Association between Tooth Loss and Hypertension: A Systematic Review

Background: An independent relationship between tooth loss and hypertension appears to exist. Objectives: The aim of this study was to systematically review the relationship between tooth loss/number of teeth and hypertension. Materials and Methods: This review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. We searched all the relevant studies in international databases of PubMed and Google Scholar search engines from January 2000 to December 2023. Results: Fourteen studies (11 cross sectionals, 2 descriptives and 1 Cohort) met the inclusion criteria for this review. Most cross-sectional studies showed that participants with more tooth loss exhibited a greater proportion of hypertension and higher systolic blood pressure than those with less tooth loss. Cohort study showed that the loss of 8 or more teeth was associated with a higher risk of developing hypertension. Descriptive studies reported that missing teeth were marginally significantly associated with hypertension. Conclusion: This study has revealed a significantly higher SBP in patients with fewer remaining teeth or more tooth loss. In addition, those with more tooth loss showed a higher risk of hypertension than those with less tooth loss.

Tooth loss inhibits neurogenesis in the dentate gyrus of adult mice

Tooth loss has been shown to affect learning and memory in mice and increases the risk of Alz- heimer＇s disease. The dentate gyrus is strongly associated with cognitive function. This study hypothesized that tooth loss affects neurons in the dentate gyrus. Adult male mice were randomly assigned to either the tooth loss group or normal control group. In the tooth loss group, the left maxillary and mandibular molars were extracted. Normal control mice did not receive any intervention. Immunofluorescence staining revealed that the density and absorbance of double- cortinand neuronal nuclear antigen-positive cells were lower in the tooth loss group than in the normal control group. These data suggest that tooth loss may inhibit neurogenesis in the dentate gyrus of adult mice.

Tooth loss patterns in older adults with special needs:a Minnesota cohort

This study was conducted to detail tooth loss patterns in older adults with special needs. A total of 491 elderly subjects with special needs were retrospectively selected and followed during 10/1999-12/2006. Medical, dental, cognitive, and functional assessments were abstracted from dental records and used to predict risk of tooth loss. Tooth loss events were recorded for subjects during follow-up. Chi-squared tests were used to study the association between tooth loss and the selected risk factors. Logistic, poisson, and negative binomial regressions were developed to study tooth loss patterns. Overall, 27% of the subjects lost at least one tooth during follow-up. Fourteen subjects had tooth loss events per 100 person-years. Tooth loss pattern did not differ significantly among different special-needs subgroups （i.e. community-dwelling vs. long-term care, physically disabled vs. functionally independent）. Special-needs subjects with three or more active dental conditions at arrival had more than twice the risk of losing teeth than those without any existing conditions. After adjusting other factors, the number of carious teeth or retained roots at arrival was a significant predictor of tooth loss for older adults with special needs （P=0.001）. These findings indicate that appropriately managing active caries and associated conditions is important to prevent tooth loss for older adults with special needs.

Smoking increases risk of tooth loss: A meta-analysis of the literature

AIM: To quantitatively evaluate the impact of smoking on tooth loss.METHODS: We performed a Pub Med search to identify published articles that investigated the risk of tooth loss by smoking, from which RRs and their variance with characteristics of each study were extracted. The random-effects models were used to derive a pooled effect across studies. Potential sources of heterogeneity on the characteristics of the study and their influence on the pooled effect size were investigated using metaregression models. RESULTS: We identified 24 studies containing a total of 95973 participants for analysis. The pooled RR of ever-smokers compared with never- smokers was 1.73(95%CI: 1.60-1.86, P < 0.001). In meta-regression analysis, only the mean age of participants alone was identified as a statistically significant source of heterogeneity. The effect of smoking on tooth loss was stronger when the mean age of study participants was higher, indicating possible enhancement of tooth loss due to aging by smoking. RR was significantly lower in former smokers(1.49, 95%CI: 1.32-1.69, P < 0.001) than in current smokers(2.10, 95%CI: 1.87-2.35, P < 0.001), indicating the substantial benefit of smoking cessation for reducing the risk of tooth loss.CONCLUSION: Smoking is an independent risk factor for tooth loss regardless of many other confounders. Smoking cessation may attenuate this effect.

A long-term follow-up analysis of associations between tooth loss and multiple cancers in the Linxian General Population cohort

Poor oral health,indicated by tooth loss and periodontal disease,may be an important risk factor for various cancers.Prior studies have found inconsistent associations between tooth loss and several cancer types.Here,we examined the relationship between tooth loss and incident cases of multiple cancers in the Linxian General Population Nutrition Intervention Trial cohort.In this large prospective cohort of over 29,000 participants,there were 3101,1701,626,327,348,and 179 incident esophageal,gastric cardia,gastric noncardia,liver,lung,and colorectal cancer cases,respectively,over 30 years of follow-up.Adjusted Cox proportional hazards regression models with time-varying covariates were used to estimate hazard ratios(HRs)and 95%confidence intervals(CIs)for the association between tooth loss and cancer outcomes during three time intervals:≤5 years(early),>5 and≤10 years(mid),>10 years(late).Tooth loss was assessed as quartiles of the number of lost teeth in excess of the loess-smoothed,age-specific median number of teeth lost.For esophageal cancer,the increase in risk associated with the highest quartile of tooth loss was 25%(95%CI:1.02,1.52)in the mid time interval,but the association weakened thereafter.For gastric cardia cancer,the increase in risk associated with the highest quartile of tooth loss was 1.34 in both the early(95%CI:1.06,1.71)and mid time intervals(95%CI:1.02,1.76),with no significant associations in the late interval.Gastric noncardia cancer was only associated with the second quartile of tooth loss in the late time interval(HR=1.54;95%CI:1.16,2.04).All associations between tooth loss and liver,lung,and colorectal cancers were null.Tooth loss was associated with risk of esophageal and gastric cancers in this updated analysis from the cohort.

Single Tooth Segmentation on Panoramic X-Rays Using End-to-End Deep Neural Networks

In dentistry, panoramic X-ray images are extensively used by dentists for tooth structure analysis and disease diagnosis. However, the manual analysis of these images is time-consuming and prone to misdiagnosis or overlooked. While deep learning techniques have been employed to segment teeth in panoramic X-ray images, accurate segmentation of individual teeth remains an underexplored area. In this study, we propose an end-to-end deep learning method that effectively addresses this challenge by employing an improved combinatorial loss function to separate the boundaries of adjacent teeth, enabling precise segmentation of individual teeth in panoramic X-ray images. We validate the feasibility of our approach using a challenging dataset. By training our segmentation network on 115 panoramic X-ray images, we achieve an intersection over union (IoU) of 86.56% for tooth segmentation and an accuracy of 65.52% in tooth counting on 87 test set images. Experimental results demonstrate the significant improvement of our proposed method in single tooth segmentation compared to existing methods.

Smoking Cigars,Pipes Can Speed Tooth Loss

抽雪茄和烟斗会加速牙齿脱落,这是一个新信息。本文非常善良地提出:This is another piece of information that people should know before theymake the decision to smoke cigars.研究人员在有了这个发现之后还有一个愿望: They expressed hope that this latest finding will spur cigar smokers to kickthe habit. 句子里的两个动词spur/kick用得何等有力。一番好意,尽在其中。

<i>In Vitro</i>Simulation of Tooth Mobility Resulting from Periodontal Attachment Loss

In our previous studies, we developed the normal periodontal ligament index (nPLI) and the residual periodontal ligament index (rPLI), to estimate residual periodontal ligament support for individual teeth during treatment planning for partially edentulous patients. The purpose of the current in vitro study was to analyze tooth mobility resulting from periodontal attachment loss, and to determine the application range of both nPLI and rPLI. The association of horizontal load-displacement and conditions of attachment loss was measured in triplicate for each anatomical tooth model at 10-minute intervals, using a universal tester at a crosshead speed of 0.05 mm/min, and a load of 0.1 N. The conditions of attachment loss were: (I) 0 mm (cementoenamel junction), (II) 2 mm attachment level, and (III) two-thirds, and (IV) one-half lengths of normal attachment. Except for the upper first molar, lower lateral incisor, lower first premolar, and the lower first molar, the displacement of each tooth type was increased significantly relative to Level I (P P < 0.01). The results indicated that nPLI at two-thirds of normal attachment and greater, and rPLI at less than two-thirds of normal attachment should be applied, respectively.

铸瓷粘结桥修复深覆[牙合]伴单颗前牙缺失的临床效果

目的探讨铸瓷粘接桥修复深覆[牙合]伴单颗前牙缺失患者的临床疗效。方法选取2023年1月—2023年6月安徽医专附属口腔医院就诊的30例深覆[牙合]伴前牙单颗缺失的患者作为研究对象,唇侧制作铸瓷粘接桥,术后1周和6个月分别检查修复体脱落、修复体折裂、边缘密合性、继发龋、边缘着色、牙周健康状况等。结果术后1周修复效果较好,无修复体脱落及折断,边缘密合性好、无着色,牙周健康。术后6个月检查见2例修复体脱落,重新粘结后继续使用,1例探针可探及边缘,牙龈轻度炎症,其余27例未见异常,未见修复体脱落和折断,边缘密合性好,基牙无龋坏,牙周健康。结论铸瓷粘接桥修深覆[牙合]伴单颗前牙缺失患者短期临床效果较好。

Poor oral health was associated with higher risk of gastric cancer: Evidence from 1431677 participants

BACKGROUND In recent years,the association between oral health and the risk of gastric cancer(GC)has gradually attracted increased interest.However,in terms of GC incidence,the association between oral health and GC incidence remains contro-versial.Periodontitis is reported to increase the risk of GC.However,some studies have shown that periodontitis has no effect on the risk of GC.Therefore,the present study aimed to assess whether there is a relationship between oral health and the risk of GC.AIM To assess whether there was a relationship between oral health and the risk of GC.METHODS Five databases were searched to find eligible studies from inception to April 10,2023.Newcastle-Ottawa Scale score was used to assess the quality of included studies.The quality of cohort studies and case-control studies were evaluated separately in this study.Incidence of GC were described by odds ratio(OR)and 95%confidence interval(CI).Funnel plot was used to represent the publication bias of included studies.We performed the data analysis by StataSE 16.RESULTS A total of 1431677 patients from twelve included studies were enrolled for data analysis in this study.According to our analysis,we found that the poor oral health was associated with higher risk of GC(OR=1.15,95%CI:1.02-1.29;I2=59.47%,P=0.00<0.01).Moreover,after subgroup analysis,the outcomes showed that whether tooth loss(OR=1.12,95%CI:0.94-1.29;I2=6.01%,P>0.01),gingivitis(OR=1.19,95%CI:0.71-1.67;I2=0.00%,P>0.01),dentures(OR=1.27,95%CI:0.63-1.19;I2=68.79%,P>0.01),or tooth brushing(OR=1.25,95%CI:0.78-1.71;I2=88.87%,P>0.01)had no influence on the risk of GC.However,patients with periodontitis(OR=1.13,95%CI:1.04-1.23;I2=0.00%,P<0.01)had a higher risk of GC.CONCLUSION Patients with poor oral health,especially periodontitis,had a higher risk of GC.Patients should be concerned about their oral health.Improving oral health might reduce the risk of GC.

个性化方案矫治先天性下颌恒切牙缺失临床分析

本文患者为年轻女性,骨性Ⅱ类,下颌先天性缺失一颗恒切牙,因面突、牙齿前突、不齐求治。根据患者的具体情况,采取个性化治疗方案。拔除14、24、26,35、45、47,矫正28、48,关闭所有拔牙间隙。患者治疗后前牙覆牙合覆盖正常,右侧尖牙及磨牙Ⅰ类关系,左侧尖牙及磨牙为Ⅲ类关系。

个案追踪管理模式配合回馈教育对外伤性牙缺失患者即刻种植修复效果的影响

目的:观察个案追踪管理模式配合回馈教育对外伤性牙缺失患者即刻种植修复效果的影响。方法:选取2011年3月-2013年3月笔者医院收治的62例外伤性牙缺失患者为研究对象,患者均接受即刻种植修复治疗,依照区组随机化分组法将其分为对照组31例和追踪组31例。对照组实施常规护理,追踪组在对照组基础上应用个案追踪管理模式配合回馈教育。比较修复1年后两组种植体修复效果及满意度(前牙隐形义齿修复满意度),对比随访1、3、6年后两组种植体留存率及牙美观程度(牙美观指数)。结果:修复1年后,追踪组种植体修复效果优于对照组(P<0.05);追踪组前牙隐形义齿修复满意度评分高于对照组(P<0.05)。随访1、3年后,两组种植体留存率比较差异无统计学意义(P>0.05)。随访6年后,追踪组种植体留存率高于对照组(P<0.05)。随访1、3、6年后,追踪组牙美观指数评分均低于对照组(P<0.05)。结论:个案追踪管理模式配合回馈教育能提高外伤性牙缺失患者即刻种植修复后种植体修复效果,提升修复满意度,同时还有利于种植体留存,保持牙美观,具有较高临床应用价值。

二硅酸锂基玻璃陶瓷单端树脂粘接桥修复个别前牙缺失的临床应用

目的探讨二硅酸锂基玻璃陶瓷单端树脂粘接桥修复个别前牙缺失的临床效果,为个别前牙缺失修复方式的选择提供参考。方法本研究已通过单位伦理委员会审查批准,并获得患者知情同意。选取42例单颌前牙缺失数量在两颗内的患者,采用二硅酸锂基玻璃陶瓷单端树脂粘接桥修复,修复后6个月、1年、2年、3年进行随访,评价美学、功能修复效果及牙周健康状况,并采用视觉模拟评分量表(VAS)调查患者的满意度。结果观察期间,42例二硅酸锂基玻璃陶瓷单端树脂粘接桥修复的患者中有1例3个月内连接体发生断裂,1例2年内发生脱粘;美学修复效果的等级均评定为A级;修复后牙周健康状况良好,基牙及桥体下的软硬组织无临床吸收现象,评价指标均为A级;患者总满意率为100%。结论对于个别前牙缺失,二硅酸锂基玻璃陶瓷单端树脂粘接桥可达到微创、固位牢靠、美观舒适和生物相容性好的修复效果,患者满意度高,在临床中可以考虑作为一种理想的修复方式。

河南食管鳞癌高低发区口腔健康和牙龈卟啉单胞菌感染状况比较

目的比较分析河南食管鳞癌(esophageal squamous cell carcinoma,ESCC)高发区和低发区无症状人群中口腔卫生和牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg)感染特征,为ESCC病因学预防提供理论依据。方法选择河南ESCC高发区1388个和毗邻低发区486个无症状当地居民,通过面对面的问询方式收集人口学特征并评估口腔健康状况,采集口腔拭子和外周血样本,实时定量PCR检测Pg,比较分析ESCC高发区和低发区口腔健康状况和Pg感染特征,Logistic回归分析口腔Pg丰度对口腔健康不良的影响。结果河南ESCC高发区无症状研究对象中度和重度牙龈出血、牙齿缺失>17颗、每天刷牙多于1次、Pg感染等百分比高于低发区研究对象,口腔Pg丰度与不良口腔健康指征显著相关,并显著增加ESCC高发区研究对象牙结石、牙龈出血和牙齿缺失的发生风险。结论河南ESCC高发区无症状居民口腔卫生不良和Pg感染率显著高于紧邻的低发区人群,且口腔高丰度Pg显著增加口腔卫生不良指征的发生风险,为ESCC高发区易感人群食管癌病因预防提供了理论依据。

中国≥65岁老年人牙齿缺失与听力损伤的关联研究

背景听力损伤和牙齿脱落在老年人群中较为常见且严重危害老年人身心健康,但目前针对老年人牙齿缺失、义齿使用与听力损伤关系的人群研究有限。目的探讨我国≥65岁老年人牙齿缺失与听力损伤之间的关联。方法于2023年1月,在中国老年健康影响因素跟踪调查(CLHLS)2018年数据中选取符合要求的≥65岁老年人15161名为研究对象。以听力损伤情况为结局变量,以口腔牙齿数量为解释变量,以社会人口学、生活方式、健康状况信息为协变量,采用多因素Logistic回归分析探讨牙齿数量对听力损失的影响,并进一步对不同年龄、性别、日常生活活动能力、义齿使用情况老年人进行分层分析。结果15161名研究对象中,牙齿数量为≥20、10~19、1~9、0颗的老年人分别有3655名(24.11%)、2355名(15.53%)、4008名(26.44%)、5143名(33.92%),听力损伤者有6148名(40.55%)。多因素Logistic回归分析结果显示,在调整了相关混杂因素后,与牙齿数量≥20颗者相比,牙齿数量为10~19、1~9、0颗者容易发生听力损伤,OR(95%CI)分别为1.31(1.08~1.58)、1.57(1.32~1.86)、1.97(1.65~2.36)。分层分析结果显示,牙齿数量与听力损伤之间的关联在≥80岁和未使用义齿的老年人中更为显著(P<0.05)。结论老年人牙齿缺失可增加听力损伤的发生风险,高龄和未使用义齿的老年人发生听力损伤的风险更高。

外胚层发育不全患者牙列缺损修复1例及文献回顾

目的 探讨外胚层发育不全患者先天缺牙的治疗方案,为临床提供参考。方法 报道1例面中份凹陷,颏部前突,面下1/3发育不足的外胚层发育不全患者,患者上颌多颗牙先天缺失,余留牙为畸形牙,下颌牙列先天缺失,牙弓较小,上下牙槽骨发育不良。通过上颌可摘局部义齿、下颌在数字化导板辅助下进行前牙区种植,杆卡式种植覆盖义齿对其进行治疗,并对其治疗方案进行文献回顾。结果 患者佩戴义齿后固位及稳定佳,咬合关系良好,患者面部外形恢复较好,上下唇饱满,面下1/3与面中1/3基本相等,恢复了咀嚼功能。文献回顾结果表明,先天缺牙的外胚层发育不全患者的口内情况通常比较复杂,修复困难,对此类患者常见的修复方式包括固定桥、可摘局部义齿、全口义齿、覆盖义齿和种植义齿,需要根据患者口内实际情况选择不同的治疗方案。目前,对于外胚层发育不全患者先天缺牙的治疗尚未达成共识,有学者建议缺牙少的患者优先选择固定修复,缺牙多的患者选择可摘义齿或种植覆盖义齿修复,未成年患者优先选择活动修复,待颌骨发育完成后视情况更换永久固定修复。结论 对于外胚层发育不全先天缺牙的患者,应该充分考虑各方面因素,以修复为导向个性化制定可行的修复方案。

老年人牙齿缺失与日常生活活动能力受限的相关性:基于CLHLS数据的实证分析

目的 探究我国老年人牙齿缺失与日常生活活动能力受限之间的关联,为提高老年生活质量提供依据。方法 基于中国老年健康影响因素追踪调查(CLHLS)中2011年和2014年的调查数据,开展回顾性队列研究。以缺牙数目为自变量,以是否出现日常生活活动能力受限为因变量,采用多因素Logistic回归分析老年人牙齿缺失与日常生活活动能力受限的关系;构建惩罚样条广义相加模型,探究二者之间是否存在非线性关联。结果 2011年调查共纳入8 310名研究对象,多因素Logistic回归分析结果表明:相较于缺牙0~8颗的受访者,缺牙9~27颗和28颗者出现日常生活活动能力受限的风险增加(OR=1.22,95%CI=1.01~1.49;OR=1.49,95%CI=1.22~1.83)。2014年调查共纳入4 240名研究对象,其结果与2011年调查结果一致。惩罚样条广义相加模型分析提示,老年人的缺牙数与日常生活活动能力受限的发生风险呈线性相关。结论 缺牙数量与老年人日常生活活动能力受限显著相关,缺牙数量过多可能是日常生活活动能力受限的危险因素之一。

老年自体牙移植修复单个牙缺失预后的影响因素分析

目的:探讨老年自体牙移植修复单个牙缺失预后的影响因素。方法:分析我院接受自体牙移植修复的老年单个牙缺失患者62例,随访观察24个月,以存留率评估预后,根据患者末次复诊时存留在口腔内的移植牙占总移植牙数目的比例分为存留组和失败组。对比两组相关资料,采用单因素和多因素Logistic回归分析老年自体牙移植修复预后的影响因素。结果:62例老年自体牙移植修复患者中,24个月累计存留43例,存留率为69.35%,归为存留组,其余19例(30.65%)为失败组。单因素分析显示,失败组和存留组年龄、吸烟、受区牙槽骨高度、供体离体时间对比有差异(P<0.05);单因素和多因素Logistic回归显示吸烟(OR=3.772,95%CI=1.250~11.378)、牙槽骨高度不足(OR=11.254,95%CI=1.236~102.466)、供牙离体时间长(OR=1.760,95%CI=1.170~2.647)为老年单个牙缺失自体牙移植修复术后移植牙失败的危险因素(P<0.05)。结论:在老年单个牙缺失自体牙移植修复患者中,吸烟情况、受区牙槽骨高度、供牙离体时间是预后的影响因素,术前严格选择适应证,减少供牙离体时间,有助于提升老年自体牙移植修复移植牙的存留率,获得相对良好的预后。

帐篷式骨增量技术用于修复上前牙单牙缺失的美学效果及其对牙槽骨宽度的影响

目的:探究帐篷式骨增量技术对上前牙单牙缺失患者的治疗效果及对牙槽骨宽度的影响。方法:选取汉滨区第三人民医院2020年2月-2021年2月收治的80例上前牙单牙缺失患者为研究对象,按治疗方法不同分为研究组(帐篷式骨增量技术)38例和对照组(引导骨再生技术)42例,比较两组的种植情况、红白美学指数评分、牙槽骨宽度、龈沟液骨代谢指标、牙周情况以及术后并发症发生率。结果:种植体植入3个月后,两组患者均无种植体松动、脱落等现象,影像学检查无透影区,种植成功率均为100%;术后6个月,研究组种植区周围红色美学指数评分高于对照组(P<0.05),两组白色美学指数评分差异无统计学意义(P>0.05)。术后6个月,两组患者牙槽骨宽度均显著增加(P<0.05),且研究组术后6个月牙槽骨宽度高于对照组(P<0.05);两组龈沟液中骨保护素(Osteoprotegerin,OPG)水平显著降低,骨桥蛋白(Osteopontin,OPN)水平显著升高(P<0.05),研究组OPG水平高于对照组(P<0.05),OPN水平低于对照组(P<0.05);两组患者牙龈指数、牙菌斑指数以及探诊深度差异均无统计学意义(P>0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:帐篷式骨增量技术应用于上前牙单牙缺失种植成功率较高,能提高修复后美学效果,增加牙槽骨宽度,减缓骨吸收,术后并发症及对牙周影响均较小,值得推广应用。

即刻种植治疗牙齿缺失的效果分析

目的:分析即刻种植治疗牙齿缺失的效果。方法:选取2020年4月—2022年4月济宁市任城区妇幼保健院收治的牙齿缺失患者100例作为研究对象,随机分为对照组与研究组,各50例。对照组实施常规种植治疗,研究组实施即刻种植治疗。比较两组治疗效果。结果:研究组修复成功率高于对照组,差异有统计学意义(P=0.027)。研究组并发症总发生率低于对照组,差异有统计学意义(P=0.025)。术后6个月,研究组种植体稳定性高于对照组,差异有统计学意义(P<0.001)。术后6个月,两组生活质量评分高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.001)。研究组满意度高于对照组,差异有统计学意义(P=0.025)。结论:即刻种植治疗牙齿缺失的效果显著,能够提高修复成功率及种植体稳定性,减少并发症,改善生活质量,提高患者满意度。