Πέμπτη 18 Μαΐου 2017

Observational study investigating tooth extraction and the shortened dental arch approach

Abstract

Background

The Shortened Dental Arch (SDA) provides a cost effective dentition, considering the population is aging and retaining teeth for longer.

Objective(s)

Observe the reasons and sites of tooth extraction, and assess the functional dentition over 15 years in dental practice.

Method

Subjects were recruited who required permanent tooth extractions between 2000-2015. The reasons for extractions were chosen from twelve extraction codes. Data was also collected for demographics, tooth position, root treated teeth and functional pairs remaining. Patient centred factors on tooth extraction and comments on chewing ability and aesthetics were recorded.

Results

Nine hundred and fifty one teeth were extracted in 900 patients. The mean age was 60 years (SD 20, SE 7, 95% CI 46,74). Reasons for extraction were periodontal disease (n=361, 38%), periapical infection (n=288, 34%) or tooth and tooth-root fractures (15%). Extractions included 201 (21%) second molars, 179 (19%) first molars, 152 (16%) second premolars, 95 (10%) first incisors, 86 (9%) second incisors, 76 (8%) canines and 67 (7%) first premolars. Following extractions, median functional pairs were 12, interquartile range (IQR) 19-7. Individuals with >10 functional pairs (60%, n=571) had no complaints with chewing ability or aesthetics.

Conclusions

Periodontal disease and periapical infection were the main causes for the extraction. First and second molars, followed by second premolars were the most commonly extracted teeth. The present study supports the SDA in creating a functional dentition, provided existing teeth and restorations are preserved/maintained and anterior aesthetic tooth replacement is ensured.

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