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Žmavc JB, Verdenik M, Skomina Z, Ihan Hren N. Tooth Loss and Systemic Diseases in the Slovenian Elderly Population: A Cross-Sectional Study of the Associaton Between Oral and Systemic Health. Zdr Varst 2024; 63:142-151. [PMID: 38881635 PMCID: PMC11178030 DOI: 10.2478/sjph-2024-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/21/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction This study aimed to assess the prevalence of edentulism and tooth loss in the Slovenian elderly population, along with the associated risk factors, and investigate the association between systemic and oral health. Methods The study included 445 individuals aged 65 or older (average age: 79.7±8.9 years). Data on preserved teeth, dental history, chronic diseases, and medications were collected through clinical examinations. Height and weight were recorded in order to calculate body mass index (BMI), and the education level was also collected. Chronic systemic diseases and medications were categorized. Statistical analysis was conducted using linear regression and nonparametric tests. Results Participants had an average of 4.7±7.7 teeth, with no significant gender differences. Higher age (β=-0.185, p<0.001) and lower education level (p<0.001) were associated with fewer teeth, while higher BMI showed no correlation (β=-0.085, p=0.325). Diabetes mellitus (p=0.031), cardiovascular diseases (p=0.025), and thyroid diseases (p=0.043) were inversely related to retained teeth. This inverse relationship also applied to individuals who recovered from malignancies, not including head and neck malignancies (p=0.019). No significant relationship was found between osteoporosis and the number of teeth (p=0.573). Notably, antidiabetic drug use was inversely related to the number of teeth (p=0.004), while analgesics showed a positive relationship (p=0.022). Conclusions This study highlights the association between specific sociodemographic factors, chronic diseases, and retained teeth among elderly individuals in Slovenia. High edentulism rates among the elderly emphasize the need for enhanced preventive measures and risk factor management, particularly for high-risk groups like the elderly.
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Affiliation(s)
- Jurij Bojan Žmavc
- University of Ljubljana, Medical Faculty, Department of Maxillofacial and Oral Surgery, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Miha Verdenik
- University of Ljubljana, Medical Faculty, Department of Maxillofacial and Oral Surgery, Vrazov trg 2, 1000 Ljubljana, Slovenia
- University Medical Centre Ljubljana, Clinical Department of Maxillofacial and Oral Surgery, Zaloška cesta 2, 1000 Ljubljana
| | - Zala Skomina
- University of Ljubljana, Medical Faculty, Department of Maxillofacial and Oral Surgery, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Nataša Ihan Hren
- University of Ljubljana, Medical Faculty, Department of Maxillofacial and Oral Surgery, Vrazov trg 2, 1000 Ljubljana, Slovenia
- University Medical Centre Ljubljana, Clinical Department of Maxillofacial and Oral Surgery, Zaloška cesta 2, 1000 Ljubljana
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Redondo-Gómez C, Parreira P, Martins MCL, Azevedo HS. Peptide-based self-assembled monolayers (SAMs): what peptides can do for SAMs and vice versa. Chem Soc Rev 2024; 53:3714-3773. [PMID: 38456490 DOI: 10.1039/d3cs00921a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Self-assembled monolayers (SAMs) represent highly ordered molecular materials with versatile biochemical features and multidisciplinary applications. Research on SAMs has made much progress since the early begginings of Au substrates and alkanethiols, and numerous examples of peptide-displaying SAMs can be found in the literature. Peptides, presenting increasing structural complexity, stimuli-responsiveness, and biological relevance, represent versatile functional components in SAMs-based platforms. This review examines the major findings and progress made on the use of peptide building blocks displayed as part of SAMs with specific functions, such as selective cell adhesion, migration and differentiation, biomolecular binding, advanced biosensing, molecular electronics, antimicrobial, osteointegrative and antifouling surfaces, among others. Peptide selection and design, functionalisation strategies, as well as structural and functional characteristics from selected examples are discussed. Additionally, advanced fabrication methods for dynamic peptide spatiotemporal presentation are presented, as well as a number of characterisation techniques. All together, these features and approaches enable the preparation and use of increasingly complex peptide-based SAMs to mimic and study biological processes, and provide convergent platforms for high throughput screening discovery and validation of promising therapeutics and technologies.
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Affiliation(s)
- Carlos Redondo-Gómez
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, Porto, 4200-135, Portugal.
- INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, Porto, 4200-135, Portugal
| | - Paula Parreira
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, Porto, 4200-135, Portugal.
- INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, Porto, 4200-135, Portugal
| | - M Cristina L Martins
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, Porto, 4200-135, Portugal.
- INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, Porto, 4200-135, Portugal
- ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 4050-313 Porto, Portugal
| | - Helena S Azevedo
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, Porto, 4200-135, Portugal.
- INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, Porto, 4200-135, Portugal
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Vemulapalli A, Mandapati SR, Kotha A, Rudraraju H, Aryal S. Prevalence of complete edentulism among US adults 65 years and older: A Behavioral Risk Factor Surveillance System study from 2012 through 2020. J Am Dent Assoc 2024:S0002-8177(24)00059-X. [PMID: 38520422 DOI: 10.1016/j.adaj.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND The rapid growth of the older adult population in the United States and their increased risk of edentulism make it essential to analyze trends and factors associated with edentulism. METHODS Data were obtained from the Behavioral Risk Factor Surveillance System from 2012 through 2020. US- and state-level trend lines were reported. Multiple logistic regression analyses were used to evaluate the association between self-reported complete edentulism and demographic characteristics, chronic diseases, smoking status, and health insurance status. Multiple imputations were used to address the missing data. RESULTS A total of 771,513 (weighted n = 50,410,576) participants were included in the study. There was a significant (P = .021) downward trend in the prevalence of edentulism from 2012 (16.36%) through 2020 (13.54%). Having less than a high school education, being a smoker, being non-Hispanic Black, having an annual household income less than $75,000, and having chronic conditions, including diabetes, myocardial infarction, arthritis, depression, and stroke, were significantly associated with complete edentulism. CONCLUSIONS Despite a decrease in prevalence of edentulism, disparities based on race, income, and education still exist. Edentulism is associated with chronic diseases in older adults. PRACTICAL IMPLICATIONS Public health initiatives should be aimed at reducing the impact of edentulism and improving overall quality of life among older adults. Community health programs allocating resources to improve access to affordable care, reducing precursors to edentulism, expanding dental coverage, and promoting oral and general health awareness are vital components of these efforts.
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Gutiérrez B, Martínez AG, Zuluaga IA. Edentulism and Individual Factors of Active Aging Framework in Colombia. Ann Geriatr Med Res 2024; 28:46-56. [PMID: 38105010 PMCID: PMC10982444 DOI: 10.4235/agmr.23.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/28/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND While edentulism remains a serious public health problem for older adults in Colombia, few analyses have been conducted from the framework of active aging as a part of the positive discourse of aging. This study analyzed complete edentulism and its relationship with determinants including personal, behavioral, and health systems and social services. METHODS This study included a total of 19,004 older adults. We used univariate, bivariate, and multivariate logistic regression type scores to investigate the relationships between the variables. The personal determinants included basic (Barthel scale) and instrumental activities of daily living (Lawton scale), public transportation, functional limitations, self-perceived health, and health problems. The behavioral factors included alcohol and tobacco use, mini nutritional tests, and physical activity. The last determinant was the healthcare system, while social services access included dental services. The analysis also included sociodemographic variables. RESULTS The results revealed significant associations for the variables of the three determinants, including the risk of malnutrition (odds ratio [OR]=1.15), functional limitation (OR=1.15), moderate physical activity (OR=1.08), and access to dental services (OR=2.31). Sex, years of education, and race were also risk factors, among other variables. Personal determinants, behavior, and use and access to health services were related to edentulism in older adults. CONCLUSION These findings support the need to include different analyses of edentulism from multicausality and to understand the oral cavity and the living conditions of aging adults.
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Affiliation(s)
- Bruno Gutiérrez
- Faculty of Medicine, School of Dentistry, Universidad del Valle, Cali, Colombia
- Faculty of Health, Universidad El Bosque, Bogota, Colombia
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Mohammadnejad L, Theurer A, Alber J, Illing B, Kimmerle-Mueller E, Schultheiss J, Krajewski S, Rupp F. Surface-Mediated Modulation of Different Biological Responses on Anatase-Coated Titanium. J Funct Biomater 2024; 15:29. [PMID: 38391882 PMCID: PMC10889146 DOI: 10.3390/jfb15020029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
Various surface modification strategies are being developed to endow dental titanium implant surfaces with micro- and nano-structures to improve their biocompatibility, and first of all their osseointegration. These modifications have the potential to address clinical concerns by stimulating different biological processes. This study aims to evaluate the biological responses of ananatase-modified blasted/etched titanium (SLA-anatase) surfaces compared to blasted/acid etched (SLA) and machined titanium surfaces. Using unipolar pulsed direct current (DC) sputtering, a nanocrystalline anatase layer was fabricated. In vitro experiments have shown that SLA-anatase discs can effectively promote osteoblast adhesion and proliferation, which are regarded as important features of a successful dental implant with bone contact. Furthermore, anatase surface modification has been shown to partially enhance osteoblast mineralization in vitro, while not significantly affecting bacterial colonization. Consequently, the recently created anatase coating holds significant potential as a promising candidate for future advancements in dental implant surface modification for improving the initial stages of osseointegration.
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Affiliation(s)
- Leila Mohammadnejad
- Department Medical Materials Science & Technology, Institute for Biomedical Engineering, University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany
| | - Antonia Theurer
- Department Medical Materials Science & Technology, Institute for Biomedical Engineering, University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany
| | - Julia Alber
- Department Medical Materials Science & Technology, Institute for Biomedical Engineering, University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany
| | - Barbara Illing
- Department Medical Materials Science & Technology, Institute for Biomedical Engineering, University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany
| | - Evi Kimmerle-Mueller
- Department Medical Materials Science & Technology, Institute for Biomedical Engineering, University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany
| | - Jacob Schultheiss
- Department Medical Materials Science & Technology, Institute for Biomedical Engineering, University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany
| | - Stefanie Krajewski
- Department Medical Materials Science & Technology, Institute for Biomedical Engineering, University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany
| | - Frank Rupp
- Department Medical Materials Science & Technology, Institute for Biomedical Engineering, University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany
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Preisser J, Moss K, Finlayson T, Jones J, Weintraub J. Prediction Model Development and Validation of 12-Year Incident Edentulism of Older Adults in the United States. JDR Clin Trans Res 2023; 8:384-393. [PMID: 35945823 PMCID: PMC10504805 DOI: 10.1177/23800844221112062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
INTRODUCTION Edentulism affects health and quality of life. OBJECTIVES Identify factors that predict older adults becoming edentulous over 12 y in the US Health and Retirement Study (HRS) by developing and validating a prediction model. METHODS The HRS includes data on a representative sample of US adults aged >50 y. Selection criteria included participants in 2006 and 2018 who answered, "Have you lost all of your upper and lower natural permanent teeth?" Persons who answered "no" in 2006 and "yes" in 2018 experienced incident edentulism. Excluding 2006 edentulous, the data set (n = 4,288) was split into selection (70%, n = 3,002) and test data (30%, n = 1,286), and Monte Carlo cross-validation was applied to 500 random partitions of the selection data into training (n = 1,716) and validation (n = 1,286) data sets. Fitted logistic models from the training data sets were applied to the validation data sets to obtain area under the curve (AUC) for 32 candidate models. Six variables were included in all models (age, race/ethnicity, gender, education, smoking, last dental visit) while all combinations of 5 variables (income, alcohol use, self-rated health, loneliness, cognitive status) were considered for inclusion. The best parsimonious model based on highest mean AUC was fitted to the selection data set to obtain a final prediction equation. It was applied to the test data to estimate AUC and 95% confidence interval using 1,000 bootstrap samples. RESULTS From 2006 to 2018, 9.7% of older adults became edentulous. The 2006 mean (SD) age was 66.7 (8.7) for newly edentulous and 66.3 (8.4) for dentate (P = 0.31). The baseline 6-variable model mean AUC was 0.740. The 7-variable model with cognition had AUC = 0.749 and test data AUC = 0.748 (95% confidence interval, 0.715-0.781), modestly improving prediction. Negligible improvement was gained from adding more variables. CONCLUSION Cognition information improved the 12-y prediction of becoming edentulous beyond the modifiable risk factors of smoking and dental care use, as well as nonmodifiable demographic factors. KNOWLEDGE TRANSFER STATEMENT This prediction modeling and validation study identifies cognition as well as modifiable (dental care use, smoking) and nonmodifiable factors (race, ethnicity, gender, age, education) associated with incident complete tooth loss in the United States. This information is useful for the public, dental care providers, and health policy makers in improving approaches to preventive care, oral and general health, and quality of life for older adults.
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Affiliation(s)
- J.S. Preisser
- Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - K. Moss
- Division of Comprehensive Oral Health University of North Carolina at Chapel Hill, Adams School of Dentistry, Chapel Hill, NC, USA
| | - T.L. Finlayson
- Health Management and Policy, San Diego State University School of Public Health, San Diego, CA, USA
| | - J.A. Jones
- University of Detroit Mercy, Detroit, MI, USA
| | - J.A. Weintraub
- Division of Pediatric and Public Health, University of North Carolina at Chapel Hill, Adams School of Dentistry, Chapel Hill, NC, USA
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Lee CT, Zhang K, Li W, Tang K, Ling Y, Walji MF, Jiang X. Identifying predictors of tooth loss using a rule-based machine learning approach: A retrospective study at university-setting clinics. J Periodontol 2023; 94:1231-1242. [PMID: 37063053 DOI: 10.1002/jper.23-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/18/2023] [Accepted: 04/12/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND This study aimed to identify predictors associated with tooth loss in a large periodontitis patient cohort in the university setting using the machine learning approach. METHODS Information on periodontitis patients and 18 factors identified at the initial visit was extracted from electronic health records. A two-step machine learning pipeline was proposed to develop the tooth loss prediction model. The primary outcome is tooth loss count. The prediction model was built on significant factors (single or combination) selected by the RuleFit algorithm, and these factors were further adopted by the count regression model. Model performance was evaluated by root-mean-squared error (RMSE). Associations between predictors and tooth loss were also assessed by a classical statistical approach to validate the performance of the machine learning model. RESULTS In total, 7840 patients were included. The machine learning model predicting tooth loss count achieved RMSE of 2.71. Age, smoking, frequency of brushing, frequency of flossing, periodontal diagnosis, bleeding on probing percentage, number of missing teeth at baseline, and tooth mobility were associated with tooth loss in both machine learning and classical statistical models. CONCLUSION The two-step machine learning pipeline is feasible to predict tooth loss in periodontitis patients. Compared to classical statistical methods, this rule-based machine learning approach improves model explainability. However, the model's generalizability needs to be further validated by external datasets.
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Affiliation(s)
- Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Kai Zhang
- The University of Texas Health Science Center at Houston, McWilliams School of Biomedical Informatics, Houston, Texas, USA
| | - Wen Li
- Division of Clinical and Translational Sciences, Department of Internal Medicine, The University of Texas McGovern Medical School at Houston, Houston, Texas, USA
- Biostatistics/Epidemiology/Research Design (BERD) Component, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kaichen Tang
- The University of Texas Health Science Center at Houston, McWilliams School of Biomedical Informatics, Houston, Texas, USA
| | - Yaobin Ling
- The University of Texas Health Science Center at Houston, McWilliams School of Biomedical Informatics, Houston, Texas, USA
| | - Muhammad F Walji
- Department of Diagnostic and Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Xiaoqian Jiang
- The University of Texas Health Science Center at Houston, McWilliams School of Biomedical Informatics, Houston, Texas, USA
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Botero JE, Zuluaga AI, Suárez-Córdoba V, Calzada MT, Gutiérrez-Quiceno B, Gutiérrez AF, Mateus-Londoño N. Using machine learning to study the association of sociodemographic indicators, biomarkers, and oral condition in older adults in Colombia. J Am Dent Assoc 2023; 154:715-726.e5. [PMID: 37500234 DOI: 10.1016/j.adaj.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/21/2023] [Accepted: 04/30/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Chronic health conditions and socioeconomic problems that affect the well-being and life expectancy of older adults are common. The objective of this cross-sectional study was to analyze the association between sociodemographic variables, oral conditions, and general health and the biomarkers of older adults using machine learning (ML). METHODS A total of 15,068 surveys from the national study of Health, Well-Being and Aging (Salud, Bienestar y Envejecimiento) data set were used for this secondary analysis. Of these, 3,128 people provided blood samples for the analysis of blood biomarkers. Sociodemographic, oral health, and general health variables were analyzed using ML and logistic regression. RESULTS The results of clustering analysis showed that dyslipidemia was associated with poor oral condition, lower socioeconomic status, being female, and low education. The self-perception of oral health in older adults was not associated with the presence of teeth, blood biomarkers, or socioeconomic variables. However, the necessity of replacing a dental prosthesis was associated with the lowest self-perception of oral health. Edentulism was associated with being female, increased age, and smoking. CONCLUSIONS Socioeconomic and educational disparities, sex, and smoking are important factors for tooth loss and suboptimal blood biomarkers in older adults. ML is a powerful tool for identifying potential variables that may aid in the prevention of systemic and oral diseases in older adults, which would improve geriatric dentistry. PRACTICAL IMPLICATIONS These findings can help the academic community identify critical sociodemographic and clinical factors that influence the process of healthy aging and serve as a useful guide to enhance health care policies and geriatric oral health care services.
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Li Y, Huang CL, Lu XZ, Tang ZQ, Wang YY, Sun Y, Chen X. Longitudinal association of edentulism with cognitive impairment, sarcopenia and all-cause mortality among older Chinese adults. BMC Oral Health 2023; 23:333. [PMID: 37244990 DOI: 10.1186/s12903-023-03015-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/04/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Tooth loss may be a surrogate for systemic health and aging. However, no previous studies have systematically assessed multiple outcomes relevant to aging trajectory in this area, and many important confounders were not adjusted in most previous studies. This study aims to prospectively evaluate the associations of complete tooth loss (edentulism) with broad markers of sarcopenia, cognitive impairment and mortality. METHODS Data were derived from the China Health and Retirement Longitudinal Study, a nationally representative household study of the Chinese population aged 45 years and older. Multivariate Weibull proportional hazards regression was used to assess the association between edentulism with sarcopenia and all-cause mortality. Average changes in cognitive function by edentulism was estimated by mixed-effects linear regression models. RESULTS During the 5-year follow-up, the prevalence of edentulism among adults aged 45 and over was 15.4%. Participants with edentulism had a greater decline in cognitive function compared to those without (β=-0.70, 95%CI:-1.09, -0.31, P < 0.001). The association of edentulism and all-cause mortality for 45-64 age group (HR = 7.50, 95%CI: 1.99, 28.23, P = 0.003), but not statistically significant for the ≥ 65 age group (HR = 2.37, 95%CI: 0.97, 5.80, P = 0.057). Effects of edentulism on sarcopenia are statistically significant for all age groups (45-64 age group: HR = 2.15, 95%CI: 1.27, 3.66, P = 0.005; ≥65 age group: HR = 2.15, 95%CI: 1.27, 3.66, P = 0.002). CONCLUSIONS These findings could have important clinical and public health implications, as tooth loss is a quick and reproducible measurement that could be used in clinical practice for identifying persons at risk of accelerated aging and shortened longevity, and who may benefit most from intervention if causality is established.
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Affiliation(s)
- Yang Li
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China
| | - Chuan-Long Huang
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China
| | - Xiu-Zhen Lu
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China
| | - Zi-Qing Tang
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China
| | - Yuan-Yin Wang
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China
| | - Ying Sun
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China.
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei, Anhui Province, 230032, China.
| | - Xin Chen
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China.
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Park HA, Shin SH, Ryu JI. Edentulous disparities among geriatric population according to the sexual difference in South Korea: a nationwide population-based study. Sci Rep 2023; 13:7854. [PMID: 37188776 DOI: 10.1038/s41598-023-35029-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
The proportion aged 60 years or older in the world's population is expected to double by 2050. In general, they have many complex diseases and poor oral health status. Oral health is one of the important health indicators of elderly people and it is affected by diverse factors, such as socioeconomic status. In this study, sexual difference was considered as an associated factor that is closely related to edentulism. The sexual difference might be more influential within the geriatric population because of lower economic and educational backgrounds at this stage. Edentulism was significantly higher among elderly females than males when combined with the education level. The lower the level of education, the higher the prevalence of edentulism as much as 24 ~ 28 times, especially in females (P = 0.002). These findings suggest a more complex relationship between oral health, socioeconomic status, and sexual difference.
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Affiliation(s)
- Hyang-Ah Park
- Department of Preventive and Social Dentistry, Graduate School, Kyung Hee University, Seoul, 02447, Korea
| | - Soon-Hee Shin
- Department of Preventive and Social Dentistry, Graduate School, Kyung Hee University, Seoul, 02447, Korea
| | - Jae-In Ryu
- Department of Preventive and Social Dentistry, College of Dentistry, Kyung Hee University, Seoul, 02447, Korea.
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The Shear Bond Strength between Milled Denture Base Materials and Artificial Teeth: A Systematic Review. Dent J (Basel) 2023; 11:dj11030066. [PMID: 36975564 PMCID: PMC10046986 DOI: 10.3390/dj11030066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/13/2022] [Accepted: 01/05/2023] [Indexed: 03/05/2023] Open
Abstract
The data about bond strength between digitally produced denture base resins and artificial teeth are scarce. Several studies investigated shear bond strength values of milled denture base resins and different types of artificial teeth. The purpose of the present study was to compare and evaluate the available evidence through a systematic review. A bibliographic search was conducted in PubMed, Scopus, and Web of Science to assess adequate studies published up to 1 June 2022. This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The appropriate studies that determined the shear bond strength values between milled denture base resins and artificial teeth were selected. The initial search identified 103 studies, which were included in the PRISMA 2020 flow diagram for new systematic reviews. Three studies met the inclusion criteria, and all of them present a moderate risk of bias (score 6). Two studies found no statistical differences between heat-polymerized and CAD/CAM (milled) denture base materials when attached with different types of artificial teeth, while one study showed higher values of CAD/CAM (milled) denture base materials. Bonding agents ensure bonding strength at least similar to the conventional methods. In order to improve the quality of future studies, it would be advantageous to use a larger number of specimens with standardized dimensions and a blinded testing machine operator to decrease the risk of bias.
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Muniz FWMG, Fernandez MDS, Pacheco KE, Martins MW, Trevisan TC, Zatt FP, Colussi PRG. Use of dental implants among older adults of two southern Brazilian cities: A population-based cross-sectional study. SPECIAL CARE IN DENTISTRY 2023; 43:56-66. [PMID: 35666997 DOI: 10.1111/scd.12736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/17/2022] [Accepted: 05/13/2022] [Indexed: 01/21/2023]
Abstract
AIM To assess the prevalence and associated factors with use of dental implants among older adults. METHODS This cross-sectional study was performed with home dwelling older adults from the cities Cruz Alta and Veranópolis, Brazil. The main outcome was obtained by a clinical oral examination, considering those with at least one dental implant. Independent variables were collected by a structured questionnaire. Crude and adjusted analysis was performed by Poisson regression with robust variance estimation; results are presented in prevalence ratio (PR) and 95% confidence interval. RESULTS It was included 569 participants. The overall prevalence of using at least one dental implant was 16.7%. Higher PR for the use of dental implants was observed in white individuals (PR:5.147; 95% CI:2.033-3.034), in those with at least medium income (PR:3.202; 95% CI:1.196-5.572) and in those with access to dental care in the last 12 months (RP:1.595; 95% CI:1.087-2.340). Older adults with a medium level of education (RP:0.484; 95% CI:0.240-0.978) and those that did not use dental floss (RP:0.627; 95% CI:0.240-0.978) demonstrated a significantly lower PR for use of dental implants. CONCLUSION A substantial prevalence of use of dental implants was observed among older adults. In addition, white ones, those with a better financial situation and users of dental floss presented higher use of dental implants.
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Affiliation(s)
| | | | - Karen Eymael Pacheco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Implant Survival Rate and Prosthetic Complications of OT Equator Retained Maxillary Overdenture: A Cohort Study. PROSTHESIS 2022. [DOI: 10.3390/prosthesis4040057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
(1) Background: The overdenture is a complete denture, an implant-supported prosthesis, that the patient can remove at home for the usual oral hygiene procedures, thanks to a simple and intuitive anchoring system. Clinically, the execution of this rehabilitation for the lower arch is often favored, but when it is necessary to limit the extension of the palate in the upper arch, it can represent the least invasive and economic solution. The aim of the study is to analyze post-loading implant loss for implant-supported prostheses in the edentulous upper jaw. (2) Methods: This retrospective study was carried out on patients who received a superior overdenture on four implants for rehabilitation. A total of 42 patients were included in this study and initially evaluated clinically and radiographically. The follow-up period for patients after delivery of the upper overdenture is between 48 and 72 months. A total of 168 implants were inserted and monitored in this period. Clinical and radiographic tests were carried out on all 168 implants, with constant re-evaluation. (3) Results: The overall implant survival rate is 92.9%, a value that corresponds to those present in the literature in previously published studies. There were few prosthetic complications, mainly the detachment of anterior prosthetic teeth. (4) Conclusions: Most of these complete prostheses, which as antagonist had another previously made overdenture on four or on two implants, achieved excellent success rates in this study at 72 months.
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de Souza VGL, Herkrath FJ, Garnelo L, Gomes AC, Lemos UM, Parente RCP, Herkrath APCDQ. Contextual and individual factors associated with self-reported tooth loss among adults and elderly residents in rural riverside areas: A cross-sectional household-based survey. PLoS One 2022; 17:e0277845. [PMID: 36413557 PMCID: PMC9681076 DOI: 10.1371/journal.pone.0277845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 11/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Tooth loss is an oral health condition with high prevalence and negative impact on quality of life. It is the result of the history of oral diseases and their treatment as well as provision of dental care and access to dental services. Socioeconomic characteristics are determinants of tooth loss and living in rural areas is also a risk factor for its incidence. OBJECTIVE To identify contextual and individual factors associated with self-reported tooth loss among adults and elderly people living in rural riverside areas. METHODS A cross-sectional household-based survey was conducted in 2019 with rural riverside communities on the left bank of the Rio Negro River, Manaus, Amazonas. These communities are covered by a fluvial health team and two riverside health teams. Interviews were conducted in a representative random sample of dwellers aged ≥ 18 years, using electronic forms to obtain information on oral health conditions, demographic and socioeconomic characteristics, and use of and access to health services. The outcome was self-reported tooth loss. After the descriptive analysis of the data, a multilevel Poisson regression analysis was performed to estimate the prevalence ratio for the outcome. Variables with p-value ≤0.20 in the bivariate analyses were included in the multiple analysis considering the hierarchy between individual and contextual variables in the multilevel model. Variables with p-value ≤0.10 were kept in the final model and the significance level adopted was 0.05. RESULTS 603 individuals from 357 households were assessed (mean age 44.1 years). The average number of missing teeth was 11.2 (±11.6); 27.4% of individuals had lost more than 20 teeth (non-functional dentition) and 12.1% were completely edentulous. Contextual characteristic of primary healthcare offered was associated with the outcome. The tooth loss was lower in territories covered by riverside health teams. At individual level, tooth loss was greater in older individuals who had experienced dental pain over the past six months and whose sugar consumption was high. Black or brown individuals, individuals whose household income was higher, those who were on the Bolsa Família cash transfer program, those who consulted a dentist over the past year, and those who reported satisfaction with their teeth/oral health reported less tooth loss. CONCLUSION Tooth loss was associated with contextual territorial factors related to the healthcare service and individual demographic, behavioral, socioeconomic, and service-related characteristics as well as self-perceived oral health conditions. The findings suggest that actions focused on the oral health of these populations involve not only changes in the healthcare service organization, but also intersectoral policies that contribute to reducing social inequalities.
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Affiliation(s)
| | - Fernando José Herkrath
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas, Brazil
- Superior School of Health Siences, State University of Amazonas, Manaus, Amazonas, Brazil
| | - Luiza Garnelo
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas, Brazil
| | - Andréia Coelho Gomes
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas, Brazil
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15
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Radiomorphometric indices for sex estimation in edentulous individuals: a receiver operating characteristic curve and discriminant function analysis-based study. Forensic Sci Int 2022; 341:111513. [DOI: 10.1016/j.forsciint.2022.111513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022]
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16
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Mastication Wear of Two Low Profile Attachment Systems for Overdenture: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2022. [DOI: 10.1155/2022/6469890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background. Edentulism is still a major problem in the world’s population today. Implant-retained overdenture has proven to be a valid therapeutic solution in the mandible. This type of rehabilitation requires replacement of the matrices when those reach inadequate retention due to wearing processes. This study is aimed at evaluating the drop in retention of low-profile precision attachments following the application of vertical chewing forces. Two different attachment designs were compared. Methods. This in vitro study simulated an implant-retained overdenture on an edentulous mandible. Two low-profile attachments were compared. Loaded and unloaded sides were considered. Tests were performed by exerting a vertical cyclic force on the prosthesis at the level of the first molar of a hemiarch. Retention tests were performed before and after 400.000 chewing cycles, comparable to one year of use. Results. The presence of vertical load wear was identified and characterized. Retention never fell below the values indicated by the manufacturer. Furthermore, significant differences were identified between the two retention systems. Conclusions. Loss of occlusal load retention is a component that must be evaluated by the clinician during the design of implant-prosthetic rehabilitation, particularly in those cases where elevated occlusal forces or parafunctions are present.
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17
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Radiographically screened periodontitis is associated with deteriorated oral-health quality of life: A cross-sectional study. PLoS One 2022; 17:e0269934. [PMID: 35687588 PMCID: PMC9187079 DOI: 10.1371/journal.pone.0269934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 05/31/2022] [Indexed: 12/22/2022] Open
Abstract
Periodontitis is greatly related to worse perceived oral health-related quality of life (OHRQoL), yet this association has never been explored using radiographically screened periodontal bone loss. Here we have radiographically screened patients for periodontitis via a validated method and assessed its association with measures of OHRQoL. From a total of 10,267 participants (6,112 females and 4,155 males), self-reported general health questionnaire, body mass index, self-reported oral health behaviours, panoramic x-rays and the oral health impact profile (OHIP-14) were gathered. Radiographically screened periodontitis was measured through a radiographic-based periodontal bone loss (R-PBL) approach. We compared the respective variables according to the R-PBL status and explored using multiple logistic regression adjusted for the significant variables. Overall, patients with periodontitis shown significantly different sociodemographic, health measures and oral hygiene characteristics. All domains of the OHIP-14 were significantly worsened in the periodontitis group, and further confirmed through adjusted logistic regression (p<0.001). Active smoking, number of missing teeth, sex and age were the most impactful variables in this relationship. Our results demonstrate the existence of a link between radiographically screened periodontitis and OHRQoL, mostly upheld by active smoking, number of missing teeth, sex and age.
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Silva RCS, Agrelli A, Andrade AN, Mendes-Marques CL, Arruda IRS, Santos LRL, Vasconcelos NF, Machado G. Titanium Dental Implants: An Overview of Applied Nanobiotechnology to Improve Biocompatibility and Prevent Infections. MATERIALS (BASEL, SWITZERLAND) 2022; 15:3150. [PMID: 35591484 PMCID: PMC9104688 DOI: 10.3390/ma15093150] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023]
Abstract
This review addresses the different aspects of the use of titanium and its alloys in the production of dental implants, the most common causes of implant failures and the development of improved surfaces capable of stimulating osseointegration and guaranteeing the long-term success of dental implants. Titanium is the main material for the development of dental implants; despite this, different surface modifications are studied aiming to improve the osseointegration process. Nanoscale modifications and the bioactivation of surfaces with biological molecules can promote faster healing when compared to smooth surfaces. Recent studies have also pointed out that gradual changes in the implant, based on the microenvironment of insertion, are factors that may improve the integration of the implant with soft and bone tissues, preventing infections and osseointegration failures. In this context, the understanding that nanobiotechnological surface modifications in titanium dental implants improve the osseointegration process arouses interest in the development of new strategies, which is a highly relevant factor in the production of improved dental materials.
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Affiliation(s)
| | | | | | | | | | | | | | - Giovanna Machado
- Centro de Tecnologias Estratégicas do Nordeste-Cetene, Av. Prof. Luiz Freire, 01, Cidade Universitária, Recife CEP 50740-545, PE, Brazil; (R.C.S.S.); (A.A.); (A.N.A.); (C.L.M.-M.); (I.R.S.A.); (L.R.L.S.); (N.F.V.)
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Afrashtehfar KI, Moawad RA, F.-Eddin AW, Wang HL. Mandibular full-arch fixed prostheses supported by three-dental-implants: A protocol of an overview of reviews. PLoS One 2022; 17:e0265491. [PMID: 35377903 PMCID: PMC8979460 DOI: 10.1371/journal.pone.0265491] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/16/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION To minimize trauma and cost of treatment, oral health practitioners have successfully rehabilitated full arches by supporting the prostheses on four implants. However, there is no consensus whether less than four implants supporting full mandibular arches would provide similar clinical outcomes to other well-established all-on-four alternative. OBJECTIVE To identify, summarize, appraise, and compare the clinical outcomes evidence of three-implant fixed full-arch prostheses in completely edentulous mandibular patients. MATERIALS AND METHODS This overview of systematic reviews (OoSRs) will include secondary synthesis studies (i.e., systematic reviews with or without a meta-analysis). A three-step search strategy will be conducted in MEDLINE (Ovid), EMBASE (Ovid), Cochrane Database of Systematic Reviews, Scopus, Web of Science (WoS Core Collection), and Google Scholar. Grey literature and a manual search in 12 specialized journals will also be conducted. Three independent reviewers will screen all retrieved articles for eligibility, extract data and assess the methodological quality of the included studies. The results will be presented as tables or narrative synthesis. The studies will be evaluated for risk of bias by ROBIS and methodology quality by the AMSTAR-2 tool. If new primary studies are identified, a meta-analysis will be conducted. Certainty of the evidence will be assessed to answer the following focused research question: In edentulous mandibular patients, what are the implant and prostheses clinical outcomes of three-implant fixed full-arch prostheses compared to other all-on-x solutions? DISCUSSION There are some systematic reviews about the use of fixed complete dental prostheses supported by three implants; however, their clinical outcomes related to the other all-on-four plus solutions are conflicting. So, an overview on this topic is required to provide recommendations. REVIEW REGISTRATION NUMBER International prospective register of systematic reviews (PROSPERO) ID#: CRD42021262175. National Institute for Health Research (NIHR) and Centre for Reviews and Dissemination, University of York, York, United Kingdom.
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Affiliation(s)
- Kelvin I. Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, Ajman Emirate, UAE
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, Bern, Switzerland
- Centre of Medical and Bio-allied Health Sciences Research (CMBHSR), Ajman University, Dubai, City of Gold, UAE
- * E-mail:
| | - Rosalin A. Moawad
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, Ajman Emirate, UAE
| | - Afaf W. F.-Eddin
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, Ajman Emirate, UAE
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
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Bond JC, McDonough R, Alshihayb TS, Kaye EA, Garcia RI, Heaton B. Edentulism is associated with increased risk of all-cause mortality in adult men. J Am Dent Assoc 2022; 153:625-634.e3. [PMID: 35241269 DOI: 10.1016/j.adaj.2021.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prior reports of positive associations between edentulism and all-cause mortality have been limited by onetime assessments of edentulism and inadequate control of known confounding variables. The authors aimed to assess the association between edentulism and mortality using a longitudinal clinical oral health cohort. METHODS The authors used data from the Department of Veterans Affairs Dental Longitudinal Study, an ongoing, closed-panel cohort study from 1968 through 2019 (N = 1,229). Dentition status was evaluated through triennial clinical examinations. Mortality was assessed via the National Death Registry. The authors used Cox regression models to estimate the association between edentulism and all-cause mortality after covariate adjustment. Furthermore, the authors calculated propensity scores and assessed hazard ratios (HRs) in a trimmed, matched, and inverse probability weighted sample. RESULTS Participants who were edentulous (N = 112) had 1.24 (95% CI, 1.00 to 1.55) times the hazard of all-cause mortality compared with those who were nonedentulous, after adjustment with time-varying covariates. Use of propensity scores in the model resulted in slightly elevated HRs compared with the standard Cox model, regardless of propensity score method; adjusted HRs were 1.35 (95% CI, 1.01 to 1.80) after matching, 1.26 (95% CI, 1.00 to 1.59) after trimming, and 1.29 (95% CI, 1.18 to 1.42) after inverse probability weighting. CONCLUSIONS Edentulism was associated with an increased risk of all-cause mortality in a cohort that captured incident edentulism. This association was consistent after multiple methods to account for confounding. PRACTICAL IMPLICATIONS The findings of this study suggest that edentulism is associated with an increase in risk of mortality, after accounting for salient confounding variables using multiple approaches. Efforts to improve equitable access to tooth-preserving treatments are critical.
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21
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Qu X, Zhang J, Wang Q, Duan D, Zhu T, Zhang W. Edentulism and select chronic diseases among adults aged ≥45 years in China, 2011-2018: A longitudinal study. Community Dent Oral Epidemiol 2021; 49:533-542. [PMID: 34558095 DOI: 10.1111/cdoe.12692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/20/2021] [Accepted: 08/10/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Information on the association between edentulism and chronic medical conditions in developing countries is lacking. We investigated such information among adults aged ≥45 years in China. METHODS A national longitudinal data set from the China Health and Retirement Longitudinal Study (CHARLS) 2011-2018 was analysed. A multilevel logistic regression model was applied to analyse the association between edentulism and select chronic diseases. RESULTS There were 74 240 Chinese adults aged ≥45 years in this study. The prevalence of self-reported edentulism was 8.8% in 2011 and had increased to 16.4% by 2018. CONCLUSION Edentulism was a factor associated with a higher risk of various self-reported chronic diseases among adults aged ≥45 years in China. Edentulism is one of the comorbidities among ageing people with chronic conditions. Preventive public health policy should consider controlling shared risk factors at an earlier age.
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Affiliation(s)
- Xing Qu
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Qingyu Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan University, Chengdu, China
| | - Dingyu Duan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ting Zhu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Wei Zhang
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China.,West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China
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22
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Mortality in Edentulous Patients: A Registry-Based Cohort Study in Sweden Comparing 8463 Patients Treated with Removable Dentures or Implant-Supported Dental Prostheses. Int J Dent 2021; 2021:9919732. [PMID: 34373694 PMCID: PMC8349274 DOI: 10.1155/2021/9919732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/11/2021] [Indexed: 02/08/2023] Open
Abstract
Objectives The purpose of this study was to investigate if edentulism is associated with all-cause mortality. The aims were to analyze the association between age, socioeconomic factors, and mortality in edentulous patients treated with either removable dentures or implant-supported prostheses. Methods All patients who became edentulous according to the Swedish Social Insurance Agency (SSIA) between 2009 and 2013 (N = 8463) were analyzed regarding prosthetic treatment, age, gender, and socioeconomic status. The patients were divided into two groups, depending on whether they were treated with dental implants (implant group; IG) or with conventional removable dentures (denture group; DG). Data on mortality for all included individuals were obtained from the Swedish National Cause of Death Register and compared to a reference population. Cumulative survival rates were calculated, and a multivariable regression analysis for the included variables was performed. Results Between 2009 and 2018, 2192 of the patients (25.9%) were treated with implant-supported dental prostheses (IG) and 6271 patients (74.1%) were treated with removable dentures without support of dental implants (DG). Altogether 2526 patients (30%) died until December 31, 2019, and the overall mortality was significantly higher for the DG compared to the IG during follow-up (p < 0.001). Younger edentulous patients (≤59 years) presented a higher mortality than the reference population, while implant patients over 79 years of age demonstrated a lower mortality. The final results from the multivariable logistic analysis showed that lower equalized disposable income (EDI) and the choice of conventional removable dentures are the most important factors for increased patient mortality (p < 0.001). Conclusions Edentulous patients have an overall higher mortality compared to a reference population. Low socioeconomic status increases all-cause mortality. Individuals treated with dental implants show statistically significant lower 10-year mortality compared to patients treated with conventional removable dentures, regardless of socioeconomic status.
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García-Minguillán G, Preciado A, Romeo M, Río JD, Lynch CD, Castillo-Oyagüe R. 'Differences in self-perceived OHRQoL between fully dentate subjects and edentulous patients depending on their prosthesis type, socio-demographic profile, and clinical features'. J Dent 2021; 114:103756. [PMID: 34333055 DOI: 10.1016/j.jdent.2021.103756] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/25/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES This observational cross-sectional study aimed to evaluate and compare the oral health-related quality of life (OHRQoL) and clinical performance between dentate subjects and edentulous patients restored with conventional dentures or implant overdentures. METHODS 85 edentulous patients were grouped as follows: Group-1 (CD): conventional denture wearers (n= 42), and Group-2 (IO): implant-retained overdenture wearers (n= 43). For the OHRQoL comparisons, a control group of subjects with a healthy natural dentition (Group-3, ND; n= 50) was included. Participants completed three validated questionnaires (OHIP-14sp, OHIP-20sp, and QoLIP-10). Socio-demographic data, prosthesis-related factors, clinical condition of the mouth, and patient subjective evaluations, were gathered. Descriptive and non-parametric probes were run (α= 0.05). RESULTS The ND group was the most unsatisfied (OHIP-14sp; p≤ 0.001). The OHIP-20sp attributed significantly worse Psychological disability (p= 0.029) and Handicap (p= 0.027) to CD wearers when compared to IO wearers. The CD group showed the significantly highest need for relining (p= 0.041), and the lowest retention (p= 0.011). The OHIP-14sp disclosed a significantly worse OHRQoL for those volunteers who had a job (p= 0.003), a basic education instead of a secondary one (p= 0.022), and no partner (p= 0.006). CONCLUSIONS The overall OHRQoL was comparable for both prosthodontic groups, being modulated by socio-demographic and prosthesis-related features. Nonetheless, CD wearers presented prosthetic complications more frequently.
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Affiliation(s)
| | - Arelis Preciado
- Faculty of Dentistry, Complutense University of Madrid (UCM), Pza. Ramón y Cajal s/n, 28040, Madrid, Spain.
| | - Marta Romeo
- Faculty of Dentistry, Complutense University of Madrid (UCM), Pza. Ramón y Cajal s/n, 28040, Madrid, Spain.
| | - Jaime Del Río
- Faculty of Dentistry, Complutense University of Madrid (UCM), Pza. Ramón y Cajal s/n, 28040, Madrid, Spain.
| | - Christopher D Lynch
- University Dental School & Hospital/ University College Cork, T12 E8YV, Wilton, Cork, Ireland.
| | - Raquel Castillo-Oyagüe
- Faculty of Dentistry, Complutense University of Madrid (UCM), Pza. Ramón y Cajal s/n, 28040, Madrid, Spain.
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Abstract
Introduction Little is understood about the socioeconomic predictors of tooth loss, a condition that can negatively impact individual’s quality of life. The goal of this study is to develop a machine-learning algorithm to predict complete and incremental tooth loss among adults and to compare the predictive performance of these models. Methods We used data from the National Health and Nutrition Examination Survey from 2011 to 2014. We developed multiple machine-learning algorithms and assessed their predictive performances by examining the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and positive and negative predictive values. Results The extreme gradient boosting trees presented the highest performance in the prediction of edentulism (AUC = 88.7%; 95%CI: 87.1, 90.2), the absence of a functional dentition (AUC = 88.3% 95%CI: 87.3,89.3) and for predicting missing any tooth (AUC = 83.2%; 95%CI, 82.0, 84.4). Although, as expected, age and routine dental care emerged as strong predictors of tooth loss, the machine learning approach identified additional predictors, including socioeconomic conditions. Indeed, the performance of models incorporating socioeconomic characteristics was better at predicting tooth loss than those relying on clinical dental indicators alone. Conclusions Future application of machine-learning algorithm, with longitudinal cohorts, for identification of individuals at risk for tooth loss could assist clinicians to prioritize interventions directed toward the prevention of tooth loss.
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25
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Rosalen NP, Muniz FWMG, Scalco NR, Dezingrini KDS, Colussi EL, Pires ALC, Colussi PRG. What variables are associated with use of and need for dental prosthesis? A cross-sectional study. Gerodontology 2021; 39:177-186. [PMID: 33749031 DOI: 10.1111/ger.12552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/11/2021] [Accepted: 03/10/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Population-based studies assessing the factors associated with use of and need for dental prosthesis among older adults are scarce. OBJECTIVE To evaluate the use of and need for dental prosthesis and associated factors in the older adult population of a southern city of Brazil. MATERIAL AND METHODS A cross-sectional study, involving community-dwelling older adults (≥60 years), was performed. A probabilistic per cluster sampling was used, and 282 participants from Veranópolis, Brazil, were included. A clinical oral health examination was performed, and a structured questionnaire was applied. Bivariate and multivariate analyses were performed to verify associations using Poisson regression with robust variance. RESULTS The prevalence of use of dental prosthesis was 87.2% (n = 246), while the prevalence of need for dental prosthesis was 27% (n = 76). Older adults with medium/high levels of education had 17.8% (P = .019) lower prevalence ratio (PR) for use of dental prosthesis. Unmarried and retired older adults had, respectively, 11.1% (PR:1.111; 95%CI:1.022-1.207) and 19.5% (PR:1.195; 95%CI:1.009-1.415) higher PR for use of prosthesis. Those without access to dental care had 11.8% (P = .012) higher PR for use of dental prosthesis. Older adults living in rural areas had 64.7% (PR:1.647; 95%CI:1.079-2.514) higher PR of need for dental prosthesis. CONCLUSION High and low prevalence of use of and need for dental prosthesis, respectively, were detected in this sample. Level of education, marital status, retirement status and access to dental care were associated with the use of dental prostheses. However, only residence area was associated with the need for oral rehabilitation.
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Affiliation(s)
| | | | - Natália R Scalco
- School of Dentistry, University of Passo Fundo, Passo Fundo, Brazil
| | | | | | - Ana Luiza C Pires
- Graduation program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Paulo R G Colussi
- Department of Periodontology, University of Passo Fundo, Passo Fundo, Brazil
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Beenackers MA, Vermaire JH, van Dommelen P, Schuller AA. Experiencing Financial Strain and Clinically Assessed Caries Experience in Dentate Adults Aged 25-44 Years: An Exploration of Potential Pathways. Caries Res 2020; 55:63-72. [PMID: 33352549 DOI: 10.1159/000511466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 09/06/2020] [Indexed: 11/19/2022] Open
Abstract
Large socioeconomic inequalities still exist in oral health. It is already known that oral health-related behaviour may contribute to these inequalities, but why people with a lower socioeconomic position behave less healthily is not easily understood. A possible explanation that integrates insights on health behaviour, stress, and financial resources is the pathway of behavioural responses to financial strain. The aim of this study was to assess to what extent financial strain is associated with clinically assessed caries experience in a population-based study of dentate adults, independently of other socioeconomic indicators. Furthermore, the potential mediating pathways of oral health-related behaviours (oral hygiene, dietary habits, preventive dental visits) were explored. Dentate participants, aged 25-44 years, taking part in a survey on oral health and preventive behaviour in the Netherlands in 2013 were clinically examined on - among others - caries experience (DMFS index) and level of oral hygiene (OHI-s index). Financial strain, frequency of tooth brushing, dietary habits, attendance of (preventive) dental visits in the past year, and demographic variables were assessed via questionnaires. Negative binomial hurdle models were used to study the association between financial strain and DMFS and between oral health behavioural indicators and DMFS. Although it was observed that experiencing financial strain did not seem to affect whether there is any caries experience or not, among those having any caries (DMFS >0) suffering from financial strain was associated with a higher caries prevalence, independent of educational level and income. None of the studied potential mediators could explain this association.
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Affiliation(s)
- Mariëlle A Beenackers
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands,
| | - Jan H Vermaire
- Department of Child Health, TNO, Netherlands Organisation for Applied Scientific Research, Leiden, The Netherlands.,Centre for Dentistry and Oral Hygiene, University Medical Centre Groningen, Groningen, The Netherlands
| | - Paula van Dommelen
- Department of Child Health, TNO, Netherlands Organisation for Applied Scientific Research, Leiden, The Netherlands
| | - Annemarie A Schuller
- Department of Child Health, TNO, Netherlands Organisation for Applied Scientific Research, Leiden, The Netherlands.,Centre for Dentistry and Oral Hygiene, University Medical Centre Groningen, Groningen, The Netherlands
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Individual- and City-Level Socioeconomic Factors and Tooth Loss among Elderly People: A Cross-Level Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072345. [PMID: 32235684 PMCID: PMC7177366 DOI: 10.3390/ijerph17072345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 01/20/2023]
Abstract
This study aimed to test the association of contextual and individual socioeconomic status with tooth loss among Brazilian elderly people aged 65–74 years. Data from 5435 elderly participants from the Brazilian National Oral Health Survey (2010) were linked to city-level data for 27 state capitals and the Federal District. Tooth loss was clinically assessed according to the number of missing natural teeth. Contextual social variables included Human Development Index income (HDI-income) and HDI-education. Individual socioeconomic measures were monthly family income and years of schooling. Covariates included sex, skin colour, number of residents per room and number of goods. Multilevel Negative Binomial regression models were used to estimate rate ratios (RR) and 95% confidence intervals between contextual and individual variables and tooth loss. Contextual and individual income and education measures were consistently associated with tooth loss. Elderly people living in cities with low HDI-income and low HDI-education were respectively 21% and 33% more likely to present tooth loss. Cross-level interaction suggested that the relationship of lower income and lower schooling with tooth loss is different across levels of city-level income and city-level education inequality, respectively. Public policies aiming to reduce the income and education gaps and preventive dental interventions are imperative to tackle tooth loss among elderly people.
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