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部分義歯高齢者の現地調査.取り外し可能な部分入れ歯の使用率に関連する要因の検討
A field survey of the partially edentate elderly: Investigation of factors related to the usage rate of removable partial dentures.
PMID: 26059645 DOI: 10.1111/joor.12318.
抄録
SDA(shortened dental arch)概念は世界的に知られているが,SDA概念が生物学的には合理的であっても,患者の立場からすると口腔保健の基準として受け入れられるかどうかは疑問である.また、日本では国民皆保険が適用されているため、SDA 患者は欠損した歯を補う補綴治療を希望しているようである。しかし、日本でのRPDの使用率を調査するための現地調査はほとんど行われていない。本研究の目的は,日本人の高齢者におけるRPDの使用率を明らかにし,RPDの使用に関連する要因を検討することであった.本研究では,一部無歯顎の被験者(n=390)を対象とした.口腔内検査を実施し、いくつかの指標を記録した。歯の欠損数とRPDの使用率との関係を評価するためにCochran-Armitage傾向検定を用いた。カイ二乗検定およびロジスティック回帰分析を行い,RPDの使用率に関連する要因を評価した.RPDの使用率は,遠位側抜歯数および両側抜歯数と有意に正の関係を示した.RPDの使用率は,欠損歯数の増加に伴って増加した(pは傾向<0-001).本研究の結論は,歯が欠損している参加者は他の参加者に比べてRPDの使用率が高く,欠損している歯の数が増えるにつれて使用率が増加していることであった.
Although the shortened dental arch (SDA) concept has been known to all over the world, acceptance of the SDA concept as an oral health standard can be questionable from the patients' point of view, even if it is biologically reasonable. Furthermore, because the health insurance system covers removable partial dentures (RPDs) for all citizens in Japan, SDA patients seem to prefer to receive prosthetic treatment to replace the missing teeth. However, there were few field surveys to investigate the usage rate of RPDs in Japan. The purpose of this study was to determine the usage rate of RPDs in older Japanese subjects and to investigate the factors related to the usage of RPDs. Partially edentate participants (n = 390) were included in this study. Oral examinations were conducted to record several indices. The Cochran-Armitage trend test was used to evaluate the relationship between the number of missing teeth and the usage rate of RPDs. Chi-squared tests and logistic regression analysis were conducted to evaluate the factors related to the usage rate of RPDs. Usage of RPDs had a significantly positive association with the number of missing distal extension teeth and bilaterally missing teeth. The usage rate of RPDs increased as the number of missing distal extension teeth increased (P for trend < 0·001). The conclusion of this study was that participants with missing distal extension teeth had higher usage rates of RPDs than other participants, and the usage rate increased as the number of missing distal extension teeth increased.
© 2015 John Wiley & Sons Ltd.