙周健康目标是不现实的,该目标假设35 - 44岁的75.0%的人群应至少拥有3个健康的牙面,而在15.0%的受检受试者中检测到深度牙周袋(6毫米)。牙周健康状况不佳伴随着这方面巨大的治疗需求。几乎100%的受试者需要关于刷牙以及去除牙菌斑的专业程序的指导,而15.0%的研究对象需要专科牙周治疗。与发达国家的人群相比,波兰人群的牙周健康状况及其在这方面的治疗需求也很不利。调查中发现的大量牙齿缺失对与上述发现密切相关的修复需求状况产生了影响。数据分析表明,不使用可摘义齿的人群比例很高,尤其是下颌可摘义齿。同时注意到,女性上下颌可摘义齿的使用者更为频繁。在所研究的受试者中,对上颌可摘义齿无治疗需求的比例高于下颌可摘义齿。要求制作上颌局部义齿的人比下颌的多。至于全口义齿,情况则相反。从关于颞下颌关节的数据来看,在70.6%的……