部分床義歯の予後に関する臨床的研究 (II) : 第5報鉤歯のウ蝕について

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The purpose of this study was to estimate the long-term clinical effects of wearing partial dentures. The material consisted of 2149 dentures, with which 1564 ratients were fitted at Tokyo Medical and Dental University. Clinical examinations were performed at the time when the dentures were inserted. And six months to five and a half years thereafter the whole cases recalled for reexamination, and 772 of them attended. This report presents the results and analyses on the attack pattern of dental caries on the abutment teeth which were observed in these examined cases. The most important results were as follows : 1. In 596 cases wearing the dentures were 4931 remaining teeth, and 723 of them (14.66 percent) were found to have carious lesions. They comprised 1814 abutment teeth and 3117 other remaining teeth. And 24.09 percent of the abutment teeth as well as 9.18 percent of the other teeth had carious lesions. The percentage of carious teeth in the former was remarkably higher than in the later, and the chi-square test at 5 percent level showed a significant difference between them. 2. 317 of 894 intact teeth embraced by clasps (35.46 percent) were attacked by caries after the examined dentures were inserted, while only 110 of 920 treated teeth embraced by clasps (11.96 rercent) were decaved. The difference between them was highly significant. It was also found in the other remaining teeth that the intact teeth were attacked more frequently than the treated teeth. 4.89 percent of the abutment teeth with full crown restorations were found to have carious lesions on the exposed root surfaces. And the carious lesions were found in 17.19 percent of the abutment teeth with metal inlay, in 22.95 percent of those with amalgam restorations, and in 25.76 percent of those with silicate cement or self-curing resin restorations respectively. 3. In the abutment teeth and the other remaining teeth, the females wearing the dentures showed significantly higher percentage of carious teeth than the males, and the percentage of carious teeth was remarkably higher in the maxillary teeth than in the mandibular teeth. But in the percentage of carious teeth was no significant discrepancy among differently aged denture wearers. 4. According to Nakazawa's classification, which classifies partial dentures on the basis of the location of the denture saddles, the examined dentures were divided into thirteen groups, and the percentage of carious abutment teeth in each group was computed. The high percentages of carious abutment teeth were found in the bilateral bounded posterior dentures, the bilateral combined anterior and posterior dentures, the bilateral bounded anterior and posterior dentures, and the bilateral free-end anterior and posterior dentures, whereas the low percentages were obtained in the unilateral and the bilateral combined posterior dentures, the unilateral combined anterior and posterior dentures, the unilateral free-end posterior dentures, and the unilateral bounded anterior and posterior dentures. 5. It appeared that the longer was the period during which the dentures were worn, the higher percentage of carious teeth were found in the abutment teeth. The percentage remained 20.08 to 37.84 percent during three years after the examined dentures were inserted. But it increased markedly into 53.61 to 60 percent after three and a half years. 6. In the denture-wearers cleaning sufficiently their mouths and dentures carious lesions were found in 28.81 percent of the abutment teeth, while in the denture-wearers cleaning insufficiently 44.83 percent of such teeth were decayed. The attack of caries was considerably reduced by good oral hygiene. 7. 20.68 percent of the abutment teeth embraced by cast clasps and 30.91 percent of such teeth embraced by wrought wire clasps were attacked by caries. The difference between them was clearly significant. 8. The markedly high percentages of carious teeth were found in the abutment teeth embraced by the half and half clasps, the reverse back action clasps, the back action clasps, the two-arm clasps (or Akers clasps) and the ring clasps. But the half clasps, the divided arm clasps and the continuous clasps showed the low percentages of carious teeth. 9. It was remarkable that 61.08 percent of carious lesions in the abutment teeth were found on the proximate surface nearest the edentulous area. The other parts attacked by caries were in order of their frequency : 20.36 percent on the occlusal surface, 10.78 percent on the buccal surface, 5.39 percent on the lingual surface and 2.40 percent on the proximate surface, away from the edentulous area.
日本補綴歯科学会の論文
1969-06-30

部分床義歯の予後に関する臨床的研究 (II) : 第5報鉤歯のウ蝕について

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部分床義歯の予後に関する臨床的研究 (II) : 第5報 鉤歯のウ蝕について

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部分床義歯の予後に関する臨床的研究 (II) : 第5報鉤歯のウ蝕について