O objetivo do presente estudo foi identificar os motivos das extrações dentárias em pacientes que procuram atendimento odontológico em uma clínica odontológica universitária no México. Este é um estudo transversal que avaliou 284 pacientes consecutivos na Faculdade de Odontologia da Universidad Autónoma del Estado de México entre agosto de 2017 e novembro de 2018. No total, foram realizadas 505 extrações. A variável dependente foi o motivo da extração: 0) cárie dentária e sequelas subsequentes (categoria de referência); 1) doença periodontal e sequelas subsequentes; e 2) outros motivos. Variáveis sociodemográficas, socioeconômicas e clínicas foram incluídas como variáveis independentes. A análise foi feita com regressão logística multinomial (Stata 14.0). De todas as extrações, 63,6% (n=321) foram devidas a cárie dentária e sequelas subsequentes; 22,0% (n=111) foram devidas a doença periodontal e sequelas subsequentes; 5,3% (n=27) a insucesso endodôntico; 5,1% (n=26) a indicações protéticas; 1,6% (n=8) a indicações ortodônticas; e o restante (2,4%) foi devido a outros motivos. No modelo multivariado, as extrações por doença periodontal vs. cárie dentária foram associadas ao tabagismo ocasional (Odds Ratio, OR=3,90) ou ao uso diário de tabaco (OR=3,19); ao fato de o dente a ser extraído ter sido restaurado anteriormente (OR=2,35); à extração de dentes anteriores em vez de posteriores (OR=2,63); e a pacientes com extrações múltiplas (OR=2,68). No caso de extrações devido a "outros motivos", nenhuma variável foi significativa. A cárie dentária e a doença periodontal foram os principais motivos de extração dentária nessa amostra. Diversas variáveis, principalmente clínicas, foram associadas às extrações por motivos periodontais.
Article • Braz. Dent. J. 34
(6)
• Nov-Dec 2023 • https://doi.org/10.1590/0103-6440202305355 linkcopiar
Clinical and socio-demographic factors associated with dental extractions in a clinical sample
Autoria
person Karla Karen Bernal-Sánchez
school Center for Advanced Studies and Research on Dentistry Dr. Keisaburo Miyata, School of Dentistry, Autonomous University of the State of Mexico, Toluca, MexicoAutonomous University of the State of MexicoMexicoToluca, Mexico Center for Advanced Studies and Research on Dentistry Dr. Keisaburo Miyata, School of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico
person Edith Lara-Carrillo
school Center for Advanced Studies and Research on Dentistry Dr. Keisaburo Miyata, School of Dentistry, Autonomous University of the State of Mexico, Toluca, MexicoAutonomous University of the State of MexicoMexicoToluca, Mexico Center for Advanced Studies and Research on Dentistry Dr. Keisaburo Miyata, School of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico
person Ulises Velázquez-Enriquez
school Center for Advanced Studies and Research on Dentistry Dr. Keisaburo Miyata, School of Dentistry, Autonomous University of the State of Mexico, Toluca, MexicoAutonomous University of the State of MexicoMexicoToluca, Mexico Center for Advanced Studies and Research on Dentistry Dr. Keisaburo Miyata, School of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico
person Juan Fernando Casanova-Rosado
person Alejandro José Casanova-Rosado
person Adriana Alejandra Morales-Valenzuela
person Sonia Márquez-Rodríguez
schoolAcademic Area of Dentistry, Health Sciences Institute, Autonomous University of the State of Hidalgo, Pachuca, MexicoAutonomous University of the State of HidalgoMexicoPachuca, MexicoAcademic Area of Dentistry, Health Sciences Institute, Autonomous University of the State of Hidalgo, Pachuca, Mexico
person Carlo Eduardo Medina-Solís
school Center for Advanced Studies and Research on Dentistry Dr. Keisaburo Miyata, School of Dentistry, Autonomous University of the State of Mexico, Toluca, MexicoAutonomous University of the State of MexicoMexicoToluca, Mexico Center for Advanced Studies and Research on Dentistry Dr. Keisaburo Miyata, School of Dentistry, Autonomous University of the State of Mexico, Toluca, MexicoschoolAcademic Area of Dentistry, Health Sciences Institute, Autonomous University of the State of Hidalgo, Pachuca, MexicoAutonomous University of the State of HidalgoMexicoPachuca, MexicoAcademic Area of Dentistry, Health Sciences Institute, Autonomous University of the State of Hidalgo, Pachuca, Mexico
person Gerardo Maupomé
Correspondence: DSc. Edith Lara-Carrillo and Carlo Eduardo Medina-Solís: Dr. Keisaburo Miyata - Center for Advanced Studies and Research on Dentistry, School of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico, 50130. E-mail:
laracaedith@hotmail.com
laracaedith@hotmail.com
SCIMAGO INSTITUTIONS RANKINGS
Center for Advanced Studies and Research on Dentistry Dr. Keisaburo Miyata, School of Dentistry, Autonomous University of the State of Mexico, Toluca, MexicoAutonomous University of the State of MexicoMexicoToluca, Mexico Center for Advanced Studies and Research on Dentistry Dr. Keisaburo Miyata, School of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico
School of Dentistry, Autonomous University of Campeche, Campeche, MexicoAutonomous University of CampecheMexicoCampeche, MexicoSchool of Dentistry, Autonomous University of Campeche, Campeche, Mexico
School of Dentistry, Autonomous University of the State of Mexico, Toluca, MexicoAutonomous University of the State of MexicoMexicoToluca, MexicoSchool of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico
Academic Area of Dentistry, Health Sciences Institute, Autonomous University of the State of Hidalgo, Pachuca, MexicoAutonomous University of the State of HidalgoMexicoPachuca, MexicoAcademic Area of Dentistry, Health Sciences Institute, Autonomous University of the State of Hidalgo, Pachuca, Mexico
Tabelas
table_chartTable 1
Sociodemographic and dental/medical characteristics of the study participants
| Variables | Mean ± SD | Limits |
|---|---|---|
| Age (years) | 46.81± 16.11 | 13-84 |
| Schooling level (years) | 9.0 ± 4.4 | 0-18 |
| Number of extractions during the study | 2.75 ± 1.92 | 1-9 |
| n | % | |
| Sex | ||
| Female | ||
| Male | 18698 | 65.534.5 |
| Dental arch | ||
| Maxilla | 255 | 50.4 |
| Mandible | 250 | 49.6 |
| Group of teeth | ||
| Anterior | 152 | 30.0 |
| Posterior | 353 | 70.0 |
| Restorations in teeth to be extracted | ||
| No | 433 | 85.8 |
| Partial crown or inlay | 9 | 1.8 |
| Full crown or bridge | 15 | 2.9 |
| Other restoration (resin or amalgam) | 48 | 9.5 |
| Multiple extractions during the study | ||
| One extraction | 167 | 33.1 |
| More than one extraction | 338 | 66.9 |
| Systemic disease (any) | ||
| No | 217 | 76.4 |
| Yes | 67 | 23.6 |
| Diabetes | ||
| No | 251 | 88.4 |
| Yes | 33 | 11.6 |
| Hypertension | ||
| No | 249 | 87.7 |
| Yes | 35 | 12.3 |
| Tobacco use | ||
| No | 203 | 71.5 |
| Yes | 81 | 28.5 |
| Current tobacco use | ||
| No | 237 | 83.5 |
| Yes, occasional | 19 | 6.7 |
| Yes, daily (at least one cigarette) | 28 | 9.8 |
| Reasons for extraction | ||
| Caries and its sequels | 321 | 63.6 |
| Periodontal disease and its sequels | 111 | 22.0 |
| Other reasons | 73 | 14.4 |
table_chartTable 2
Association between reasons for extraction of permanent teeth and independent variables. Part 1
| Periodontal disease and its sequels | Other reasons | |
|---|---|---|
| Variable | OR (95% CI); | OR (95% CI) |
| Age (years) | 1.03 (1.00 - 1.05)‡ | 1.00 (0.97 - 1.03)n/s |
| Schooling level (years) | 0.95 (0.88 - 1.04)n/s | 1.05 (0.95 - 1.16)n/s |
| Sex | ||
| Male | 1* | 1* |
| Female | 1.53 (0.72 - 3.24)n/s | 1.50 (0.58 - 3.75)n/s |
| Dental arch | ||
| Maxilla | 1* | 1* |
| Mandible | 1.40 (0.73 - 2.58)n/s | 0.95 (0.42 - 2.12)n/s |
| Group of teeth | ||
| Anterior | 1* | 1* |
| Posterior | 0.29 (0.16 - 0.54)¶ | 0.88 (0.40 - 1.96)n/s |
| Tooth restoration | ||
| Restored | 1* | 1* |
| Unrestored | 1.30 (0.60 - 2.84)n/s | 2.03 (0.86 - 4.80)n/s |
| Multiple extractions during the study | ||
| One extraction | 1* | 1* |
| More than one extraction | 3.34 (1.70 - 6.57)¶ | 0.91 (0.43 - 1.94)n/s |
| Diabetes | ||
| No | 1* | 1* |
| Yes | 2.13 (0.85 - 5.33)n/s | 1.60 (0.31 - 8.30)n/s |
| Hypertension | ||
| No | 1* | 1* |
| Yes | 2.09 (0.81 - 5.37)n/s | 0.50 (0.15 - 1.70)n/s |
| Tobacco use at any point in life | ||
| No | 1* | 1* |
| Yes | 1.60 (0.75 - 3.43)n/s | 0.40 (0.17 - 0.92)† |
| Current tobacco use | ||
| Never or not currently | 1* | 1* |
| Occasionally or daily | 1.7 (1.09 - 2.86)¶ | 0.54 (0.30 - 0.96)† |
-
*Reference category
-
Crude multinomial logistic regression analysis
-
The reference group for each variable was extraction due to caries.
-
Confidence intervals were calculated with robust standard errors per mouth cluster.
table_chartTable 3
Association between reasons for extraction of permanent teeth and independent variables. Part 2
| Periodontal disease and its sequels | Other reasons | |
|---|---|---|
| Variable | OR (95% CI) | OR (95% CI) |
| Current cigarette smoking | ||
| No | 1* | 1* |
| Occasionally | 3.90 (1.17 - 13.04)† | 1.65 (0.56 - 4.85)n/s |
| Yes, daily (at least 1 cigarette per day) | 3.19 (1.15 - 8.90)† | not calculated |
| Tooth restoration | ||
| Previously unrestored | 1* | 1* |
| Previously restored | 2.35 (1.03 - 5.38)† | 2.13 (0.88 - 5.19)n/s |
| Group of teeth | ||
| Posterior | 1* | 1* |
| Anterior | 2.63 (1.35 - 5.00)‡ | 1.35 (0.65 - 2.85)n/s |
| Multiple extractions during the study | ||
| One extraction | ||
| More than one extraction | 2.68 (1.25 - 5.72)† | 1.03 (0.48 - 2.22)n/s |
-
*Reference category
-
Multinomial logistic regression multivariate analysis.
-
The reference group for each variable was extraction due to caries.
-
Note: Model adjusted for the variables contained in the table in addition to age and sex. Confidence intervals were calculated with robust standard errors per mouth cluster.
-
n/s = not significant, † <0.05, ‡ <0.01
table_chartTable 4
Prevalence of extraction per tooth type
| Tooth type | n | Percentage |
|---|---|---|
| 18 | 8 | 1.6 |
| 17 | 11 | 2.1 |
| 16 | 9 | 1.8 |
| 15 | 15 | 3.0 |
| 14 | 21 | 4.1 |
| 13 | 25 | 5.0 |
| 12 | 10 | 2.0 |
| 11 | 14 | 2.8 |
| 21 | 19 | 3.8 |
| 22 | 14 | 2.8 |
| 23 | 15 | 3.0 |
| 24 | 21 | 4.1 |
| 25 | 17 | 3.3 |
| 26 | 25 | 5.0 |
| 27 | 18 | 3.5 |
| 28 | 13 | 3.0 |
| 38 | 16 | 3.1 |
| 37 | 13 | 2.5 |
| 36 | 11 | 2.1 |
| 35 | 6 | 1.1 |
| 34 | 8 | 1.5 |
| 33 | 29 | 5.8 |
| 32 | 21 | 4.1 |
| 31 | 11 | 2.1 |
| 41 | 15 | 3.0 |
| 42 | 8 | 1.5 |
| 43 | 13 | 2.6 |
| 44 | 18 | 3.6 |
| 45 | 19 | 3.8 |
| 46 | 29 | 5.8 |
| 47 | 19 | 3.8 |
| 48 | 14 | 2.8 |
| Total | 505 | 100 |
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