Reasons for extraction of permanent teeth in general dental practices in Tehran, Iran

Common Reasons for Permanent Tooth Extraction and Its Correlation with Demographical Factors in Kabul, Afghanistan

Objective

The aim of this survey was to investigate the main reasons for extraction of permanent teeth, and its correlation with age, gender, education level, smoking habits, and time of last dental visit, family income, and professions in Kabul, Afghanistan.

Subjects and Methods

The study proposal was approved by Research Ethics Committee of Khatam AL Nabieen and was conducted over a period of 5 months; its population consisted 594 patients, aged 10-70 years, who underwent extraction. The frequency distribution was calculated using X2 test, ANOVA and t-test for differences in mean number of patients.

Results

A total of 594 patients underwent extraction. The highest rate (53.8%) of extraction occurred for those 21-40 years old. Females compromised 51.3% of patients. Two hundred (33.6%) patients were uneducated. Tooth loss due to caries was 30.1%; patient-request was 18.3%; impacted teeth was 14.4%. Other causes were periodontal reasons, failed root canal therapy (RCT), Tooth mobility, and Root fractures.

Conclusion

The result of this survey indicated that caries, patient request, and impaction were the leading reasons for tooth extraction. The majority of patients were uneducated, and had insufficient family income. Most of the patients were housewives and laborers.

Reasons behind permanent tooth extraction at a dental university hospital in Morocco: a survey among patients of the International Faculty of Dental Medicine of Rabat

Introduction

this cross-sectional study aimed to investigate the factors contributing to tooth extractions and possible correlations between tooth loss and various variables.

Methods

the study took place at the dental university hospital affiliated with the International University of Rabat over a period of two months (December 15th, 2020, to February 15th, 2021). The data collected has been recorded from patients who had tooth extraction procedures. The variables analyzed included age, gender, and the reason for extraction. To analyze the significance of the variables Chi-square test was used, and to investigate the variance in the mean number of teeth extracted per patient ANOVA was used.

Results

in 159 patients with different ages, a total of 586 permanent teeth were extracted. Men had an extraction rate of 54.5% while women formed 45.5%. Overall, the most frequent reason for tooth extraction was caries (46.28%), and periodontal diseases (44.90%). Other reasons for extraction included prosthetics (4.31%) and aesthetics (2.7%). However, orthodontics reasons were not observed. The topmost tooth extraction rate per patient was seen in the 41 to 50-year-old age group with a mean of 4.22 teeth. Analysis of the reasons for extraction by gender did not show a statistically significant difference (p>0.29).

Conclusion

caries and periodontal disease were the main causes of tooth extractions. Improving oral prevention health programs can help patients maintain healthier and functional oral health throughout their lives.

Overview of oral health status and associated risk factors in maritime settings: An updated systematic review

OBJECTIVES

The aim of this study is to provide an updated overview of the oral health status and associated risk factors in maritime settings.

METHODS

We systematically searched PubMed, Ovid Embase, Web of Science, CINAHL and SCOPUS from January 2010 to April 2023. Two independent reviewers extracted the data. The quality of included studies was assessed using relevant assessment tools.

RESULTS

A total of 260 records were found in the initial search; 24 articles met the inclusion criteria. Most studies had descriptive design, and only two randomized controlled trials were found. The main oral health issues noted are oral cancer, dental caries, periodontal diseases, oral mucosal lesions, and dental emergency. Male seafarers have higher risk of oral cancers in the tongue, lips, and oral cavity while oral mucosal lesions are more prevalent among fishermen.

CONCLUSIONS

Dental caries and periodontal diseases are prevalent in both seafarers and fishermen. The consumption of tobacco, alcohol, fermentable carbohydrate, and poor oral hygiene are risk factors that affect the oral health status at sea. The occurrence of oral diseases in maritime setting requires more attention of researchers and authorities to develop strategies to tackle these issues.

TRIAL REGISTRATION

Systematic review registration number in PROSPERO: CRD42020168692.

Placebo hypoalgesic and nocebo hyperalgesic effects in post-extraction patients-A cross sectional study

Background and objectives

Pain is an unpleasant sensory and emotional experience that affects people's physical, mental, and social health. Patients at times present with postoperative pain with no clinical signs after the surgical dental procedures and adequate pharmacological management. This can be due to the amplified emotional component of the individual in their postoperative period. Hence, this study aimed to estimate the association between placebo, nocebo effects, and postoperative pain associated with tooth extraction procedures.

Methods

A cross-sectional study was conducted among 301 patients attending the Department of Oral and Maxillofacial Surgery for tooth extraction. Preoperatively, the expected postoperative pain score was recorded using the "Numerical Rating Scale" (NRS), Anxiety and Depression were assessed using the "Hospital Anxiety and Depression Scale" (HADS), and Patients' expectancy regarding the treatment outcome was assessed using the "Credibility Expectancy Questionnaire" (CEQ). Observed postoperative pain scores at the 6th hour, 24th hour, and peak pain score of the day were recorded using the NRS.

Results

There were statistically significant associations (p < 0.05) found between expected and observed postoperative pain, preoperative anxiety and observed postoperative pain, preoperative depression and observed postoperative pain, placebo, nocebo effects, and observed postoperative pain.

Interpretation and conclusion

Our study showed a strong association between these variables suggesting that post-extraction pain is a multifaceted condition wherein pain expectation, preoperative anxiety, depression, and expectancy regarding the treatment outcome should be scrutinized before the extraction procedure.

Level of difficulty of tooth extractions among roughly 100,000 procedures in primary care

OBJECTIVES

The study examined treatment codes of extracted teeth and aimed to assess degree of difficulty concerning all tooth extractions.

MATERIALS AND METHODS

Retrospective data on treatment codes of all tooth extractions during a two-year period were obtained from the patient register in primary oral healthcare of the City of Helsinki, Finland. Prevalence, indication, and method of extraction appeared in the treatment codes (EBA-codes). Degree of difficulty was determined from the method and classified as non-operative or operative and as routine or demanding. Statistics included frequencies, percentages, and χ2 test.

RESULTS

Total number of extraction procedures was 97,276, including 121,342 extracted teeth. The most frequent procedure was a routine extraction of a tooth with forceps (55%, n = 53,642). The main reason for extraction was caries (27%, n = 20,889). Of the extractions, 79% (n = 76,435) were non-operative, 13% (n = 12,819) operative, and 8% (n = 8,022) multiple extractions in one visit. Level of difficulty was distributed as routine non-operative (63%), demanding non-operative (15%), routine operative (12%), demanding operative (2%), and multiple extractions (8%).

CONCLUSIONS

Two-thirds of all tooth extractions in primary care were relatively simple. However, 29% of procedures were classified as demanding.

CLINICAL RELEVANCE

As earlier methods for assessing level of difficulty were aimed at third molars alone, an analysis was presented for all tooth extractions. This approach may be useful for research purposes, and the profile of tooth extractions and their difficulty level may be practical also for decision-makers in primary care.

How the Loss of Second Molars Corresponds with the Presence of Adjacent Third Molars in Chinese Adults: A Retrospective Study

Third molars (M3s) can increase the pathological risks of neighboring second molars (M2s). However, whether the M3 presence affects M2 loss remains unknown. This retrospective study aimed to reveal the reasons for M2 loss and how M2 loss relates to neighboring M3s. The medical records and radiographic images of patients with removed M2(s) were reviewed to analyze why the teeth were extracted and if those reasons were related to adjacent M3s. Ultimately, 800 patients with 908 removed M2s were included. In the included quadrants, 526 quadrants with M3s were termed the M3 (+) group, and the other 382 quadrants without M3s were termed the M3 (−) group. The average age of patients in the M3 (+) group was 52.4 ± 14.8 years and that of the M3 (−) group was 56.7 ± 14.9 years, and the difference between the two groups was statistically significant (p < 0.001). Of the 908 M2s, 433 (47.7%) were removed due to caries and sequelae and 300 (33.0%) were removed due to periodontal diseases. Meanwhile, 14.4% of the M2s with adjacent M3s were removed due to distal caries and periodontitis, which were closely related to the neighboring M3s; this percentage was much lower when M3 were absent (1.8%). Additionally, 42.2% of M3s were removed simultaneously with neighboring M2s. The presence of M3s, regardless of impaction status, was associated with an earlier loss of their neighboring M2s.

Cells and material-based strategies for regenerative endodontics

<p class = "Abstract" style = "margin: 0 cm; line-height: 32px; font-size: 12 pt; font-family: "Times New Roman", serif; color: rgb(0, 0, 0); "><span lang = "EN-US">The carious process leads to inflammation of pulp tissue. Current care options include root canal treatment or apexification. These procedures, however, result in the loss of tooth vitality, sensitivity, and healing. Pulp capping and dental pulp regeneration are continually evolving techniques to regenerate pulp tissue, avoiding necrosis and loss of vitality. Many studies have successfully employed stem/progenitor cell populations, revascularization approaches, scaffolds or material-based strategies for pulp regeneration. Here we outline advantages and disadvantages of different methods and techniques which are currently being used in the field of regenerative endodontics. We also summarize recent findings on efficacious peptide-based materials which target the dental niche.<o:p></o:p></span></p>

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Pulp infection necessitates removal of necrotic, inflamed and infected tissue.

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Materials used clinically are inert (such as gutta percha, mineral trioxide aggregate).

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Recent developments in materials (angiogenic hydrogels, stem cell composites) have tuneable bioactivity.

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Dental pulp regeneration may now be possible through the use of bioactive systems, that guide regeneration.

Tooth life expectancy and burden of tooth loss: Two cross-sectional studies in Taiwan

Background/purpose

Materials and methods

Results

Conclusion

Bone remodeling around dental implants after 1-1.5 years of functional loading: A retrospective analysis of two-stage implants

OBJECTIVES

This study aims to retrospectively assess to what extent peri-implant bone level changes occur from exposing the implant to the oral environment at the second stage of surgery (SSS) to the baseline assessment and, additionally, after 1-1.5 years of functional loading. Further, this study aims to examine the role of the emergence angle in marginal bone changes.

MATERIAL AND METHODS

This retrospective study included 46 patients treated between 2012 and 2019. These patients received 64 bone-level dental implants. After implant placement, SSS, and baseline assessment, relevant clinical peri-implant conditions and radiographical data were collected. A radiographic examination of the marginal bone level was performed after SSS, the baseline assessment, and 1-1.5 years of follow-up.

RESULTS

The peri-implant periodontal probing depth increased significantly from 3.08 ± 0.7 mm at the baseline to 3.27 ± 0.81 mm at the 1-1.5-year follow-up. The mean marginal bone level at the implant level was 0.12 ± 0.23, 0.35 ± 0.43, and 0.47 ± 0.47 mm at the SSS, baseline, and the 1-1.5-year follow-up, respectively. Most changes occurred at the implant's distal site. A significant relationship was found between the emergence angle and the extent of change in the marginal bone level between the SSS and baseline (r = .430, p ≤ .001).

CONCLUSIONS

Most changes in the marginal bone level occurred between SSS and baseline assessments. For diagnostic purposes, it is advised to obtain a standardized radiograph after SSS to monitor peri-implant bone-level alterations.

Cost-utility analysis of an implant treatment in dentistry

Background

When dealing with the replacement of one missing tooth, the patient has the option of choosing between different types of treatment interventions. Several important factors play a role in his decision-making process, including his limited financial means and his efforts to solve the problem of missing teeth as effectively as possible. The main goal of the study is the economic-clinical evaluation of implant treatment, as a surgical-prosthetic method in dentistry, in case of replacement of one missing tooth of the molar area.

Methods

Cost-utility analysis from the patient's perspective is used for evaluation. The selected comparator is a purely prosthetic solution with the help of a three-unit fixed dental prosthesis. Cost-utility analysis is modelled using Markov models, which consider a 30-year time horizon.

Results

Based on the results of modelling, the intervention evaluated by the patient, i.e. treatment with the help of implant-supported single crown, brings exactly 15.31 quality-adjusted prosthesis years (QAPY) after 30 years. The value of incremental cost-utility ratio amounted to USD − 1434.

Conclusion

The results of the cost-utility analysis suggest that implant treatment with an implant-supported single crown is more cost-effective than treatment with the three-unit fixed dental prosthesis.

Prevalence of Missing First Permanent Molars in a Selected Population in a University Dental Clinic Setting: A Retrospective Radiographic Study

Aim and objective

This study aimed to determine the prevalence of missing first permanent molars (FPMs) in the 7–29-year-old selected population of Al Ahsa, Saudi Arabia.

Materials and methods

This study retrospectively analyzed 398 panoramic radiographs of patients aged from 7 to 29 years old for missing FPM. Patients were divided into two age-groups: 7–15 and 16–29 years old. Study variables including gender, age, missing FPM, dental arch, and right or left sides of the arch were recorded. The data were statistically analyzed using Chi-square tests.

Results

Of the total study sample, 23.1% of patients had only one missing FPM, 13.3% of patients had two, and 2.8% of them had three missing FPM teeth. No patient had four missing FPM teeth. A total of 60.8% (242) radiographs in the overall sample did not show any missing teeth. The mandibular FPMs (35.2%) were found missing more frequently than their maxillary counterparts (17.4%) and the left mandibular quadrant showed a higher rate of missing FPM (21.9%). No statistically significant association was seen between the missing FPM and the gender or age-group (p > 0.05).

Conclusion

The high prevalence rates of missing FPM in the study population warrants attention. Further prospective studies are needed to comprehensively evaluate the effect of early loss of the FPM on space changes in the arch and subsequent reduction in complex orthodontic treatment needs.

How to cite this article

Almugla YM. Prevalence of Missing First Permanent Molars in a Selected Population in a University Dental Clinic Setting: A Retrospective Radiographic Study. Int J Clin Pediatr Dent 2021;14(2):269–272.

Risk factors for tooth loss with a mean follow-up period of 13.9 years in supportive periodontal therapy patients

Background

Clinical evidence indicates that there are various risk factors of tooth loss. However, the degree of this risk among other risk factors remains unclear. In this retrospective cohort study, the authors evaluated the hazard ratios of several risk factors for tooth loss.

Methods

Included patients had all been treated for dental disorders, were in the supportive phase of periodontal therapy by dental hygienists, and visited a Japanese dental office continually during a 10-year period. Periodontal parameters, tooth condition, and general status of all teeth (excluding third molars) at the initial visit and at least 10 years later were evaluated by using multiple classification analysis.

Results

The authors evaluated a total of 7584 teeth in 297 patients (average age: 45.3, mean follow-up time: 13.9 years) Non-vital pulp was the most significant predictor of tooth loss according to Cox hazards regression analysis (hazard ratio: 3.31). The 10-year survival rate was approximately 90% for teeth with non-vital pulp and 99% for teeth with vital pulp. Fracture was the most common reason for tooth loss.

Conclusions

Non-vital pulp had the most significant association with tooth loss among the parameters. Therefore, it is very important to minimize dental pulp extirpation.

Reasons for Extraction of Permanent Teeth in a University Dental Clinic Setting

Purpose

This study aimed to explore the reasons for tooth extraction and investigated the potential correlations between tooth loss and several variables including age, gender, education level, and other risk factors, such as diabetes and smoking habit.

Patients and Methods

The study retrospectively analyzed 1811 dental records of patients who underwent extraction procedure of at least one tooth. Patients’ variables included: age, gender, level of education, diabetes, and smoking habit. Reasons for extraction were recorded as follows: caries, periodontal disease, endodontic treatment complications, orthodontic treatment, impactions, trauma, pre-prosthetic, and others (esthetic reasons, tooth malposition, or unspecified reasons).

Statistical analysis

The significance of variables was analyzed by Chi square test, P < 0.05. The variances in the mean number of extracted teeth per patient were investigated using ANOVA. Pearson correlation test was used to test the strength of the association among the tested variables, P < 0.01.

Results

Out of 1811 reviewed patients’ records, 2654 extracted teeth were identified. Males had a higher number of extracted teeth, 1447 (54.5%), than females, 1207 (45.5%). Males had more extractions due to periodontal disease, while females had more extractions for orthodontic and pre-prosthetic reasons. The highest mean of extracted teeth was identified among the 51-year-old and above age groups (3.73 ± 0.53 teeth) where periodontal disease was shown to have a significant association (P < 0.05). Diabetic patients showed a significant association with periodontal diseases, while smokers showed a significant association with caries. Both diabetics and smokers had moderate correlation (0.055 and 0.04, respectively).

Conclusion

Caries, periodontal disease, and endodontic complications were the most common causes of tooth extraction. In addition, this study indicated that age, diabetes, and smoking habits were found to be suitable forecasters for permanent tooth loss as these variables displayed significant statistical association.

Antibiotics to prevent complications following tooth extractions

BACKGROUND

The most frequent indications for tooth extractions, generally performed by general dental practitioners, are dental caries and periodontal infections. Systemic antibiotics may be prescribed to patients undergoing extractions to prevent complications due to infection. This is an update of a review first published in 2012.

OBJECTIVES

To determine the effect of systemic antibiotic prophylaxis on the prevention of infectious complications following tooth extractions.

SEARCH METHODS

Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health Trials Register (to 16 April 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2020, Issue 3), MEDLINE Ovid (1946 to 16 April 2020), Embase Ovid (1980 to 16 April 2020), and LILACS (1982 to 16 April 2020). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.

SELECTION CRITERIA

We included randomised, double-blind, placebo-controlled trials of systemic antibiotic prophylaxis in patients undergoing tooth extraction(s) for any indication.

DATA COLLECTION AND ANALYSIS

At least two review authors independently performed data extraction and 'Risk of bias' assessment for the included studies. We contacted trial authors for further details where these were unclear. For dichotomous outcomes, we calculated risk ratios (RR) and 95% confidence intervals (CI) using random-effects models. For continuous outcomes, we used mean differences (MD) with 95% CI using random-effects models. We examined potential sources of heterogeneity. We assessed the certainty of the body of evidence for key outcomes as high, moderate, low, or very low, using the GRADE approach.

MAIN RESULTS

We included 23 trials that randomised approximately 3206 participants (2583 analysed) to prophylactic antibiotics or placebo. Although general dentists perform dental extractions because of severe dental caries or periodontal infection, only one of the trials evaluated the role of antibiotic prophylaxis in groups of patients affected by those clinical conditions. We assessed 16 trials as being at high risk of bias, three at low risk, and four as unclear.  Compared to placebo, antibiotics may reduce the risk of postsurgical infectious complications in patients undergoing third molar extractions by approximately 66% (RR 0.34, 95% CI 0.19 to 0.64; 1728 participants; 12 studies; low-certainty evidence), which means that 19 people (95% CI 15 to 34) need to be treated with antibiotics to prevent one infection following extraction of impacted wisdom teeth. Antibiotics may also reduce the risk of dry socket by 34% (RR 0.66, 95% CI 0.45 to 0.97; 1882 participants; 13 studies; low-certainty evidence), which means that 46 people (95% CI 29 to 62) need to take antibiotics to prevent one case of dry socket following extraction of impacted wisdom teeth. The evidence for our other outcomes is uncertain: pain, whether measured dichotomously as presence or absence (RR 0.59, 95% CI 0.31 to 1.12; 675 participants; 3 studies) or continuously using a visual analogue scale (0-to-10-centimetre scale, where 0 is no pain) (MD -0.26, 95% CI -0.59 to 0.07; 422 participants; 4 studies); fever (RR 0.66, 95% CI 0.24 to 1.79; 475 participants; 4 studies); and adverse effects, which were mild and transient (RR 1.46, 95% CI 0.81 to 2.64; 1277 participants; 8 studies) (very low-certainty evidence).  We found no clear evidence that the timing of antibiotic administration (preoperative, postoperative, or both) was important. The included studies enrolled a subset of patients undergoing dental extractions, that is healthy people who had surgical extraction of third molars. Consequently, the results of this review may not be generalisable to all people undergoing tooth extractions.

AUTHORS' CONCLUSIONS

The vast majority (21 out of 23) of the trials included in this review included only healthy patients undergoing extraction of impacted third molars, often performed by oral surgeons. None of the studies evaluated tooth extraction in immunocompromised patients. We found low-certainty evidence that prophylactic antibiotics may reduce the risk of infection and dry socket following third molar extraction when compared to placebo, and very low-certainty evidence of no increase in the risk of adverse effects. On average, treating 19 healthy patients with prophylactic antibiotics may stop one person from getting an infection. It is unclear whether the evidence in this review is generalisable to patients with concomitant illnesses or patients at a higher risk of infection. Due to the increasing prevalence of bacteria that are resistant to antibiotic treatment, clinicians should evaluate if and when to prescribe prophylactic antibiotic therapy before a dental extraction for each patient on the basis of the patient's clinical conditions (healthy or affected by systemic pathology) and level of risk from infective complications. Immunocompromised patients, in particular, need an individualised approach in consultation with their treating medical specialist.

Residual periodontal ligament in extracted teeth - is it associated with indication for extraction?

BACKGROUND

Periodontal disease is a major cause of tooth loss. Few studies have evaluated the residual area of the periodontal ligament in extracted teeth and, to the best of our knowledge, none from Latin America have done so regarding indications for extraction. The aim of this study was to evaluate the residual periodontal ligament (RPL) with respect to indication for extraction in a sample of teeth from a Brazilian Public Health Service district.

MATERIALS AND METHODS

All teeth extracted within the Public Health Service district of Santa Maria, Brazil, over a 5-month period were requested for analysis. A total of 414 teeth eligible for measurement were stained and evaluated for RPL using a stereo microscope. Participating Public Health Service dentists completed a questionnaire detailing demographic variables and indication for each extracted tooth. The percentage of RPL was determined for each tooth. Comparisons of RPL between teeth extracted on periodontal versus other indications were made using the Mann-Whitney test.

RESULTS

RPL averaged 34.8% for teeth extracted on periodontal indications versus 79.5% for other teeth (P ≤ 0.001). When considering teeth with an RPL ≥ 30% as possible to maintain, 189 (76%) of the teeth extracted on periodontal indications could have been maintained. When RPL cut-off limits of ≥ 40% or ≥ 50% are applied, 93 (37%) and 43 (17%) teeth, respectively, could have been maintained.

CONCLUSION

This study suggests that strictly based on RPL, a large number of teeth extracted on periodontal indications conceivably could be maintained.

Pattern and Reasons for Permanent Tooth Extractions at Dental Clinics of the University of Science and Technology of Fujairah, UAE

Objectives:

To evaluate the pattern and reasons for permanent tooth extractions in an adult patient seeking free dental care at clinics of the University of Science and Technology of Fujairah, UAE.

Methods:

The current retrospective study involved patients who had a dental extraction in the student dental clinics of the University of Science and Technology of Fujairah. Data of 1000 randomly selected extractions were collected from the archive of the university dental clinics.

Results:

Males had more teeth extracted (88.3%) than females. The most frequent extraction (58.9%) was in individuals of 30-49 years old range. Dental caries was the major reason (44.6%) of extractions, followed by wisdom teeth related extraction (23.4%), periodontal disease (18.1), failure of endodontically treated teeth (8.7%), prosthetic reasons (2.6), orthodontic reasons (1.7%), and trauma (0.9%) respectively. The most extracted teeth were the maxillary posterior teeth (45.6%), followed by mandibular posterior teeth (38.2%); then, maxillary anterior teeth (8.8) and lastly, were the mandibular anterior teeth (7.4%). Caries was significantly more frequent in female gender (χ2= 250.126; p=.000), while the periodontal disease was more common in male gender (χ2 = 146.790; p=.000).

Conclusion:

Caries is the principal reason for tooth extractions, followed by wisdom teeth related problems and periodontal disease. There is an increasing percentage of tooth extraction due to periodontal disease with both aging and male gender. Caries was the more frequent reason for extraction in all quadrants, except the lower anterior teeth in which periodontal disease was the more frequent reason. Lastly, anterior teeth were retained in the oral cavity more than posterior teeth.

Reasons for Tooth Extractions and Related Risk Factors in Adult Patients: A Cohort Study

Background: The aim of this study was to evaluate oral status, the reasons for tooth extractions and related risk factors in adult patients attending a hospital dental practice. Methods: 120 consecutive patients ranging from 23 to 91 years in age (mean age of 63.3 ± 15.8) having a total of 554 teeth extracted were included. Surveys about general health status were conducted and potential risk factors such as smoking, diabetes and age were investigated. Results: a total of 1795 teeth were missing after extraction procedures and the mean number of remaining teeth after the extraction process was 16.8 ± 9.1 per patient. Caries (52.2%) was the most common reason for extraction along with periodontal disease (35.7%). Males were more prone to extractions, with 394 of the teeth extracted out of the total of 554 (71.1%). Male sex (β = 2.89; 95% CI 1.26, 4.53; p = 0.001) and smoking habit (β = 2.95; 95% CI 1.12, 4.79; p = 0.002) were related to a higher number of teeth extracted. Age (β = −0.24; 95% CI −0.31, −0.16; p < 0.001) and diabetes (β = −4.47; 95% CI −7.61, −1.33; p = 0.006) were related to a higher number of missing teeth at evaluation time. Moreover, periodontal disease was more common as a reason of extraction among diabetic patients than among non-diabetic ones (p = 0.04). Conclusions: caries and periodontal disease were the most common causes of extraction in a relatively old study population: further screening strategies might be required for the early interception of caries and periodontal disease.

Tooth extraction: Pattern and etiology from extreme Northwestern Nigeria

Objective:

Tooth extraction is a commonly performed procedure in dental clinics. It has been shown that the reasons for and pattern of tooth extraction vary across geographical regions. Few reports on the pattern of extraction among a semi-urban populace exist. To the best of our knowledge, there is no study on the pattern and reasons for tooth mortality from Sokoto, Northwestern Nigeria, which is a semi-urban region.

Materials and Methods:

A review of the records of patients that had tooth extraction at our center between January 2009 and January 2016, was done. Data such as the age, gender, type of tooth extracted, and reasons for extraction were retrieved and analyzed. Cross tabulations for age and gender were also made. The level of statistical significance was set at P < 0.05.

Results:

A total of 1167 extractions were performed in 984 patients. An age range of 18–107 years with a mean (±standard deviation) of 34.8 (13.3) was observed. Most of the patients were in the 21–30 years age group accounting for 35.7% of cases. Dental caries and its sequelae (DCS) (631, 54.1%) were the most common reasons for extraction, followed by periodontal disease (192, 16.5%). The difference in proportions of reasons for tooth extraction between the gender was statistically significant (P = 0.02; df = 24). The difference in the reasons for extraction among the age groups was statistically significant (P < 0.001; df = 132).

Conclusion:

DCS along with periodontal disease were the major reasons for extractions. These are largely preventable causes of tooth extraction; therefore, there is a need for commencement of far-reaching preventative actions.

Risk factors for tooth loss in adults: A population-based prospective cohort study

The aim of this study was to identify the risk factors for tooth loss in an extended age group of adults over 4 years. The prospective cohort study assessed adults (20–64 years old) in 2011 and 2015, from Piracicaba, São Paulo, Brazil. The sample selection was planned based on the adult population in the city. The inclusion criteria were randomly selected residences per census tract unit (one adult per household). The exclusion criteria comprised of a physical or psychological state that prevented the achievement of clinical procedures or understanding of the questionnaire. The home oral examination was performed using the index of decayed, missing, and filled teeth (DMFT), the Community Periodontal Index according to the World Health Organization, and visible biofilm. Demographic and socio-economic data, information on health habits, and the use of dental services were obtained by questionnaire. The outcome was a presence incidence of tooth loss, assessed by the difference between Missing teeth (M>0) from DMFT in 2011 and that in 2015. The conceptual theoretical model ‘Ethnicity, aging and oral health outcomes’ was adapted for tooth loss and used in a Hierarchical multivariate Poisson Regression analysis (p<0.20). The reference category for the Poisson regression were individuals who had no missing teeth (M) due to caries or periodontal disease (p<0.05). There were a total of 143 (follow-up rate = 57.7%) participants in the four-year study, and there was incidence of tooth loss in 51 (35.7%) adults over this period. The risk factors for tooth loss were reason for seeking dental services by pain (RR = 2.72; 95.0% CI: 1.04–7.37), previous tooth loss (RR = 3.01; 95.0% CI: 1.18–7.73) and decayed teeth (RR = 2.87; 95.0% CI: 1.22–6.73). The risk factors for tooth loss were: reason for seeking dental services by pain, previous tooth loss and dental caries.

A Radiographic Evaluation of Missing of Permanent First Molars in a Group of Iranian Children and Adults: A Retrospective Study

The missing of permanent first molars influences the occlusal status and dental health. The purpose of this study was to determine the prevalence of missing first molar teeth in a selected population of Shiraz, Iran. Methods. A total of 2206 panoramic views of patients aged from 7 to 75 years old were inspected for missing of permanent first molars. Patients were categorized into five age groups: from 7 to 15, 16 to 30, 31 to 45, 46 to 60, and more than 60 years old. Data were categorized according to sex, age, and number of lost teeth using SPSS software. Results. No first molar was missing in 59.9% of the cases, 17.05% had lost one, 10.4% had lost two, 7.2% had lost three, and 5% were missing all four of their permanent first molars. The mandibular first molar was the most commonly lost tooth, and the left side in both jaws was more affected than the right side. There was a positive relation between age and missing first molar. Conclusions. A missing first molar is a common finding in southern Iran population. Due to the important role of permanent first molars in occlusion, more education and dental care is recommended to preserve these teeth.

Oral health condition and reasons for tooth extraction among an adult population (20-64 years old)

The study characterized the oral health condition and main self-reported reasons for tooth extraction in an adult population. The cross-sectional study examined 248 adults aged 20-64 years, representative of the population of Piracicaba, São Paulo, Brazil. The oral examination conducted in households used the DMFT and CPI indexes, use and necessity of prosthodontics according to the WHO criteria and the presence of visible biofilm. Demographic and socioeconomic data were collected along with reasons for tooth extraction through a questionnaire. Descriptive analysis was stratified by age in groups: 20-44 and 45-64 years old. The average DMFT was 20.37 (EP = 0.50), P = 3.34 (EP = 0.33) for young adults and P = 13.41 (EP = 1.45) for the older adults. Gingival pockets (CPI ≥ 3) were found on 20.5% of young adults and 53.0% of the older ones. While 38.8% used upper prosthesis, 46.7% needed lower prosthesis. Pain was the most prevalent self-reported reason for tooth extraction (37.5%), being this choice primarily because of lack of another treatment option (52%) and done in the private sector (47.2%). We concluded that young adults (20-44 years old) showed less missing teeth, periodontal diseases, and need for prosthetic use. Pain and lack of options of other treatments were the main self-reported reasons for performing tooth extractions.

The burden of tooth loss in Italian elderly population living in nursing homes

Background

This survey aims to evaluate the prevalence and severity of tooth loss in the Italian elderly population living in nursing homes and to associate the oral data with demographic, socioeconomic factors, the Mini-Mental State Examination (MMSE), the Body Mass Index (BMI) and the Mini Nutritional Assessment (MNA) scores.

Methods

A cluster sample method was performed using each nursing home as a cluster. Twenty-three nursing homes located in the five areas of the Italy (North-West, North-East, Centre, South and Islands) were selected. An informed consent to participate was distributed by the personnel of the selected nursing homes and signed directly by subjects/caregivers; 2114 forms were distributed, 1998 forms signed and finally 1976 subjects were examined. Chewing ability was scored as good (≥10 functional units (FUs)), sufficient (7–10 FUs), and insufficient (< 7 FUs). The presence of prosthetic dental restorations was summarized as: absent of prosthesis, fixed prosthesis, removable prosthesis, combined prosthesis. Age, gender, socioeconomic status, MMSE, BMI and MNA were obtained from medical charts.

Results

Almost three quarters of the subjects were ≥ 80 years old (74.37%) and women (74.04%). The prevalence of edentulism was 42.10% with a large variation among the five areas of Italy (from 34.43% in Centre to 53.46% in North-West). Insufficient presence of FUs was preeminent in each age group (prevalence 42.10%) and statistically associated to age and to female gender (p <  0.01). Overweight/obese (7.47%) subjects showed the highest FUs. Area of living, MMSE (both < 0.01), BMI (p = 0.01) were statistically significant associated to the type of prosthetic dental restorations in the oldest group. Subjects with no mental impairment showed the highest percentage of prosthetic dental restorations (32.36%).

Conclusions

More than half of the sample has an insufficient number of functional units for chewing and this is more pronounced in females. The presence and the type of prosthetic dental restorations are linked to cognitive impairment: the higher is the mental impairment the higher is the number of subjects with absence of prosthetic restorations. The findings of this national survey highlight the need for public health policy, aiming to increase awareness regarding oral health though health education.

Electronic supplementary material

The online version of this article (10.1186/s12877-018-0760-0) contains supplementary material, which is available to authorized users.

Incidence of Tooth Loss in Adults: A 4-Year Population-Based Prospective Cohort Study

Objective

To verify the incidence of tooth loss in extended age group of adults in 4 years.

Materials and Methods

The prospective cohort study assessed adults (20–64 years old) between 2011 and 2015, from Piracicaba, São Paulo, Brazil. The dependent variable was cumulative incidence of tooth loss, assessed by difference between missing teeth (M) of decayed, missing, and filled tooth index (DMFT) in 2011 and 2015. Participants were stratified into young (20–44 years old) and older (45–64 years old) adults. Mann–Whitney U test (p < 0.05) was used to compare the means of incidence of tooth loss between age groups.

Results

After four years, 57.7% (n = 143) of adults were followed up and the mean incidence of tooth loss was 0.91 (SD = 1.65); among these, 51 adults (35.7%) who lost their teeth showed mean tooth loss of 2.55 (SD = 1.86). In older adults, incidence of tooth loss was higher (p = 0.008), but no difference between age groups was found when only adults with incidence of tooth loss were assessed (p = 0.844).

Conclusion

There was higher incidence of tooth loss in older adults after four years, however, without difference between age groups when only those who lost teeth were evaluated.

Permanent tooth loss and sugar-sweetened beverage intake in U.S. young adults

OBJECTIVE

In young adults, sugar-sweetened beverage (SSB) intake is associated with dental caries, which in turn is a major contributor to tooth loss. The independent role of SSB intake on tooth loss, however, has not been well-described. This cross-sectional study examined associations between tooth loss and SSB intake among U.S. young adults.

METHODS

The outcome was number of permanent teeth lost because of dental caries or periodontal disease (0, 1-5, ≥6 teeth). Data from the 2012 Behavioral Risk Factor Surveillance System were used. The 22,526 adults aged 18-39 years completed the Sugar Drink Module. The exposure variable was daily frequency of SSB intake. We used multinomial logistic regression to examine the adjusted associations between tooth loss and daily SSB consumption (0, >0 to <1, 1-2, >2 times/day).

RESULTS

Approximately, 26% of young adults reported losing at least one permanent tooth. Tooth loss was positively associated with SSB intake frequency; the odds of losing 1-5 teeth were higher among adults drinking SSBs >0-<1 times/day (OR = 1.44, 95%CI = 1.16-1.79), 1-2 times/day (OR = 1.58, 95%CI = 1.25-1.99), and >2 times/day (OR = 1.97, 95%CI = 1.51-2.58) than non-SSB consumers. The odds of losing ≥6 teeth were higher among adults drinking SSBs 1-2 times/day (OR = 2.20, 95%CI = 1.15-4.22) and >2 times/day (OR = 2.81, 95%CI = 1.37-5.76) than non-SSB consumers.

CONCLUSIONS

Frequency of SSB consumption was positively associated with tooth loss among young adults even when the average SSB intake was less than one time per day. This study suggests that efforts to reduce SSB intake among young adults may help to decrease the risk of tooth loss.

Contribution of prosthetic treatment considerations for dental extractions of permanent teeth

Background. Tooth loss is an easily identifiable outcome that summarizes a complex suite of factors in an individual's history of dental disease and its treatment by dental services over a lifetime. Assessment of overall tooth loss data is essential for epidemiologically evaluating the adequacy of dental care provided at a systems level, as well as for placing in context tooth loss for non-disease causes. For example, when derived from prosthetic treatment planning, the latter may unfortunately lead to some teeth being extracted (pulled) for the sake of better comprehensive clinical results. The objective of the present manuscript was to identify the contribution to overall tooth loss, by extraction of permanent teeth because of prosthetic treatment reasons. Material and Methods. A cross-sectional study included sex, age, total number of extractions performed by subject, sextant (anterior vs. posterior), group of teeth (incisors, canines, premolars and molars), upper or lower arch, and the main reason underlying extraction (extraction for any reason vs. prosthetic treatment), in patients 18 years of age and older seeking care at a dental school clinic in Mexico. A multivariate logistic regression model was generated. Results. A total of 749 teeth were extracted in 331 patients; 161 teeth (21.5% of total) were extracted for explicit prosthetic treatment indications. As age increased, the likelihood of having an extraction for prosthetic reasons increased 3% (OR = 1.03, p < 0.001). Women (OR = 1.57, p < 0.05) were more likely to be in this situation, and molars (OR = 2.70, p < 0.001) were most at risk. As the total number of extractions increased, the risk of having an extraction for prosthetic reasons decreased (OR = 0.94, p < 0.05). Conclusions. A significant amount (21.5%) of the extractions of permanent teeth were performed for prosthetic reasons in this dental school clinical environment; age, sex, type of tooth, and the total number of extractions moderated such pattern.

Analysis of the Factors Affecting Surgical Success of Implants Placed in Iranian Warfare Victims

OBJECTIVE

The aim was to evaluate the survival time and success rates of dental implants in warfare victims and factors that affect implant success.

SUBJECTS AND METHODS

This retrospective study involved 250 Iranian warfare victims who received dental implants from 2003 to 2013. Patients' demographic characteristics, as well as the brand, diameter, length, location and failure rate of the implants were retrieved from patients' dental records and radiographs. The associations between these data and the survival rate were analyzed. Statistical analysis was carried out with χ2 and log-rank tests.

RESULTS

Overall, out of the 1,533 dental implants, 61 (4%) failed. The maxillary canine area had the highest failure rate [9 of 132 implants (6.8%)], while the mandibular incisor region had the least number of failures [3 of 147 implants (2.0%)] and the longest survival time (approximately 3,182 days). Maxillary canine areas had the shortest survival (about 2,996 days). The longest survival time was observed in implants with 11 mm length (3,179.72 ± 30.139 days) and 3.75-4 mm diameter (3,131.161 ± 35.96 days), and the shortest survival was found in implants with 11.5 mm length (2,317.79 ± 18.71 days) and 6.5 mm diameter (2,241.45 ± 182.21 days). Moreover, implants with 10 mm length (10.7%) and 5.5-6 mm diameter (22.2%) had the highest failure rate; however, the least failure rate occurred when the implants were 11.5 mm in length (1.9%) and 3-3.5 mm in diameter (3.1%).

CONCLUSIONS

The brand, length and diameter of implants affected the survival time, failure rate and time to failure. The location of the implant was not statistically significant regarding the mentioned factors, although it has clinical significance.

Impact of untreated dental caries and its clinical consequences on the oral health-related quality of life of schoolchildren aged 8-10 years

OBJECTIVE

This study aims to evaluate the impact of untreated dental caries and its clinical consequences on the quality of life of Brazilian schoolchildren aged 8-10 years.

METHODS

A randomly selected sample of 587 children underwent a clinical oral examination for the assessment of untreated dental caries and clinical consequences. The WHO criteria (decayed component of the decayed, missing, and filled teeth--D-DMFT in permanent teeth or d-dfmt in primary teeth) and the PUFA index, which records the presence of severely decayed permanent (upper case) and primary (lower case) teeth with visible pulpal involvement (P/p), as well as ulceration caused by dislocated tooth fragments (U/u), fistula (F/f), and abscesses (A/a), were used for the oral examination. Oral health-related quality of life (OHRQoL) was evaluated using the Child's Perception Questionnaire (CPQ8-10). Poisson regression was employed to test unadjusted and adjusted associations between untreated dental caries/clinical consequences and OHRQoL.

RESULTS

The prevalence of untreated dental caries was 64.6% (D/d component of DMFT/dmft > 0) and 17.9% of children exhibited clinical consequences of caries (PUFA/pufa index >0). In the adjusted models, untreated caries was significantly associated with the total CPQ8-10 score and all subscale scores. The clinical consequences of dental caries (PUFA/pufa index >0) were significantly associated with the total CPQ8-10 as well as the oral symptoms and functional limitations' subscales.

CONCLUSION

Untreated dental caries and its clinical consequences exerted a negative impact on the OHRQoL of the schoolchildren analyzed.

Reasons why erupted third molars are extracted in a public university in Mexico

PURPOSE

The aim of this study was to determine the reasons for which erupted third molars (3M) are extracted in a sample of Mexican patients.

SUBJECTS AND METHODS

A retrospective cross-sectional study was performed on a sample of 83 patients attending exodontia (minor oral surgery) clinics of a public university in Mexico (Autonomous University of Hidalgo State). The outcome variable was the reason for extractions using Kay and Blinkhorn's classification. The independent variables were age, gender, arch and tooth number according to the World Health Organization (WHO). For statistical analysis, we used the Chi-squared test in Stata 9.0.

RESULTS

Eighty-three patients underwent 150 3M extractions. Mean age was 38.67 ± 13.96 years, and 71.1% were female. The four reasons for 3M extraction were prosthetic (44.0%), followed by orthodontic (24.7%), dental caries (20.0%) and periodontal disease (11.3%). Differences were observed in the reasons for 3M extractions across age groups (p < 0.05). No significant differences existed between men and women (p > 0.05), or the WHO tooth number (p > 0.05).

CONCLUSION

Women and patients 18 to 34 years of age had erupted 3M extracted more frequently, primarily for prosthetic reasons. The age profile indicated a trend in demand for services that differ from those of overall tooth extractions, but not for the trend across gender.

Clinical Consequences of Untreated Dental Caries Evaluated with the Pulpal Involvement-Roots-Sepsis Index in the Primary Dentition of School Children from the Raipur and Durg Districts, Chhattisgarh State, India

Objective: To evaluate the prevalence of the clinical consequences of untreated dental caries in primary dentition among 6- to 8-year-old children using the prs [pulpal involvement (p), roots (r) and sepsis (s)] index and record the distribution of prs among boys and girls. Subjects and Methods: The study included a sample of 371 children aged 6-8 years with at least one carious primary molar tooth, who had been randomly selected from schools in the districts of Raipur and Durg, Chhattisgarh State, India. We recorded the presence of decayed, extracted and filled (i.e. def) teeth. The prevalence of the consequences of untreated dental caries was evaluated using the prs index. The data were statistically analyzed to express the prevalence of prs among boys and girls and the distribution of individual prs codes in the sample population. Results: The prevalence of carious lesions was very high (87%) and teeth with clinical consequences of untreated dental caries were found in 49.3% of the children. The prs distribution in children who were 8 years old (40.9%) was higher than in the 6-year-old children (25.6%). In the group of 8-year-olds, the occurrence of prs was greater among the boys whereas in the 6- and 7-year-old group, it was greater among the girls. Conclusion: The prs index is a valuable tool for measuring the clinical consequences of untreated dental caries. It could be useful for epidemiological studies and provide relevant information regarding treatment needs. © 2014 S. Karger AG, Basel.

Association between edentulism and angina pectoris in Mexican adults aged 35 years and older: a multivariate analysis of a population-based survey

BACKGROUND

The possible association between oral infection and chronic inflammation and cardiovascular disease risk has been studied intensively. The present study is designed to determine the strength of association between edentulism and angina pectoris in Mexican adults aged 35 years and older.

METHODS

Using the tools and sampling strategies of the World Health Survey of the World Health Organization, cross-sectional data were collected in Mexico in the National Performance Assessment Survey (probabilistic, multistage, and cluster sampling). Dental information was available for 20 of the 32 states of Mexico. Angina and edentulism are self-reported in this study. Statistical analysis was performed using binary logistic regression adjusting for complex samples.

RESULTS

A total of 13,966 participants, representing a population of 29,853,607 individuals, were included. Of the complete study population, 3,052,263 (10.2%) were completely toothless, and 673,810 (2.3%) were diagnosed with angina pectoris. After adjusting for smoking, alcohol consumption, diabetes, body mass index, and sex, the effect of edentulism on angina was modified by age (interaction), being more marked in the younger age group (odds ratio [OR] = exp(2.5597) =12.93) than in the older individuals surveyed (OR = exp(2.5597 + (-0.0334)) =12.51). Additionally, low physical activity (OR = 1.51; 95% confidence interval [CI] = 1.03 to 2.22) and higher socioeconomic status (OR = 1.37; 95% CI = 1.00 to 1.90) were more likely to be associated with angina pectoris.

CONCLUSIONS

Overall, the results of this study, conducted in a representative sample of Mexican adults, suggest that an association exists between edentulism and angina pectoris. Additional studies are necessary to elucidate the underlying mechanism for this association.

Pulpal involvement-roots-sepsis index: a new method for describing the clinical consequences of untreated dental caries

OBJECTIVES

To describe a modification of the index of clinical consequences of untreated dental caries [pulpal involvement, ulceration, fistula and abscess (PUFA/pufa) index] to pulpal involvement-roots-sepsis (PRS/prs) and to compare the two indices using the example of caries in primary molar teeth in children aged 6-8 years.

SUBJECTS AND METHODS

The study sample included 542 children aged 6-8 years, from five randomly selected schools in the Bialystok District, Poland. The occurrence of clinical consequences of untreated caries in deciduous molars using the pufa and prs indices was evaluated. Data were analysed to express the prevalence, the experience and the distribution of particular pufa and prs codes in the sample population. The differences in layout of the pufa and prs components were expressed.

RESULTS

The response rate was 77.6%. The prevalence of the clinical consequences of untreated caries was 40.77%, mean pufa and prs were the same (0.85 ± 1.33). According to the pufa index, the following mean values were obtained: p = 0.79, u = 0.01, f = 0.04 and a = 0.01. For the prs index, the mean values were as follows: p = 0.45, r = 0.35 and s = 0.05.

CONCLUSION

The proposed prs index was a useful epidemiological instrument for the evaluation of the clinical consequences of untreated caries in the surveyed population. The PRS instrument could be a good alternative to the PUFA index.