Using machine learning algorithms to investigate factors associated with complete edentulism among older adults in the United States.

AIMS: Edentulism is an incapacitating condition, and its prevalence is unequal among different population groups in the United States (US) despite its declining prevalence. This study aimed to investigate the current prevalence, apply Machine Learning (ML) Algorithms to investigate factors associated with complete tooth loss among older US adults, and compare the performance of the models. METHODS: The cross-sectional 2020 Behavioral Risk Factor Surveillance System (BRFSS) data was used to evaluate the prevalence and factors associated with edentulism. ML models were developed to identify factors associated with edentulism utilizing seven ML algorithms. The performance of these models was compared using the area under the receiver operating characteristic curve (AUC). RESULTS: An overall prevalence of 11.9% was reported. The AdaBoost algorithm (AUC = 84.9%) showed the best performance. Analysis showed that the last dental visit, educational attainment, smoking, difficulty walking, and general health status were among the top factors associated with complete edentulism. CONCLUSION: Findings from our study support the declining prevalence of complete edentulism in older adults in the US and show that it is possible to develop a high-performing ML model to investigate the most important factors associated with edentulism using nationally representative data.

Modelling time-varying risk factors of tooth loss: Results from joint model compared with extended Cox regression model.

AIM: To illustrate the use of joint models (JMs) for longitudinal and survival data in estimating risk factors of tooth loss as a function of time-varying endogenous periodontal biomarkers (probing pocket depth [PPD], alveolar bone loss [ABL] and mobility [MOB]). MATERIALS AND METHODS: We used data from the Veterans Affairs Dental Longitudinal Study, a longitudinal cohort study of over 30 years of follow-up. We compared the results from the JM with those from the extended Cox regression model which assumes that the time-varying covariates are exogenous. RESULTS: Our results showed that PPD is an important risk factor of tooth loss, but each model produced different estimates of the hazard. In the tooth-level analysis, based on the JM, the hazard of tooth loss increased by 4.57 (95% confidence interval [CI]: 2.13-8.50) times for a 1-mm increase in maximum PPD, whereas based on the extended Cox model, the hazard of tooth loss increased by 1.60 (95% CI: 1.37-1.87) times. CONCLUSIONS: JMs can incorporate time-varying periodontal biomarkers to estimate the hazard of tooth loss. As JMs are not commonly used in oral health research, we provide a comprehensive set of R codes and an example dataset to implement the method.

The role of differential exposure and susceptibility to heavy drinking linking income inequalities and tooth loss: An investigation of the alcohol harm paradox using a four-way decomposition analysis.

OBJECTIVES: To examine the extent to which the effect of income inequalities on tooth loss is attributable to differential exposure and susceptibility to heavy drinking in older Brazilian adults. METHODS: We conducted a secondary analysis using data from The Brazilian Longitudinal Study of Ageing (ELSI-Brazil 2015-2016), a nationally representative sample of community-dwelling people aged 50 years and over. Causal mediation analysis based on the counterfactual outcome framework decomposed the effect of income on tooth loss mediated by heavy drinking into four components (four-way decomposition): controlled direct effect (neither mediation nor interaction), reference interaction (interaction only), mediated interaction (both mediation and interaction) and pure indirect effect (mediation only). Proportions of effect attributable to each component were calculated to estimate the differential exposure (the sum of the third and fourth components) and differential susceptibility (the sum of the second and third components) to heavy drinking. RESULTS: The analytical sample comprised 8114 participants. After adjusting for covariates, 7.3% (95% CI: 3.8%; 10.9%) and -39.5% (95% CI: -75.8%; -3.3%) of the effects of income on tooth loss were attributable to differential exposure and susceptibility to heavy drinking, respectively, consistent with the alcohol harm paradox. When setting non-functional dentition as outcome, only the effect of differential susceptibility remained (-81.7% [95% CI: -128.2%; -35.2%]). CONCLUSION: Our findings suggest that individuals of low-income groups appear to be more susceptible to the effects of heavy drinking on tooth loss.

Association between toothbrushing frequency and dental caries and tooth loss in adolescents: a cohort study.

This cohort study assessed the association between toothbrushing frequency and the increment of dental caries and tooth loss in a population-based sample of southern Brazilian adolescents, to investigate whether there is any additional benefit in performing a third daily brushing. At baseline, 1,528 12-year-old schoolchildren attending 42 schools were examined for gingivitis and dental caries, and answered a questionnaire. After a mean period of 2.5 years, 801 schoolchildren were re-examined. Dental caries and tooth loss increment were outcomes of the study. The main predictor variable was toothbrushing frequency (≥3 times/day vs. twice/day or ≤1 time/day). Poisson regression models were used to estimate the risk for caries and tooth loss increment. Incidence risk ratios (IRR) and 95% confidence intervals (CI) were estimated. The final model adjusted for sociodemographic, behavioral, and clinical variables showed that brushing twice/day afforded 40% greater risk (IRR = 1.40; 95%CI: 1.02-1.92) for caries increment than ≥3 times/day. Regarding the tooth loss increment, adolescents who brushed their teeth twice/day had a fourfold greater risk (IRR = 3.92; 95%CI: 1.23-12.49) than those who brushed ≥ 3 times/day. Sex, school type, and gingivitis were found to act as effect modifiers, inasmuch as a third daily brushing presented advantages against tooth loss only for girls, public school attendees, and those with ≥ 50% of bleeding sites. This study suggests that adolescents benefit from a third daily toothbrushing. Increasing brushing frequency to 3 times/day may be a suitable strategy to control dental caries and tooth loss among high-risk adolescents.

Prevalence of stable and successfully treated periodontitis subjects and incidence of subsequent tooth loss within supportive periodontal care: A systematic review with meta-analyses.

AIM: To identify (i) the prevalence of meeting the endpoints of 'stable periodontitis' (probing pocket depth [PPD] ≤ 4 mm, bleeding on probing [BoP] < 10%, no BoP at 4 mm sites), 'endpoints of therapy' (no PPD > 4 mm with BoP, no PPD ≥ 6 mm), 'controlled periodontitis' (≤4 sites with PPD ≥ 5 mm), 'PPD < 5 mm' and 'PPD < 6 mm' at the start of supportive periodontal care [SPC]) and (ii) the incidence of tooth loss in relation to not meeting these endpoints within a minimum of 5 years of SPC. MATERIALS AND METHODS: Systematic electronic and manual searches were conducted to identify studies where subjects, upon completion of active periodontal therapy, entered into SPC. Duplicate screening was performed to find relevant articles. Corresponding authors were contacted to confirm inclusion and retrieve required clinical data for further analyses to assess the prevalence of reaching endpoints and incidence of subsequent tooth loss, if available, within at least 5 years of SPC. Meta-analyses were carried out to evaluate risk ratios for tooth loss in relation to not reaching the various endpoints. RESULTS: Fifteen studies including 12,884 patients and 323,111 teeth were retrieved. Achievement of endpoints at baseline SPC was rare (1.35%, 11.00% and 34.62%, respectively, for 'stable periodontitis', 'endpoints of therapy' and 'controlled periodontitis'). Less than a third of the 1190 subjects with 5 years of SPC data lost teeth-a total of 3.14% of all teeth were lost. Statistically significant associations with tooth loss, at the subject-level, were found for not achieving 'controlled periodontitis' (relative risk [RR] = 2.57), PPD < 5 mm (RR = 1.59) and PPD < 6 mm (RR = 1.98). CONCLUSIONS: An overwhelming majority of subjects and teeth do not achieve the proposed endpoints for periodontal stability, yet most periodontal patients preserve most of their teeth during an average of 10-13 years in SPC.

The risk of healing complications in primary teeth with root fractures: A retrospective cohort study.

BACKGROUND/AIM: Primary teeth are frequently affected by traumatic dental injuries. Root fractures are rare and have a reported incidence of 2% in the primary dentition. Hence, there is limited evidence on this topic. This study aims to evaluate the risk of healing complications in primary teeth with root fracture and to identify possible sequelae in the permanent dentition following root fracture in the primary dentition. MATERIALS AND METHODS: A retrospective analysis of a cohort of 53 patients with 74 root fractured primary teeth. The standard follow-up program included clinical and radiographic examination after 4 weeks, 8 weeks, 6 months, and 1 year after the trauma and when the patient was 6 years of age. The following complications were registered: pulp necrosis (PN), pulp canal obliteration (PCO), ankylosis with replacement root resorption (ARR), infection-related root resorption (IRR), premature tooth loss (PTL), and repair-related resorption (RRR). STATISTICS: The Kaplan-Meier and Aalen-Johansen estimators were employed. The level of significance was 5%. RESULTS: A total of 74 teeth were included. 42 teeth were extracted at the initial examination. Risks estimated after 3 years: PTL 45.9% [95% CI: 28.8-63.0], PCO 12.9% [95% CI: 2.3-23.4], PN 14.9% [95% CI: 3.9-25.9], RRR 2.6% [95% CI: 0.0-7.5]. No teeth showed ARR or IRR. All complications were diagnosed within the first year. Most common sequelae in the permanent dentition was demarcated opacities, with an estimated risk of 20% [95% CI: 8.2-41.3]. CONCLUSIONS: There is a low risk of healing complications following a root fracture in the primary dentition. Root fractures often result in early extraction of the coronal fragment. The remaining apical fragment will undergo a physiological resorption. Aside from opacities, there is a low risk of sequelae in the permanent dentition.

Tooth-level predictors of tooth loss and exposed bone after radiation therapy for head and neck cancer.

BACKGROUND: The objective of this study was to identify tooth-level risk factors for use during preradiation dental care management to predict risk of tooth failure (tooth lost or declared hopeless) and exposed bone after radiation therapy (RT) for head and neck cancer (HNC). METHODS: The authors conducted a prospective observational multicenter cohort study of 572 patients receiving RT for HNC. Participants were examined by calibrated examiners before RT and then every 6 months until 2 years after RT. Analyses considered time to tooth failure and chance of exposed bone at a tooth location. RESULTS: The following pre-RT characteristics predicted tooth failure within 2 years after RT: hopeless teeth not extracted pre-RT (hazard ratio [HR], 17.1; P < .0001), untreated caries (HR, 5.0; P < .0001), periodontal pocket 6 mm or greater (HR, 3.4; P = .001) or equaling 5 mm (HR, 2.2; P = .006), recession over 2 mm (HR, 2.8; P = .002), furcation score of 2 (HR, 3.3; P = .003), and any mobility (HR, 2.2; P = .008). The following pre-RT characteristics predicted occurrence of exposed bone at a tooth location: hopeless teeth not extracted before RT (risk ratio [RR], 18.7; P = .0002) and pocket depth 6 mm or greater (RR, 5.4; P = .003) or equaling 5 mm (RR, 4.7; P = .016). Participants with exposed bone at the site of a pre-RT dental extraction averaged 19.6 days between extraction and start of RT compared with 26.2 days for participants without exposed bone (P = .21). CONCLUSIONS: Individual teeth with the risk factors identified in this study should be considered for extraction before RT for HNC, with adequate healing time before start of RT. PRACTICAL IMPLICATIONS: The findings of this trial will facilitate evidence-based dental management of the care of patients receiving RT for HNC. This clinical trial was registered at Clinicaltrials.gov. The registration number is NCT02057510.

Tooth Loss as a Predictor of Postoperative Complications and Prognosis in Patients with Colorectal Cancer.

PURPOSE: We hypothesized that preoperative tooth loss could predict general health conditions, including inflammation, postoperative complications (POCs), and overall survival (OS), in patients with colorectal cancer (CRC) and other gastrointestinal cancers. METHODS: Data of patients who underwent curative surgical resection for CRC during 2017-2021 at our hospital were retrieved. The primary outcomes were POCs, whereas the secondary endpoint was OS. According to the Japanese database, patients within each age range with more than the age-adjusted average number of teeth were classified as the Oral N (normal) group, whereas those with less than the age-adjusted average number of teeth were classified as the Oral A (abnormal) group. The relationship between tooth loss and POCs was assessed using a logistic regression model. RESULTS: Overall, 146 patients were enrolled, with 68 (46.6%) and 78 (53.4%) patients in the Oral N and A groups, respectively. In the multivariate analysis, the Oral A group was an independent risk factor for POCs [hazard ratio (HR), 5.89; 95% confidence interval (CI), 1.81-19.1; p < 0.01]. Similarly, univariate analysis revealed that the Oral A group tended to be associated with OS (HR, 4.57; 95% CI, 0.99-21.2; p = 0.052), but the association was not statistically significant. CONCLUSION: In CRC patients who underwent curative resection, tooth loss was a predictor of POCs. Although further investigations are needed, our results support the use of tooth loss as a simple and essential preoperative evaluation system.

Smoking, Serum Albumin and 25-hydroxy Vitamin D Levels, and Bone Mineral Density Are Associated with Tooth Loss in Patients with Rheumatoid Arthritis.

Objectives This study investigated factors associated with tooth loss in patients with rheumatoid arthritis (RA). Methods A total of 429 patients with RA were enrolled in the study. We examined tooth loss and clinical data. Patients were classified into two groups: a group with tooth loss (tooth loss-positive group), and a group without tooth loss (tooth loss-negative group). Patients were included in the tooth loss-positive group if they had fewer remaining teeth than the number defined by the Ministry of Health, Labour and Welfare in Japan to be the normal number teeth for that age and sex. Factors associated with tooth loss were analyzed by comparing the tooth loss-positive and loss-negative groups. Results The frequency of patients with tooth loss was 39.6%. The factors associated with tooth loss were smoking [odds ratio (OR) 1.638; 95% confidence interval (CI) 1.165-2.302], serum levels of albumin (OR 0.325; 95% CI 0.149-0.707) and 25-hydroxy vitamin D (OR 0.947; 95% CI 0.915-0.980), and total hip T score (OR 0.713; 95% CI 0.535-0.950). Conclusion This study revealed that tooth loss is associated with smoking, serum levels of albumin and 25-hydroxy vitamin D, and the total hip T score in patients with RA. Our findings may help prevent tooth loss in patients with RA.

Longevity of teeth in patients susceptible to periodontitis: Clinical outcomes and risk factors associated with tooth loss after active therapy and 30 years of supportive periodontal care.

AIM: (i) To evaluate the efficacy of active periodontal therapy supplemented by supportive periodontal care (SPC) in retaining dentition during a 30-year follow-up period in patients susceptible to periodontitis, and (ii) to assess the prognostic factors associated with tooth loss. MATERIALS AND METHODS: One-hundred and fifty-four patients with periodontitis, retrospectively classified as stage I-IV and grade B-C periodontitis, treated between 1984 and 1986 in a private practice, were enrolled in this study. After periodontal assessment, patients received non-surgical treatment followed by surgical periodontal therapy, orthodontic treatment, and tooth-splinting, where appropriate. SPC consisted of a strict recall programme every 3-6 months over a 30-year period. Recurrences were treated either with subgingival root planing or flap surgery. Dental and periodontal variables were measured at baseline (T0), end of active therapy (T1), and after 25 (T2) and 30 (T3) years. Generalized mixed models were analysed to assess the prognostic factors associated with and survival analyses for tooth loss. RESULTS: Data on 154 patients (4083 teeth) were available at baseline (T0). Teeth considered unworthy of treatment were extracted during active therapy (160, 3.9%) and at re-assessment (13, 0.3%; T1). After 25 years of SPC, 140 teeth out of 3910 in 154 patients (3.6%) were lost (24 in 18 patients for periodontal reasons). Between 25 and 30 years, 20 patients (482 teeth) dropped out, and 61 teeth (2%) were lost (15 in 14 patients for periodontal reasons). Overall, 201 teeth (5.1%) were lost (39 for periodontal reasons) in 30 years of SPC. Generalized mixed models showed that stage III or stage IV periodontitis was associated with greater tooth loss during SPC compared to stage I or stage II (OR = 2.10; p = .048). Generalized periodontitis showed a statistically significant OR = 3.24 (p = .016) compared to the localized one. In SPC (T1-T3), age (p = .011), gender (male; p = .038), molar teeth (p = < .001), T0 and T1 pocket depth (p = < .001), tooth mobility grades 2 (p = .018) and 3 (p = .050), T0 and T1 bone loss (p = < .001), and presence of a root canal treatment (p = < .001) and a crown (p = .009) were statistically significantly associated with tooth loss. CONCLUSION: (i) Periodontal therapy and a stringent SPC are effective in maintaining most of the teeth in patients with moderate/advanced periodontitis for 30 years, and (ii) age, gender, molar teeth, pocket depth, bone loss, and the presence of a root canal treatment and a crown are prognostic factors associated with tooth loss.

[Multivariable analysis of tooth loss in subjects with severe periodontitis over 4-year natural progression].

OBJECTIVE: To evaluate the characteristics of severe periodontitis with various number of tooth loss during 4-year natural progression, and to analyze the factors related to higher rate of tooth loss. METHODS: A total of 217 patients aged 15 to 44 years with severe periodontitis were included, who participated in a 4-year natural progression research. Data obtained from questionnaire survey, clinical examination and radiographic measurement. Tooth loss during 4-year natural progression was evaluated. The baseline periodontal disease related and caries related factors were calculated, including number of teeth with bone loss > 50%, number of missing molars, number of teeth with widened periodontal ligament space (WPDL), number of teeth with periapical lesions and etc. Characteristics of populations with various number of tooth loss and the related factors that affected higher rate of tooth loss were analyzed. RESULTS: In 4 years of natural progression, 103 teeth were lost, and annual tooth loss per person was 0.12±0.38. Nine patients lost 3 or more teeth. Thirty-four patients lost 1 or 2 teeth, and 174 patients were absent of tooth loss. Molars were mostly frequent to lose, and canines presented a minimum loss. The number of teeth with WPDL, with periapical lesions, with intrabony defects, with probing depth (PD)≥7 mm, with PD≥5 mm, with clinical attachment loss≥5 mm, with bone loss > 50% and with bone loss > 65% were positively correlated to number of tooth loss. Results from orderly multivariate Logistic regression showd that the number of teeth with bone loss > 50% OR=1.550), baseline number of molars lost (OR=1.774), number of teeth with WPDL (1 to 2: OR=1.415; ≥3: OR=13.105), number of teeth with periapical lesions (1 to 2: OR=4.393; ≥3: OR=9.526) and number of teeth with caries/residual roots (OR=3.028) were significant risk factors related to higher likelihood of tooth loss and multiple tooth loss. CONCLUSION: In 4 years of natural progression, the number of teeth with bone loss > 50%, baseline number of missing molars, number of teeth with WPDL, baseline number of teeth with periapical lesions and number of teeth with caries/residual roots were significantly related to higher risk of tooth loss and multiple tooth loss among Chinese young and middle-aged patients with severe periodontitis in rural areas.

Risk factors for tooth loss and progression of periodontitis in patients undergoing periodontal maintenance therapy.

AIM: The aim of this study was to investigate patient- and tooth-level factors that may predict tooth loss and periodontitis progression in patients who have undergone at least 5 years of periodontal maintenance. MATERIALS AND METHODS: In this retrospective cohort study, 135 patients were examined after active periodontal therapy (APT) and periodontal maintenance for 5.09-8.65 years (mean 6.16 ± 0.74 years). Regression models were applied to identify risk factors associated with tooth loss and disease progression. RESULTS: Stage IV periodontitis (incidence rate ratio [IRR] = 4.61; 95% confidence interval, CI [2.97-7.18], p < .001), the presence of ≥5 sites with probing pocket depth (PPD) ≥5 mm at the end of APT (IRR = 2.04; 95% CI [1.32-3.20], p < .01), and residual PPD ≥7 mm at the end of APT (odds ratio [OR] = 3.01; 95% CI [1.14-7.94], p < .05) were risk factors for tooth loss. Residual PPDs of 5 mm (OR = 2.02; 95% CI [1.20-3.40], p < .01) and 6 mm (OR = 2.41; 95% CI [1.22-4.76], p < .05) at the end of APT were risk factors for disease progression. Above 3 mm, each 1 mm increase in maximum PPD/clinical attachment loss was associated with an increased risk of tooth loss and disease progression. CONCLUSIONS: Stage IV periodontitis is associated with an increased risk of tooth loss. Teeth with PPD ≥5 mm at the end of APT are at risk of periodontitis progression or tooth loss.

Caries, periodontitis and tooth loss after haematopoietic stem cell transplantation: A systematic review.

OBJECTIVE: A systematic review was conducted to assess scientific knowledge concerning the effect of haematopoietic stem cell transplantation (HSCT) on the occurrence of caries, periodontal conditions and tooth loss, and to evaluate the prevalence of these diseases in adult HSCT survivors (PROSPERO 152906). METHODS: PubMed and Embase were searched for papers, published from January 2000 until November 2020 without language restriction, assessing prevalence, incidence or parameters of caries, periodontal conditions and tooth loss in HSCT recipients (≥80% transplanted in adulthood). Bias risk was assessed with checklists from Joanna Briggs Institute, and data synthesis was performed by narrative summary. RESULTS: Eighteen papers were included (1618 subjects). Half were considered at high risk of bias. Longitudinal studies did not show caries progression, decline in periodontal health or tooth loss after HSCT. The prevalence in HSCT survivors ranged from 19% to 43% for caries, 11% to 67% for periodontitis, and 2% to 5% for edentulism. Certainty in the body of evidence was very low. CONCLUSIONS: Haematopoietic stem cell transplantation, on the short term, may have little to no effect on caries, periodontal conditions and tooth loss. Caries and periodontitis may be more common in HSCT survivors compared with the general population, whereas edentulism may be comparable. However, the evidence for all conclusions is very uncertain.

Multivariable analysis of tooth loss in subjects with severe periodontitis over 4-year natural progression / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the characteristics of severe periodontitis with various number of tooth loss during 4-year natural progression, and to analyze the factors related to higher rate of tooth loss.@*METHODS@#A total of 217 patients aged 15 to 44 years with severe periodontitis were included, who participated in a 4-year natural progression research. Data obtained from questionnaire survey, clinical examination and radiographic measurement. Tooth loss during 4-year natural progression was evaluated. The baseline periodontal disease related and caries related factors were calculated, including number of teeth with bone loss > 50%, number of missing molars, number of teeth with widened periodontal ligament space (WPDL), number of teeth with periapical lesions and etc. Characteristics of populations with various number of tooth loss and the related factors that affected higher rate of tooth loss were analyzed.@*RESULTS@#In 4 years of natural progression, 103 teeth were lost, and annual tooth loss per person was 0.12±0.38. Nine patients lost 3 or more teeth. Thirty-four patients lost 1 or 2 teeth, and 174 patients were absent of tooth loss. Molars were mostly frequent to lose, and canines presented a minimum loss. The number of teeth with WPDL, with periapical lesions, with intrabony defects, with probing depth (PD)≥7 mm, with PD≥5 mm, with clinical attachment loss≥5 mm, with bone loss > 50% and with bone loss > 65% were positively correlated to number of tooth loss. Results from orderly multivariate Logistic regression showd that the number of teeth with bone loss > 50% OR=1.550), baseline number of molars lost (OR=1.774), number of teeth with WPDL (1 to 2: OR=1.415; ≥3: OR=13.105), number of teeth with periapical lesions (1 to 2: OR=4.393; ≥3: OR=9.526) and number of teeth with caries/residual roots (OR=3.028) were significant risk factors related to higher likelihood of tooth loss and multiple tooth loss.@*CONCLUSION@#In 4 years of natural progression, the number of teeth with bone loss > 50%, baseline number of missing molars, number of teeth with WPDL, baseline number of teeth with periapical lesions and number of teeth with caries/residual roots were significantly related to higher risk of tooth loss and multiple tooth loss among Chinese young and middle-aged patients with severe periodontitis in rural areas.

Tooth Loss: The Nigerian Experience - A Narrative Review.

BACKGROUND: Tooth loss is an irreversible condition and it is an indicator of overall dental health. Tooth loss impairs speech, aesthetics, mastication, and deglutition, affecting an individual's oral health related quality of life. This study aimed to review the pattern of tooth loss in Nigerians over a forty-one-year period. MATERIALS AND METHODS: A literature search for articles on tooth loss and related subjects was performed on databases (NICB PubMed, Medline and Cochrane). Keywords used for the search included "tooth loss" and "Nigeria' as well as partial edentulousness, partial denture, implant and prosthodontics. The articles included were studies published between 1972 and 2019, written in English language and involving human subjects. A self-developed proforma was used to extract clinical and demographic data from the articles. RESULTS: All the studies assessed were observational. Most studies were conducted in tertiary hospitals. There was a marginal difference in the prevalence of tooth loss between males and females. The mean age of persons presenting in hospitals across Nigeria for extraction of their teeth was identical across several studies. Most of the studies reported the molars as the teeth most frequently lost. CONCLUSION: In younger adults, tooth loss was more common in 20-29-year-old subjects, while among the elderly it peaked in the 60-70-year-old group. Dental caries was the predominant cause of tooth loss over the years. Community based studies may provide more accurate information on the extent of tooth loss in Nigerians.

CONTEXTE: La perte de dents est un état irréversible et un indicateur de la santé dentaire globale. La perte de dents nuit à l'élocution, à l'esthétique, à la mastication et à la déglutition, affectant ainsi la qualité de vie d'un individu liée à sa santé bucco-dentaire. Cette étude avait pour but d'examiner le profil de la perte de dents chez les Nigérians sur une période de quarante et un ans. MATÉRIEL ET MÉTHODES: Une recherche documentaire d'articles sur la perte de dents et les sujets connexes a été effectuée sur des bases de données (NICB PubMed, Medline et Cochrane). Les motsclés utilisés pour la recherche comprenaient "perte de dents" et "Nigeria" ainsi que édentation partielle, prothèse partielle, implant et prosthodontie. Les articles inclus étaient des études publiées entre 1972 et 2019, rédigées en langue anglaise et impliquant des sujets humains. Un proforma auto-développé a été utilisé pour extraire les données cliniques et démographiques des articles. RÉSULTATS: Toutes les études évaluées étaient observationnelles. La plupart des études ont été menées dans des hôpitaux tertiaires. Il y avait une différence marginale dans la prévalence de la perte de dents entre les hommes et les femmes. L'âge moyen des personnes se présentant dans les hôpitaux du Nigeria pour l'extraction de leurs dents était identique dans plusieurs études. La plupart des études ont indiqué que les molaires étaient les dents les plus fréquemment perdues. CONCLUSION: Chez les jeunes adultes, la perte de dents était plus fréquente chez les sujets âgés de 20 à 29 ans, tandis que chez les personnes âgées, elle atteignait un pic dans le groupe des 60-70 ans. Les caries dentaires étaient la cause prédominante de la perte de dents au fil des ans. Des études communautaires pourraient fournir des informations plus précises sur l'étendue de la perte de dents chez les Nigérians. Mots clés: Perte de dents, Édentation, Prévalence, Nigeria.

Traumatized teeth: clinical practice guideline for the interim management of teeth with various poor prognosis scenarios in growing patients.

OBJECTIVES: Many treatment options accepted for unsalvageable traumatized teeth in adults would seem contraindicated in children and adolescents. Instead, growing patients need interim restorative measures, thus extensively preserving their local bone and soft tissue structures and, ideally, preparing the involved site for later definitive restoration while they transform to skeletal maturity. This narrative topic review addresses the interim management in case of very deep intra-extra-alveolar fractures, extensive infection-related root resorption, tooth ankylosis, and anterior tooth loss in growing patients, and seeks to empower the clinician to select the appropriate treatment approach. DATA SOURCES: The literature up to 2021 was reviewed based on several scoping searches on PubMed and the Cochrane Library using relevant terms. Due to the complexity of the topic (with various poor prognosis scenarios and the differing therapeutic options), a systematic review was deemed inappropriate. CONCLUSION: Suitable interim treatment options include extrusion of teeth showing deep intra-extra-alveolar fractures, and decoronation of ankylosed teeth as well as resin-bonded fixed dental prostheses, natural tooth pontics, and primary tooth autotransplantations after tooth loss. The interim management options described in this article represent compromises chosen in the absence of better alternatives after a careful risk-benefit analysis. However, if adequately performed, the presented treatment options have the potential to achieve the temporary restoration of function and esthetics in growing patients. Close clinical and (if appropriate) radiologic monitoring of these patients is considered mandatory to ensure early detection of possible complications that might jeopardize or could render impossible subsequent therapeutic measures. (Quintessence Int 2022;53:722-731; doi: 10.3290/j.qi.b3236409; Modified from a previously published article (in German) Quintessenz 2022;73(2):162-169).

Do Tooth Loss and Dentures Cause Body Image Disturbance?

PURPOSE: To investigate the psychologic morbidities associated with tooth loss despite treatment with technically successful dentures. MATERIALS AND METHODS: This cross-sectional questionnaire-based study compared the psychologic disturbance and functional difficulties in two groups: individuals with tooth loss who wore optimal-quality removable dentures (test group), and individuals with tooth loss who did not wear dentures (control group). The questionnaire used was developed and validated previously. The short-form revised Eysenck personality questionnaire was also used to assess the relationship with personality traits. A total of 138 participants were recruited (denture group = 70; control group = 68). RESULTS: There was a significant difference in body image dissatisfaction between the groups (χ2 = 7.72, P value = .005). The denture group had 5.75-times higher probability than the control group of suffering from body image disturbance. Older patients were predicted to have 75% less probability of body image disturbance (OR = 0.25), and men were predicted to have up to 70% less disturbance (OR = 0.3). As for psychologic morbidities, participants in both groups presented with somatic symptoms related to depression or anxiety, which were nearly double that expected in the general population (15.7% and 7.8%, respectively). Furthermore, participants who complained about body image impairment were more likely to have higher scores on the neuroticism scale (OR = 3.64). CONCLUSION: Tooth loss and dentures could be associated with body image dissatisfaction and psychologic morbidity. Planning for patient-centered care is paramount prior to extracting any teeth and providing replacement options.

Comparison of the efficacy of periodontal prognostic systems in predicting tooth loss.

AIM: The aim of this analysis was to assess how different tooth-prognosis systems could predict tooth loss in a cohort of periodontitis patients followed up prospectively during supportive periodontal care (SPC). MATERIALS AND METHODS: Clinical and radiographic data of 97 patients undergoing regular SPC for 5 years were used to assign tooth prognosis using four different systems (McGuire & Nunn, 1996; Kwok & Caton, 2007; Graetz et al., 2011; Nibali et al., 2017). Three independent examiners assigned tooth prognosis using all four systems, following a calibration exercise. The association between prognostic categories and tooth loss was tested for each prognostic system separately and across prognostic systems. RESULTS: All four systems showed good reproducibility and could identify teeth at higher risk of being lost during 5 years of SPC; the risk of tooth loss increased with the worsening of tooth-prognosis category (p < .0001). Although specificity and negative predictive values were good, low sensitivity and positive predictive values were detected for all systems. CONCLUSIONS: Previously published periodontal prognostic systems exhibited good reproducibility and predictive ability for tooth retention. However, low sensitivity was detected, with several teeth in the worst prognosis category being retained at 5 years. Some modifications in the number of categories and their definitions are suggested.

Minimal periodontal basic care - no surgery, no antibiotics, low adherence. What can be expected? A retrospective data analysis.

OBJECTIVE: This retrospective study aimed to evaluate tooth loss and the evolution of periodontal inflammatory parameters within a strict nonsurgically treated patient cohort with < 2 supportive periodontal care visits per year, defined as minimal periodontal basic care, of 2.5 to 10.7 years. METHOD AND MATERIALS: Data for nonsurgically treated patients were checked for: complete periodontal examination data at baseline (T0), after active periodontal therapy (T1), and after ≥ 2.5 years of supportive periodontal care (T2); smoking, diabetes mellitus, age (at least 18 years), plaque and gingival indices, bleeding on probing, percentage of residual pockets, supportive periodontal care adherence, and number of supportive periodontal care visits were assessed as risk factors for tooth loss. RESULTS: In total, 132 patients were included (76 female, mean age 56.7 ± 10.3 years), mean T1-T2: 4.5 ± 1.6 years. 26.5% of all patients lost 118 teeth (0.5 teeth/patient, 0.12 teeth/patient/year). Plaque and bleeding parameters were: mean plaque control record, 59.77 ± 28.07%; mean Papilla Bleeding Index, 47.46 ± 34.12%; mean bleeding on probing, 33.46 ± 21.52%. Supportive periodontal care duration (P = .013) and T2 bleeding on probing (P = .048) were identified as patient-related risk factors for tooth loss. CONCLUSION: Minimal periodontal basic care was characterized by elevated bleeding on probing, Papilla Bleeding Index, and plaque control record scores. This possibly highlights a lack of consequent applied surgical intervention (if needed) transitioning into regular supportive periodontal care, including insufficient patient behavioral changes regarding domestic oral hygiene procedures and possibly nonaddressed proinflammatory dietary habits as a negative effect. An apparently low tooth loss rate could be observed. The duration of supportive periodontal care was identified as a risk factor for tooth loss.