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標題: | 牙周/牙根尖病變和口腔健康狀態與頸動脈鈣化之間的關聯性 Association of periodontal/periapical lesions and oral health status with the carotid artery calcification |
作者: | 陳怡伶 Yi-Ling Chen |
指導教授: | 鄭景暉 Jiiang-Huei Jeng |
關鍵字: | 頸動脈鈣化,頸動脈粥樣硬化,牙周狀態,根尖病變,口腔感染,環口X光攝影, panoramic radiographs,oral infection,periapical lesion,periodontal status,carotid artery calcification,carcarotid artery atheromas, |
出版年 : | 2024 |
學位: | 碩士 |
摘要: | 背景:
炎症是一種重要的保護性反應,涉及免疫細胞、血管和分子媒介,對抗有害刺激至關重要。然而,持續的炎症可能導致各種疾病。本文深入探討頸動脈鈣化、動脈粥樣硬化、牙周病、根尖周圍炎和口腔健康之間的關聯。在現代社會普遍存在的慢性炎症條件明顯影響整體健康,並促成心血管問題。在例行牙科檢查中早期檢測頸動脈鈣化並及時轉介,及早介入治療,可能有助於減少相關疾病的發生。 儘管環口X光攝影並非診斷頸動脈鈣化的直接工具,但它提供有價值的信息,包括對頸部區域的觀察。關於全景X光攝影在檢測頸動脈鈣化的精確度存在爭議,研究結果不一。本文旨在探討牙周疾病、根尖周圍炎、口腔健康和頸動脈鈣化之間的關聯,為臨床醫師和患者提供不同的觀點,增強醫療協助和疾病預防。 材料和方法: 本研究深入探討頸動脈鈣化與口腔健康條件之間的相關性,具體包括牙周組織炎症和根尖病變。利用橫斷式設計和來自國立臺灣大學醫院牙科部的數據,研究旨在了解頸動脈鈣化與牙齒損失、DMFT(蛀牙、缺牙、充填牙齒指數)、齒槽骨損失和根尖病變數量之間的關係。獨立變量包括頸動脈鈣化的存在與否,而依變量包括各種口腔健康參數、社會人口學因素和危險行為。 研究包括972例,利用環口X光攝影圖像進行數據收集。統計分析包括描述性和推論性統計,用於分析頸動脈鈣化、人口統計因素、危險行為和口腔健康參數之間的關係。研究程序包括倫理審查批准、文獻審查、設計修改、病例招募準備、確認數據收集方法以及實際收集病歷和X光。在IRB批准後,研究對674例進行統計分析,旨在提供有關牙周/根尖病變、口腔健康狀態和頸動脈鈣化之間聯繫的相關信息。 結果: 結果呈現了人口統計數據;46.4%為男性,平均年齡為47.1歲。教育數據顯示23.9%高中或以下,15.3%大學,7.1%碩博士學位。還概述了吸煙(24.6%),飲酒(8.2%)和嚼食檳榔(4.5%)的習慣。觀察到76.7%個案沒有頸動脈鈣化具有頸動脈鈣化則佔23.0%。 結果也說明了缺牙、DMFT(龋齒、缺失、具填充物之牙齒)、牙根尖病變和齒槽骨缺損。有頸動脈鈣化的病例顯示了略多的缺牙和更高的DMFT。雖然牙根尖病變略高,但差異不顯著。然而,在有鈣化的病例中,齒槽骨缺損更為嚴重,表明牙周健康較差。 多元迴歸和羅吉斯迴歸分析說明了年齡是影響缺牙、DMFT、牙根尖病變和牙槽骨失的重要因素。在有頸動脈鈣化的分析結果中,年齡、性別和教育水平是顯著的,表明它們的影響。在具有人口統計變量的分析結果中,年齡顯著是影響這項研究中的缺牙、DMFT、牙根尖病變和齒槽骨缺損的最重要因素。 結論: 該研究提供了有關頸動脈鈣化對口腔健康參數的潛在影響的見解,重點關注缺牙、DMFT、根尖病變和齒槽骨缺損。了解這些相互關係有助於提供更好的患者護理和預防措施。 Background: Inflammation, a crucial response involving immune system, vessels, and molecular compounds, is essential for countering harmful stimuli. However, persistent inflammation can contribute to various diseases. This article delves into the interconnections between atherosclerosis, periodontal disease, apical periodontitis, and oral health. Chronic inflammatory conditions, prevalent in modern society, significantly impact overall health and contribute to cardiovascular issues. Early detection of carotid artery calcification during routine dental check-ups and timely intervention may mitigate the occurrence of related diseases. While panoramic radiography isn''t a direct tool for diagnosing carotid artery calcification, it provides valuable information, including observations of the cervical region. The precision of panoramic radiographs in identifying carotid artery calcification is debated, with varying study results. The article aims to explore relationships between periodontal diseases, periapical inflammation, oral health, and carotid artery calcification. This exploration offers a distinctive perspective for clinicians and physicians, enhancing medical assistance and disease prevention education. Material and methods: This study delves into the correlation between carotid artery calcification and oral health conditions, specifically periodontal tissue inflammation and periapical lesions. Utilizing a cross-sectional design and data from the National Taiwan University Hospital Dental Department, the research aims to understand how carotid artery calcification relates to tooth loss, DMFT (Decayed, Missing, Filled Teeth index), alveolar bone loss, and the number of periapical lesions. Independent variables encompass the presence of carotid artery calcification, while dependent variables include various oral health parameters, socio-demographic factors, and risk behaviors. The study includes 972 cases, utilizing panoramic radiographic images for data collection. Statistical analyses, including descriptive and inferential statistics, are employed to analyze relationships between carotid artery calcification, demographic factors, risk behaviors, and oral health parameters. The research procedure involves ethical approval, literature review, design modification, case recruitment preparations, confirmation of data collection methods, and the actual collection of medical records and X-rays. Following IRB approval, statistical analysis is performed on 674 cases, aiming to offer insights into the correlation between periodontal/periapical lesions, oral health status, and carotid artery calcification. Results: There’s table presents demographic data; 46.4% are male, average age is 47.1. Educational data reveal 3.1% with primary school or below, 20.8% secondary school, and 22.4% with university or above. It also outlines smoking (24.6%), drinking (8.2%), and betel nut chewing (4.5%) habits. Carotid artery calcification is observed in 76.6% without. There’re tables detail missing teeth, DMFT, root apex lesions, and alveolar bone loss. Cases with calcification show slightly more missing teeth and higher DMFT. Although periapical lesions are slightly higher, the difference is not significant. However, alveolar bone loss is more severe in cases with calcification, indicating poorer periodontal health. Multiple regression and logistic regression analyses identify age as a significant factor impacting missing teeth, DMFT, periapical lesions, and alveolar bone loss. In logistic regression with carotid artery calcification, age is significant factor, suggesting their influence. Age is notably the most significant factor in logistic regression with demographic variables, affecting missing teeth, DMFT, periapical lesions, and alveolar bone loss in this study. Conclusions: In conclusion, the study provides insights into the potential impact of carotid artery calcification on oral health parameters, with a focus on missing teeth, DMFT, root apex lesions, and alveolar bone loss. Understanding these correlations can contribute to better patient care and preventive measures. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/91671 |
DOI: | 10.6342/NTU202400732 |
全文授權: | 同意授權(全球公開) |
顯示於系所單位: | 臨床牙醫學研究所 |
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