乳牙牙槽骨丧失的危险因素分析

Risk Factors of Alveolar Bone Loss of Primary Teeth

目的研究儿童乳牙牙槽骨丧失的危险因素。方法选择106名在北京大学口腔医院儿童口腔科就诊的3—10岁初诊儿童为研究对象,检查儿童的龋齿、充填体、食物嵌塞、牙髓根尖病变、牙石和牙周状况。并拍摄后牙翼片,应用计算机定点测量釉牙骨质界到牙槽嵴顶的距离。以釉质牙骨质界到牙槽嵴顶的距离大于2mm,牙槽嵴顶骨硬板不清晰、消失为牙槽骨丧失。根据牙槽骨是否丧失分为正常组和牙槽骨丧失组。采用SPSS10.0软件分析两组龋均(dmft)和邻面dmft有无差异,并用Logistic回归分析牙槽骨丧失的相关危险因素。结果106名儿童中,骨丧失组31名,占整个儿童的29%。骨丧失多发生在第一乳磨牙和第二乳磨牙之间。方差分析发现骨丧失组dmft和邻面dmft均高于正常组(P<0.01)。Logistic回归分析发现,牙槽骨丧失与邻面龋、不良充填体和根尖病变相关。结论儿童应积极完善治疗邻面龋,抑制根尖病变的进展,从而预防牙槽骨的丧失。

Objective To study the risk factors of alveolar bone loss CABL）of primary teeth in Chinese children. Methods Caries, restoration, food impact, pulp pathosis, calculus, and periodontal status were examined in 106 children aged 3-10 years old. Bite-wing radiographs of posterior teeth were scanned into computer. The distance from the cemento-enamel junction to alveolar bone crest was measured from the mesial surface of the first primary molar to the distal surface of the second primary molar using Adobe Photoshop 5.0 image analyzing system. ABL was recorded if the distance was more than 2 mm and the lamina dura was absent. All patients were divided into ABL group and non-ABL group. All data were analyzed by SPSS 10.0. Results Alveolar bone loss was found in 31 children （29%）. Most of the affected areas were located at the proximal surface of primary molars. The mean of dmft and proximal dmft in ABL group were higher than those in non-ABL group （P〈0.01）. Logistic regression also confirmed that proximal caries was high related factor. Inadequate restoration, and pulp pathosis were also related to alveolar bone loss in primary tooth. Conclusion In children, alveolar bone loss was mainly associated with local factors such as proximal caries, inadequate restoration, and pulp pathosis. Caries and pulp pathosis might be treated in time. Children with bone loss should be re-examined regularly.