義歯と生命予後 Influence of Denture Use on Mortality

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著者

    • 吉田 光由 YOSHIDA Mitsuyoshi
    • 広島大学大学院医歯薬学総合研究科顎口腔頚部医科学講座先端歯科補綴学研究室 Department of Advanced Prosthodontics, Division of Cervico-Gnathomatology, Hiroshima University Graduate School of Biomedical Sciences
    • 森川 英彦 MORIKAWA Hidehiko
    • 広島大学大学院医歯薬学総合研究科顎口腔頚部医科学講座先端歯科補綴学研究室 Department of Advanced Prosthodontics, Division of Cervico-Gnathomatology, Hiroshima University Graduate School of Biomedical Sciences
    • 吉川 峰加 YOSHIKAWA Mineka
    • 広島大学大学院医歯薬学総合研究科顎口腔頚部医科学講座先端歯科補綴学研究室 Department of Advanced Prosthodontics, Division of Cervico-Gnathomatology, Hiroshima University Graduate School of Biomedical Sciences
    • 赤川 安正 AKAGAWA Yasumasa
    • 広島大学大学院医歯薬学総合研究科顎口腔頚部医科学講座先端歯科補綴学研究室 Department of Advanced Prosthodontics, Division of Cervico-Gnathomatology, Hiroshima University Graduate School of Biomedical Sciences

抄録

歯の喪失は, そこにいたるまでの問題のある食習慣や生活習慣などの結果としての病態であるといえる. その意味から, 無歯顎者は健康でなくなるリスクの高い人たちともいえる. また, 無歯顎という病態そのものが, 咀嚼障害や審美障害をもたらし, 社会的活動性を制限することから, より健康でなくなるリスクを高める可能性がある. これまでの報告から, 歯が20本以上もしくは16本以上残存している高齢者は, そうでない高齢者に比べて有意に長命であることが示されている. さらに, 義歯装着と生命予後との関係について, われわれが行った調査では, 上下顎で残存歯による咬合のない高齢者では, 義歯を装着していない者は装着している者に比べて1.52倍 (95%CI: 1.25-1.83) 有意に死亡率が高いことが示されている. このように, 歯や咬合の有無が生命予後に影響を及ぼす可能性が明らかになったことは, 今後われわれがなすべき研究のひとつの方向性を示しており, ここでは, 考えられるそのいくつかについて, 文献的考察ならびにわれわれの調査結果を含めて提示した. このような疫学的研究に基づいた仮説とその立証が, 超高齢社会における歯科補綴学の意義を明確にしていくうえで重要な取り組みの1つであると考える.

An association between mortality and dental status has been reported in several studies. These studies indicate that subjects with adequate dental status, defined as at least 16 teeth or at least 20 teeth, have a lower relative risk of mortality compared with those with fewer teeth or denture users. However, there is an obvious important confounding socio-economic factor. It may be impossible to demonstrate definitively whether the risk of death is directly related to tooth loss or whether such a risk is an indirect outcome of common underlying factors such as lifestyle. A more important issue for 21 st century dentistry, however, is whether dental treatment can decrease the risk of mortality among elderly people. While more elderly persons are retaining their own teeth, tooth loss remains a serious problem faced by the elderly in developed countries. To evaluate the influence of dental occlusion, with or without the use of dentures, on mortality in community-dwelling elderly persons, we conducted an 8-year cohort study at Kure city in Japan. 1, 030 randomly selected healthy independent elderly aged 65 or over took part in this study. Subjects were classified into three groups according to the presence or absence of maxillo-mandibular tooth contacts. Subjects with no maxillomandibular tooth contacts were further subdivided into those with and without dentures. Data on mortality were obtained from Kure City Council in September 2003. Cox regression models were used in analyzing the risk of death with gender and age as covariates. The results showed individuals whose teeth had contact in at least the bilateral premolar regions at baseline had 0.78 times (95% CI: 0.60-0.99) lower risk of death during the succeeding 8 years than those who had no occlusion. Among those who had no occlusion with their own teeth, the risk of mortality among denture non-users was 1.52 times (95% CI: 1.25-1.83) higher than the risk of denture users. These results support the view that, in the elderly, poor dental occlusion is associated with an increased risk of mortality and that the use of dentures is associated with a decreased risk of mortality.

収録刊行物

  • 日本補綴歯科學會雜誌 = The journal of the Japan Prosthodontic Society

    日本補綴歯科學會雜誌 = The journal of the Japan Prosthodontic Society 48(4), 521-528, 2004-08-10

    社団法人 日本補綴歯科学会

参考文献:  22件中 1-22件 を表示

被引用文献:  8件中 1-8件 を表示

各種コード

  • NII論文ID(NAID)
    10013495775
  • NII書誌ID(NCID)
    AN00197911
  • 本文言語コード
    JPN
  • 資料種別
    REV
  • ISSN
    03895386
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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