非う蝕性歯頸部病変、歯頸部象牙質知覚過敏症、歯肉退縮、および関連するリスクファクターとの関係。横断的研究

Relationship between noncarious cervical lesions, cervical dentin hypersensitivity, gingival recession, and associated risk factors: A cross-sectional study.

抄録

目的:

本研究の目的は、非う蝕性歯頸部病変（NCCL）、歯頸部象牙質知覚過敏症（CDH）、歯肉退縮（GR）に関連する危険因子と、これらの状態間の関係をブラジル人の特定のサンプル集団で評価することである。

OBJECTIVES: The aim of this study was to evaluate the risk factors associated with noncarious cervical lesions (NCCLs), cervical dentin hypersensitivity (CDH), and gingival recession (GR), besides the relationship among these conditions in a specific Brazilian sample population.

方法:

非う蝕性頸部病変および頸部象牙質知覚過敏症患者のリハビリテーションのための外来プログラム」に参加した185人の患者を評価し、5180本の歯を分析した。被験者がフォームに記入し，キャリブレーションされた検査者が臨床検査を行い，NCCL，CDH，GRの有無を判定した．NCCLは形態と深さによって，CDHレベルは空気刺激に対する反応によって，GRはMillerの分類によって分類された．危険因子とNCCL，CDH，GRとの関連は，Mann-Whitney U検定および重回帰で判定した．相関については、95％信頼水準でスピアマン検定が用いられた。

METHODS: 185 patients who attended the "Ambulatory Program for Rehabilitation of Patients with Noncarious Cervical Lesions and Cervical Dentin Hypersensitivity" were evaluated, and 5180 teeth were analyzed. The subjects filled out a form and a calibrated examiner performed the clinical exams to determine the presence of NCCLs, CDH, and GR. NCCLs were classified according to their morphology and depth, CDH levels were evaluated according to air stimuli response, and GRs were categorized according to Miller's classification. The association of the risk factors with NCCLs, CDH, and GR was determined with the Mann-Whitney U test and multiple linear regression. For the correlations, the Spearman test was used with a 95%-confidence level.

結果:

NCCL，CDH，GRの分布は，それぞれ88.1％，89.1％，59.4％であった．上顎小臼歯は、3つの条件すべてにおいて最も影響を受けていた。年齢と NCCL，GR の間，NCCL と CDH，CDH と GR，GR と NCCL の間に正の相関がみられた．年齢，性別，口腔衛生状態，胃食道疾患，咬合性外傷は，3つの疾患の存在と有意に関連していた．

RESULTS: The NCCLs, CDH, and GR distributions within the study were 88.1%, 89.1%, and 59.4%, respectively. Maxillary premolars were the most affected by all three conditions. A positive correlation was found between age, NCCLs, and GR; between NCCLs and CDH; CDH and GR; GR and NCCLs. Age, gender, oral hygiene, gastroesophageal diseases, and occlusal trauma were significantly associated with the presence of all three conditions.

結論:

NCCL と GR の分布は年齢とともに増加した．NCCL，CDH，GR は正の相関を示した．病変の深さと形態は，高い感度と後退の重症度に寄与した．NCCL，CDH，GR の発生には，年齢，性別，胃疾患，咬合外傷が関連因子であった．

CONCLUSIONS: The NCCLs and GR distributions increased with age; NCCLs, CDH, and GR had positive correlation; the lesions' depth and morphology contributed to high levels of sensitivity and severity of recessions; age, gender, gastric disease, and occlusal trauma were relevant factors for the occurrence of NCCLs, CDH, and GR.

臨床的意義:

NCCL、CDH、GRの分布が拡大していることは、人々のライフスタイルと密接に関連している。したがって、臨床医は、そのような変化を予防し、制御するために、病因とその最も関連性の高い要因を認識することが、人々のQOLを向上させるために重要である。

CLINICAL SIGNIFICANCE: The increasing distribution of NCCLs, CDH, and GR is closely associated with people's lifestyles. Thus, it is important for the clinicians to recognize the etiological factors and their most relevant associations to prevent and control such alterations, in order to improve the population's quality of life.