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1.
J Dent Hyg ; 94(1): 39-48, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32127428

RESUMO

Purpose: An aging population, combined with increasing tooth retention, could significantly impact the dental care delivery system. The purpose of this study was to assess self-reported oral health and the factors associated with oral health outcomes among a random sample of older adults in Washington State.Methods: A telephone survey of adults 55+ years was used to collect information on factors associated with oral health, plus four outcome variables; substantial tooth loss (6+ teeth lost), oral problems, oral pain, and poor health of teeth. Data were weighted to reflect the state's age and gender statistics.Results: A total of 2,988 older adults completed the survey during 2017. Substantial tooth loss (18%), oral problems (17%) and oral pain (13%) were the most frequently reported issues. Of the adults with teeth, 17% reported fair/poor health of teeth. Compared to adults with an income of $75,000 or more, adults with an income less than $25,000 were twice as likely to have substantial tooth loss and oral problems (OR=2.1 and 2.2, respectively) and were three times more likely to report oral pain and poor health of teeth (OR=3.1 and 3.3, respectively). The oldest old (adults 75+ years), as compared to those 55-64 years, were significantly more likely to have substantial tooth loss (OR=2.6) but were less likely to report oral problems (OR=0.6), pain (OR=0.3), or poor health of teeth (OR=0.5).Conclusions: Although the majority of Washington's older adults report having good oral health, a small subgroup has oral problems which may have a negative impact on quality of life.


Assuntos
Saúde Bucal , Perda de Dente , Idoso , Idoso de 80 Anos ou mais , Humanos , Qualidade de Vida , Inquéritos e Questionários , Washington
3.
J Am Dent Assoc ; 151(4): 276-286, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32222176

RESUMO

BACKGROUND: The objective of this study was to compare the experience and distribution of tooth loss in people with and without diabetes. METHODS: The authors conducted a comparative cross-sectional study of patients at a public university. Analysis included medical records of those treated from 2013 through 2017. The dependent and main independent variables were the number of missing teeth and a diagnosis of diabetes, respectively. As covariables, the authors analyzed the sociodemographic and socioeconomic characteristics, as well as the general and oral health status of patients. A multivariate model based on negative binomial regression was constructed. RESULTS: Of the 3,406 medical records analyzed, 64.2% (n = 2,185) pertained to women, the mean age was 42.45 years, 87.9% did not have diabetes, and 12.1% had received a diagnosis of diabetes. The mean (standard deviation) number of missing teeth was 7.46 (7.89), 7.09 (7.60) in patients without diabetes, and 10.12 (9.32) in patients with diabetes. According to our final multivariate model, the expected mean number of missing teeth was 11.4% higher in patients with diabetes than in those without (P = .006). For every 1-year increase in age, the expected mean number of missing teeth increased by 3.9% (P < .001). Other variables related to tooth loss included occupation, marital status, and type of insurance. CONCLUSIONS: The results of the study indicate that the mean number of missing teeth is higher in people with diabetes and suggest that certain socioeconomic inequalities exist in the area of oral health. PRACTICAL IMPLICATIONS: The population needs to be apprised of the impact of diabetes on oral health.


Assuntos
Diabetes Mellitus , Perda de Dente , Adulto , Estudos Transversais , Feminino , Humanos , México , Saúde Bucal
4.
Bull Tokyo Dent Coll ; 61(1): 37-42, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32074589

RESUMO

Maintaining dental and oral health and increasing healthy life expectancy are important issues for Japan as it deals with the rapid aging of its population. The purpose of this study was to determine effective dental health measures aimed at increasing the number of present teeth in the elderly. Change in the number of present teeth was determined based on data obtained from the 2009 and 2014 "Good Teeth Tokyo (Ii-ha Tokyo)" surveys carried out by the Tokyo Metropolitan Government. The number of present teeth and percentile curves were compared between these two time points. The number only showed a significant increase in individuals aged 60 years in 2014 (p<0.05). This may have been due to the establishment of a national public insurance system. The number of present teeth showed an increase in 2014 in the 25th, 50th, and 75th percentile curves. In the 75th and 90th percentile curves, tooth loss accelerated when the number of present teeth was fewer than 25. This finding is consistent with studies reporting that tooth loss itself is a risk for tooth loss. Tooth loss showed a slight acceleration between the ages of approximately 20 and 45 years in the 90th percentile curve. These results indicate that dental check-ups at universities and companies, periodontal disease check-ups performed by local governments, and health instruction at these check-ups are necessary to increase the number of present teeth in the elderly. They further suggest that implementing measures to promote periodic visits to dental clinics and providing incentives to undergo treatment for tooth defects are necessary in high-risk individuals. In conclusion, dental check-ups, health instruction, and strategies for high-risk individuals in their 20s and 40s are necessary to increase the number of present teeth in the elderly.


Assuntos
Perda de Dente , Adulto , Idoso , Humanos , Japão , Pessoa de Meia-Idade , Saúde Bucal , Inquéritos e Questionários , Tóquio , Adulto Jovem
5.
Spec Care Dentist ; 40(2): 151-159, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32086835

RESUMO

AIM: To evaluate the systemic conditions, tooth loss, oral health, body image perceptions, and quality of life of women with obesity and women who underwent bypass surgery. METHODS AND RESULTS: Sixty women were classified into the gastric bypass (G1, n = 30) and obesity (G2, n = 30) groups, and their systemic condition, oral health perception, oral hygiene, tooth loss, body image perception (Stunkard scale), and quality of life (WHOQOL-bref) were evaluated. The t-test, Mann-Whitney, chi-square, and multiple linear regression were used for statistical analysis (P < .05). G2 presented higher prevalence of hypertension (P = .020) and G1 higher prevalence of anemia (P = .040). G2 demonstrated less favorable perceptions of oral health, primarily associated with chewing (P = .0007) and speech (P = .005), and a lower frequency of dental floss usage (P = .047); however, there were no intergroup differences regarding the prevalence of missing teeth (P = .180). G1 demonstrated greater satisfaction with regard to their body image (P < .0001), contrary to those in G2, who negatively perceived the same (P = .001), particularly considering the physical, psychological, and environmental parameters (P < .05). CONCLUSION: High body mass index (BMI) indicated a higher prevalence of hypertension and a negative impact on oral health perception and quality of life. However, bariatric surgery was associated with a positive body image perception and quality-of-life parameters.


Assuntos
Derivação Gástrica , Perda de Dente , Imagem Corporal , Feminino , Humanos , Obesidade , Qualidade de Vida
6.
Community Dent Health ; 37(1): 59-64, 2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32031342

RESUMO

OBJECTIVE: To clarify the association between multiple tooth loss and dementia. BASIC RESEARCH DESIGN: Case-control study based on the claims data from National Health Insurance Research Database (NHIRD). Patients were divided into two groups: the dementia groups and non-dementia group. For each case patient, one control patient was randomly selected and frequency matched by age (per 5 years) and sex. The case group comprised patients newly diagnosed with dementia, and the index date was the the date of dementia diagnosis, which became the baseline for comorbidity and age calculations. RESULTS: Among the 43,026 individuals, patients with dementia had a significantly higher extraction density at ages 60-69 (p ⟨ 0.0001) and 70-79 (p = 0.04) years compared with control patients. CONCLUSIONS: This population-based retrospective study demonstrated an association between tooth loss and dementia. Patients in Taiwan with more tooth extraction experience are likely to have an increased risk of dementia.


Assuntos
Demência , Perda de Dente , Idoso , Estudos de Casos e Controles , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Taiwan
7.
J Prosthodont ; 29(3): 193-200, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31913534

RESUMO

PURPOSE: To systematically review the available evidence on screening tools to detect the psychological disturbance in patients with tooth loss and technically successful removable dentures (partial and complete). MATERIALS AND METHODS: The study protocol was registered with the National Institute of Health Research Database (I.D. CRD42017082125). The PICOS tool (patients, intervention, control, outcomes measure, and study design) was used to formulate an effective search strategy. Participants were adults (≥ 18), who were edentulous or had significant tooth loss (< 9 remaining teeth). The intervention included undergoing replacement with technically successful dentures (partial or complete). A control group of adults were either edentulous or had significant tooth loss and without dentures. Outcomes included assessing psychological disturbance due to treatment with dentures or due to no treatment using a validated tool. A structured search strategy was used to complete a standard systematic search of the electronic database without any date limit and/or language restriction. Only quantitative studies using a validated measuring tool to screen for psychological distress in adults with significant tooth loss were included. Two authors independently assessed the risk of bias in the included studies. Data homogeneity was assessed in regards to the screening tools to measure psychological disturbance following the management of tooth loss with dentures. The significant level was set at 0.05, using IBM SPSS Statistics 24.0 (SPSS Inc., New York, NY). The psychometric properties and the validation processes of the screening tools were assessed. RESULTS: From the original 3510 studies identified, only eight studies were found to meet the inclusion criteria. All eight studies used the same questionnaire to screen for the emotional distress of tooth loss. In addition, one study also used the Patient Health Questionnaire-9 (PHQ-9) to screen for the association of depression with tooth loss. Six studies suggested that a significant number of patients have difficulties in accepting tooth loss, were less confident, and had emotional distress related to tooth loss. However, two studies reported no significant link. All studies found a marked impact on functional activities and social interaction. However, four studies had a potentially biased selection process, and the questionnaire used was assessed to be at high-risk of measurement bias, as the development and validation process was not clear. There was also a lack of well-defined control groups in all studies. CONCLUSION: Tooth loss could cause psychological disturbance in some patients. To date, there is a lack of available tools that are suitable to screen and measure psychological disturbance in patients with tooth loss. Additional research is required to develop tools to identify and measure such impact and to recommend suitable interventions when needed.


Assuntos
Boca Edêntula , Perda de Dente , Adulto , Dentaduras , Depressão , Humanos , Qualidade de Vida
8.
Rev Saude Publica ; 54: 07, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31967276

RESUMO

OBJECTIVE: This study evaluated the oral health-related quality of life (OHRQoL) of older adults participating or not in Seniors Centers (SC). METHODS: Two independent samples were compared: older adults who participate in SC (n = 124) and older adults who visited Primary Healthcare Centers (PHC) and do not participate in SC (n = 164). The data collected consisted of sociodemographic (sex, age, educational level, marital status, family income) and psychosocial characteristics-Sense of Coherence (SOC), anxiety and depression using HADS, happiness-, and oral clinical evaluation-use and need of dental prosthesis and decayed (D), missing (M), or filled (F) teeth. The resulting OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14). The Mann-Whitney test was used to assess the associations between the independent variables and the OHIP-14. Poisson regression models were also used in the analyses (α=0.05). RESULTS: In the PHC, of the 270 individuals invited to participate in the study, 164 (60.7%) were interviewed and clinically examined; while in the SC, of the 166 individuals invited to participate in the study, 124 (74.7%) were interviewed and clinically examined. After adjustments for sociodemographic, psychosocial and clinical factors, we found that the impact on OHRQoL was 2.8 times higher (95%CI 2.0-4.2) for older adults who did not participate in SC. CONCLUSION: Older adults who participated in SC showed better perception on OHRQoL, independently of sociodemographic, psychosocial and clinical factors.


Assuntos
Saúde Bucal/estatística & dados numéricos , Qualidade de Vida/psicologia , Idoso , Brasil/epidemiologia , Estudos Transversais , Prótese Dentária/psicologia , Prótese Dentária/estatística & dados numéricos , Feminino , Acesso aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Centros Comunitários para Idosos , Senso de Coerência , Fatores Socioeconômicos , Inquéritos e Questionários , Perda de Dente/epidemiologia , Perda de Dente/psicologia
9.
Clin Oral Investig ; 24(1): 47-60, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31729576

RESUMO

OBJECTIVES: This systematic review aims to evaluate current literature regarding available techniques for removal of osseointegrated implants in terms of explantation's success, complications, and bone loss. MATERIAL AND METHODS: Two reviewers conducted a systematic literature search through electronic databases (PubMed and EMBASE), complimented by manual and grey literature searches. Successful explantation was defined as the primary outcome. Complications and availability of residual bone for immediate implantation were defined as secondary outcomes. RESULTS: Eighteen articles, comprising 372 implants and 241 patients, were included. Five techniques were identified: reverse torque, trephines, burs, piezosurgery, and laser-assisted explantation. Peri-implantitis was the most common reason for explantation, followed by crestal bone loss, fracture, and malpositioning. The reverse torque was the most frequently reported technique (284 implants) with 87.7% success rate. Burs were used for explantation of 49 implants with a 100% success rate, while trephines were utilized for removal of 35 implants with 94% success. Piezosurgery (11 implants) and Er.Cr:YSGG laser (1 implant) showed 100% success. One study reported perforation of the sinus floor following trephine explantation, while another reported fracture of 3 implants following reverse torque application. Further analysis was hindered by the quality of the available studies and their lack of data. CONCLUSIONS: Reverse torque seems the most conservative, and in the authors' opinion, should be the first choice for explantation despite its inferior success rate. Additional studies with randomized controlled designs and larger sample sizes are required. CLINICAL RELEVANCE: Dental implants have become the leading choice to replace missing teeth with gradually increasing numbers of complications and failures. An effective, conservative, and economic explantation technique is necessary to allow a successive implant placement.


Assuntos
Prótese Ancorada no Osso , Implantes Dentários , Implantação Dentária Endo-Óssea , Humanos , Peri-Implantite , Levantamento do Assoalho do Seio Maxilar , Perda de Dente
10.
J Oral Rehabil ; 47(3): 319-324, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31729769

RESUMO

BACKGROUND: The articular eminence of the temporomandibular joint is an anatomical structure exposed to functional loads resulting from masticatory forces. Tooth loss may change the biomechanics of the masticator system, and the articular eminence can be affected by this change. OBJECTIVE: The aim of this study is to examine the relationship between the edentulousness and the articular eminence inclination of the temporomandibular joint. METHODS: The articular eminence inclination was measured in panoramic radiographs in the right and left temporomandibular joint on a total of 100 patients (50 dentate and 50 edentulous). The articular eminence inclination of dentate and edentulous patients was compared, as well as the influence of gender and duration of edentulousness. RESULTS: The mean articular eminence inclination value in the dentate group (42.6 ± 4.30 ) was higher than that of the edentulous group (35.1 ± 4.70 , P < .001). Although there was no significant difference between males and females in the dentate group with regard to articular eminence inclination (42.0 ± 4.70 and 42.9 ± 4.10 , respectively, P = .373), in the edentulous group, males had higher values as compared to females (37.1 ± 4.70 and 34.2 ± 4.50 , respectively, P = .003). Finally, the duration of edentulousness and the degrees of articular eminence inclination values did not show positive correlations (P = .782). CONCLUSION: According to the results of this study, we found that edentulous patients had lower articular eminence inclination than dentate patients, and it was more prominent in female than male patients.


Assuntos
Boca Edêntula , Perda de Dente , Força de Mordida , Feminino , Humanos , Masculino , Radiografia Panorâmica , Articulação Temporomandibular
11.
J Oral Rehabil ; 47(2): 212-220, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31742736

RESUMO

OBJECTIVES: To explore impairments due to tooth loss and expectations of prosthetic replacements in an urban group and a rural group of patients in Sweden. MATERIAL AND METHODS: Semi-structured interviews were performed on 35 partially edentulous patients from prosthodontic specialist clinics located in an urban area and a rural area in Sweden. The interviews focused on impairments due to tooth loss and expectations of prosthetic restorations. Analysis was made using the grounded theory approach, allowing in-depth investigation of the phenomenon. RESULTS: Functional, aesthetic and social impairments were mentioned, and coping strategies (eg chewing differently and laughing less) and modifications (eg age, time and social setting) of the impairments were described. The rural patient group accepted impairments somewhat better than the urban one. Otherwise, there was only minor difference between the groups. Removable prosthodontic restorations were more acceptable among rural patients. Urban patients insisted more often on implant-based restorations and had higher expectations of longevity. Patients with minor impairments still wanted treatment, based on concerns about the future of their dentition. The interviews themselves generated new thoughts in the patients and were thus considered valuable by the patients. CONCLUSIONS: Impairments due to tooth loss and expectations of prosthetic replacements were expressed in the same way in the rural and urban patient groups. However, in the rural population, there was a higher acceptance of impairments and also of removable prosthetic restorations, whereas the urban population expressed a higher demand for implant-based restorations.


Assuntos
Perda de Dente , Estética Dentária , Humanos , Motivação , Suécia , População Urbana
12.
Int J Paediatr Dent ; 30(2): 171-180, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31710730

RESUMO

BACKGROUND: Several factors can influence the oral health. AIM: To explore the clinical factors, individual characteristics, and environmental factors (religious-spiritual coping-RSC, sense of coherence [SOC], and socio-economic status) related to oral status and impact on oral health-related quality of life (OHRQoL) of children/adolescents (C/A). DESIGN: This study evaluated C/A up to 15 years old and their caregivers. Number of decayed (NDT) and missing teeth (NMT); history of dental trauma; caregiver's RSC and SOC, socio-economic factors, and OHRQoL were evaluated. Theoretical model exploring the direct and indirect effects was tested using a structural equation analysis. RESULTS: For younger group (0-6 years), having more NDT or more NMT had a greater impact on the OHRQoL (ß = 0.382, ß = 0.203, respectively). In the oldest group (7-15 years), a higher SOC had an inverse relationship with the impact on the family OHRQoL (ß=-0.201). The higher the age of the C/A, the lower the NDT (ß=-0.235), and the higher the family income the lower, the need for social benefit (ß = 0.275). Indirect relationships were observed between schooling with social benefit and OHRQoL in younger group. The family income indirectly influenced the OHRQoL in oldest group. CONCLUSIONS: Quality of life is affected directly and indirectly by environmental characteristics, oral status, and the age of patients.


Assuntos
Senso de Coerência , Perda de Dente , Adolescente , Criança , Estudos Transversais , Humanos , Saúde Bucal , Qualidade de Vida
13.
J Oral Rehabil ; 47(2): 229-234, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31452211

RESUMO

OBJECTIVES: To compare the patient-reported effect of treatment with implant-supported fixed prosthesis (ISFP) and fixed dental prosthesis (FDP) in patients with a small number of tooth losses to replace. METHODS: From a population of 155 patients receiving either ISFP or FDP, 68 patients were matched in pairs based on gender, number of teeth replaced, zone of replacement, age and number of remaining teeth. The patient-reported effect was prospectively obtained by measuring change in the short-form oral health impact (OHIP-14) from before to one month after treatment. Effect size (ES), standardised response mean (SRM) and a minimal important difference of two units were applied to estimate the magnitude of the change. RESULTS: Both the ISFP and FDP groups decreased significantly in OHIP-14 after treatment (P < .01). The change was not significantly different between the ISFP and FDP groups. The magnitude of the change was for both treatments moderate and slightly higher in the ISFP group (ES = 0.52 and SRM = 0.58) than in the FDP group (ES = 0.48 and SRM = 0.47). Applying the minimal important difference showed that 23 participants in the ISFP group and 21 in the FDP group had good effect. CONCLUSIONS: The patient-reported effect of treatment with ISFP or FDP was similar, clinically meaningful and of moderate magnitude in patients with a small number tooth losses to replace.


Assuntos
Implantes Dentários , Perda de Dente , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Prótese Parcial Fixa , Humanos , Saúde Bucal , Medidas de Resultados Relatados pelo Paciente
14.
Braz. dent. sci ; 23(3): 1-9, 2020. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1095733

RESUMO

Objective: The Oral Health Impact Profile-14 (OHIP14) and the Geriatric/General Oral Health Assessment Index (GOHAI) have never been compared to a group of the same subjects in the Brazilian population. The aim of the study was to compare the OHIP-14 and GOHAI measures. Material and Methods: 129 independently living people over the age of 60 were included in the study. The GOHAI and OHIP-14 measures were used. Other variables were included: age, gender, education, number of missing teeth, annual household income and frequency of dentist visits. Results: The mean age of respondents was 65 years. The internal reliability (Cronbach's alpha) showed a high internal consistency for both measures. Spearman's rank correlation coefficient between the GOHAI and OHIP-14 scores was 0.73. Using the additive method of creating scores, none of the respondents had the GOHAI score of zero, indicating no impact from oral conditions, while 9.3% of them had an OHIP-14 score of zero. Dental status, age, gendler and frequency of dental visit were significantly associated with the results ofthe GOHAI and the OHIP-14 (Kruskal­Wallis test, Mann­Whitney U test). Conclusions: There was a strong correlation between the GOHAI and the OHIP14. Both instruments demonstrated good discriminant properties and helped capture the respondents' oral health problems. (AU)


Objetivo: O Perfil de Impacto na Saúde Oral-14 (OHIP14) e o Índice Geral de Avaliação de Saúde Oral em Geriatria (GOHAI) nunca foram comparados a um grupo dos mesmos sujeitos na população brasileira. O objetivo do estudo foi comparar as medidas OHIP-14 e GOHAI. Material e Métodos: 129 pessoas independentes com idade superior a 60 anos foram incluídas no estudo. Foram utilizadas as medidas GOHAI e OHIP-14. Outras variáveis foram incluídas: idade, sexo, escolaridade, número de dentes ausentes, renda familiar anual e frequência de visitas ao dentista. Resultados: a média de idade dos entrevistados foi de 65 anos. A confiabilidade interna (alfa de Cronbach) mostrou uma alta consistência interna para ambas as medidas. O coeficiente de correlação de Spearman entre os escores GOHAI e OHIP-14 foi de 0,73. Utilizando o método aditivo de criação de escores, nenhum dos entrevistados obteve pontuação zero no GOHAI, indicando nenhum impacto das condições bucais, enquanto 9,3% deles tiveram pontuação zero no OHIP-14. O estado dentário, a idade, o sexo e a frequência da visita foram significativamente associados aos resultados do GOHAI e do OHIP-14 (teste de Kruskal-Wallis, teste de Mann-Whitney U). Conclusões: Houve uma forte correlação entre o GOHAI e o OHIP-14. Ambos os instrumentos demonstraram boas propriedades discriminantes e ajudaram a capturar os problemas de saúde bucal dos entrevistados. (AU)


Assuntos
Humanos , Idoso , Qualidade de Vida , Saúde Bucal , Perda de Dente , Serviços de Saúde para Idosos
15.
Arq. odontol ; 56: 1-9, jan.-dez. 2020. tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1087819

RESUMO

Objetivo: Analisar fatores associados ao uso e à necessidade de prótese dentária em adultos e idosos do estado de Minas Gerais. Métodos: Estudo transversal foi realizado com amostra de 2.404 adultos e idosos. Regressão logística, estimativas de odds ratio e respectivos intervalos de confiança foram realizados. Resultados: Dos 2.404 indivíduos avaliados, 59,9% tinham necessidade de prótese pela ausência de prótese ou presença de prótese insatisfatória e 41,9% usavam prótese. Idosos tiveram 10,22 vezes mais chances de usar prótese comparados aos adultos. Indivíduos de menor escolaridade (< 2 anos de estudo) apresentaram 2,18 vezes mais chances de usar prótese do que indivíduos de maior escolaridade (> 11 anos de estudo). Indivíduos que usaram o serviço público na última consulta odontológica tiveram menos chance de usar prótese do que indivíduos que usaram o serviço privado. Conclusão:A necessidade e o uso de prótese dentária foram associados a fatores sociodemográficos.


Aim: To analyze factors associated with the need and use of dental prostheses in adults and the elderly in Minas Gerais, Brazil. Methods: This research conducted a cross-sectional study with 2,404 adult and elderly individuals. Logistic regression, odds ratio estimates, and respective confidence intervals were performed. Results:Among the 2,404 individuals evaluated in this study, 59.9% needed prosthesis due to a lack of a prosthesis or the use of an unsatisfactory prosthesis, while 41.9% used satisfactory prostheses. The elderly individuals were 10.22 times more likely to use prostheses w hen compared to adults. Individuals with a lower educational level (< 2 years of education) were 2.18 times more likely to use a prosthesis than were individuals with a higher educational level (> 11 years of education). Individuals who used the public dental services for their last dental appointment were less likely to use a prosthesis than were individuals who used private dental services. Conclusion: The need and use of dental prostheses were associated with sociodemographic factors.


Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Fatores Socioeconômicos , Idoso , Inquéritos e Questionários , Perda de Dente , Prótese Dentária , Adulto , Atenção Primária à Saúde , Estudos Transversais , Necessidades e Demandas de Serviços de Saúde
16.
Artigo em Inglês | MEDLINE | ID: mdl-31815978

RESUMO

This retrospective study evaluated the long-term response of periodontal tissues and survival rate of teeth with advanced attachment loss and pathologic migration in 21 periodontitis patients treated with combined periodontal and orthodontic treatment. All anterior migrated teeth were in function at the end of 10 to 15 years of maintenance. Residual probing depths and clinical attachment levels improved after treatment and remained stable through the follow-up. A total of 55 hopeless teeth were lost during active therapy, as well as 6 molars over the course of the supportive periodontal therapy (for nonperiodontal reasons). In highly compliant patients, all migrated teeth with initial unfavorable prognosis showed long-term clinical stability.


Assuntos
Periodontite , Perda de Dente , Seguimentos , Humanos , Dente Molar , Prognóstico , Estudos Retrospectivos
17.
J Oral Rehabil ; 47(1): 78-85, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31402463

RESUMO

OBJECTIVE: This study assessed changes in masticatory laterality in patients with unilateral posterior missing teeth 3 months after treatment with an implant-supported fixed partial prosthesis (ISFPP). METHODS: Thirty patients with unilateral posterior missing teeth participated in this prospective study. They were treated with one-, two- or three-unit ISFPPs. The control group comprised 10 healthy individuals with complete natural dentition. Each participant performed masticatory assays at baseline and at 3-month follow-up, chewing pieces of silicon inside a latex bag. Masticatory laterality was determined using three different methods: assessment of the first chewing cycle, of all cycles and application of a visual analogue scale. Data were compared using the Kruskal-Wallis or the Mann-Whitney U test as appropriate. RESULTS: Three months after treatment, a significant change in the asymmetry index towards the treated side and a significant reduction in the Unilateral Chewing Index were observed in the ISFPP group. No significant differences in masticatory laterality between groups were detected at 3-month follow-up, regardless of the method assessed. CONCLUSION: Treatment with ISFPPs alters the masticatory laterality, moving it to the treated side and increasing the degree of bilateral chewing in patients with unilateral posterior missing teeth.


Assuntos
Implantes Dentários , Boca Edêntula , Perda de Dente , Prótese Dentária Fixada por Implante , Humanos , Mastigação , Estudos Prospectivos
18.
Periodontol 2000 ; 82(1): 268-285, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31850630

RESUMO

The concept of precision dentistry as it relates to precision medicine is relatively new to the field of oral health. Precision dentistry is a contemporary, multifaceted, data-driven approach to oral health care that uses individual characteristics to stratify similar patients into phenotypic groups. The objective is to provide clinicians with the information that will allow them to improve treatment planning and a patient's response to treatment. Providers that use a precision oral health approach would move away from using an "average treatment" for all patients with a particular diagnosis and move toward more specific treatments for patients within each diagnostic subgroup. Precision dentistry requires a method or a model that places each individual in a subgroup where each member is the same as every other member in relation to the disease of interest. Precision dentistry is a paradigm shift that requires a new way of thinking about diagnostic categories. This approach uses patients' risk factor data (including, but not limited to, genetic, environmental, and health behavioral), rather than expert opinion or clinical presentation alone, to redefine traditional categories of health and disease. We review aspects of current efforts to allow precision dentistry to be realized and focus on one of the major innovations that may help precision dentistry to be practiced by periodontists, the World Workshop Model. Another approach is the Periodontal Profile Class system. These two approaches represent examples of supervised and unsupervised learning systems, respectively. This review compares and contrasts these two learning systems for their ability to classify patients into homogeneous disease and risk groups, as well as their feasibility at achieving the objective of enabling precision dentistry. We conclude that: (a) the World Workshop Model concept of stages and grades works as expected, in that periodontal status appears to be more serious in each successive stage. In addition, the seriousness and the complexity of the disease are greater as the grade increases within each stage. Stages and grades are important for precision dentistry because they consider the risk of future disease and the prognosis, and enable practitioners to use more signs, symptoms, and other associated factors when placing a patient in a diagnostic category; (b) the assignment of stages and grades using unsupervised learning systems is superior to using supervised learning systems for the prediction of 10-year tooth loss and 3-year attachment loss progression. In addition, the unsupervised learning approach (Periodontal Profile Class stages) results in stronger associations between the periodontal phenotypes and systemic diseases and conditions (prevalent diabetes, C-reactive protein, and incident stroke). This probably occurs because an unsupervised learning model produces more data-driven, mutually exclusive, homogeneous groups than a supervised learning model.


Assuntos
Saúde Bucal , Perda de Dente , Humanos , Planejamento de Assistência ao Paciente , Fatores de Risco
19.
Arq Bras Cir Dig ; 32(3): e1458, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31826085

RESUMO

BACKGROUND: Obesity and its surgical treatment have been related with oral diseases. Aim: To evaluate and compare dental wear and dental loss in eutrophic and morbidly obese patients submitted to Roux-en-Y gastric bypass. METHOD: Observational and analytical study with gender and age matching. The sample consisted of 240 patients, divided into four groups: eutrophic (GC=60), morbidly obese (GO=60), operated with up to 24 months (G24=60) and operated on for more than 36 months (G36=60). The following variables were analyzed: race, schooling, economic class, hypertension, diabetes, triglycerides, cholesterol, BMI, weight loss, waist-hip ratio, smoking, alcoholism, tooth loss and tooth wear. RESULTS: GO presented lower economic class (p=0.012), hypertension (p<0.001), diabetes (p<0.001), cholesterol (p=0.001), BMI (p<0.001), waist-hip ratio (p<0.001) and percentage of weight loss percent (p<0.001) than groups G24 and G36. Dental wear was higher among the II and V sextants. CONCLUSION: Individuals submitted to Roux-en-Y gastric bypass, regardless of the surgery period, presented more dental wear on the incisal/occlusal surfaces, and the anterior teeth were the most affected. Dental wear was associated with age and number of missing teeth.


Assuntos
Derivação Gástrica/efeitos adversos , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Perda de Dente/etiologia , Estudos Transversais , Feminino , Humanos , Masculino
20.
Rev Saude Publica ; 53: 105, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31826174

RESUMO

OBJECTIVE: To evaluate the factors associated with tooth loss in adults from the position and number of teeth lost in the dental arches. METHODS: This is a cross-sectional, population-based study with adults participating in the epidemiological survey of oral health of São Paulo in 2015. The outcome of the study was tooth loss, assessed by the proposed classification, namely: I) lost up to 12 back teeth; II) lost up to 12 teeth (including front teeth); and III) lost more than 12 teeth. A four-block analysis was conducted, supported by a conceptual theoretical model adapted for tooth loss. For the multinomial logistic regression, "individuals who did not lose teeth due to caries or periodontal disease" was used as reference (p < 0.05). RESULTS: Of 6,051 adults evaluated, 25.3% (n = 1,530) were classified in category I, 32.7% (n = 1,977) in II, 9.4% (n = 568) in III, and 1.9% (n = 117) were edentulous. Lower income and schooling, the perception of need for treatment and the last appointment motivated by routine, pain or extraction were associated with tooth loss, regardless of the classification. The negative evaluation of the dental service was associated with individuals who lost up to 12 teeth, both front and back. The presence of women and periodontal pocket were associated with tooth loss of up to 12 teeth, including front, and more than 12 teeth. Caries were associated with adults who lost up to 12 teeth, including front teeth. CONCLUSION: The proposed classification allowed the identification of differences between the associated factors. Thus, the need to consider such classification in future studies is evident.


Assuntos
Perda de Dente/epidemiologia , Adulto , Fatores Etários , Brasil/epidemiologia , Estudos Transversais , Cárie Dentária/epidemiologia , Cárie Dentária/fisiopatologia , Feminino , Humanos , Masculino , Saúde Bucal , Doenças Periodontais/classificação , Bolsa Periodontal/epidemiologia , Bolsa Periodontal/fisiopatologia , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Perda de Dente/etiologia
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