Date of Award

12-2020

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Shafquat Rozi

Second Advisor

Dr. Amna Rehana Siddiqui

Third Advisor

Dr. Nida Zahid

Department

Community Health Sciences

Abstract

INTRODUCTION: Alveolar bone supports teeth and dental implants. Implant prosthesis replaces the missing teeth following extractions. A dental implant depends on quality and quantity of alveolar bone. It is important to understand the quantity and biologic events (function, physiology, histology, and response to stress) of the alveolar bone to anticipate post extraction healing of bone around the implant in the alveolar bone socket, planning the stages of implant therapy and their successful outcomes. Normal levels of alveolar bone loss around the tooth should not exceed 1mm per anum hence the objective is to evaluate an association between alveolar bone loss and dental implant placement among adults 18 years and above from NHANEs study USA (2017-2018) while adjusting for demographic and clinical factors.
METHOD: This was a cross sectional study selected from a US based NHANES (2017-2018) study. The sample size comprised of 1985 subjects selected from the 162011 subjects included in NHANES study (2017-2018). Data was selected from an oral health questionnaire which included questions based on last visit to dentist or lack of dental care, periodontal disease self-report or dental health perception and basic demographic characteristics. The main exposure variable was a qualitative categorical binary variable ever been told about bone loss categorized as yes or no. The outcome variable was a categorical binary variable implant placement categorized as yes and No. Other independent categorical variables included age of participants, gender (Male/female), giving up cigarettes, checking blood sugar, treatment for gum disease whereas the independent quantitative variables include reason for last dental visit (Own checkup, dentist called for 4 checkup, something hurting/bothering, dental treatment, other), rate health of teeth and gums, floss/service, gum and gum disease, duration of last Dental Visit (in Months) (Never, less than 6 months, 6 - 59 months, 60 months and above), full sample 2 year MEC Exam weight, masked variance PSU and masked variance pseudo strata. Data was setup according to survey data design using PSU, strata and weights, following which Cox regression algorithm was used to report crude and adjusted prevalence ratios with 95% confidence intervals are reported to identify the factors related with implant placement.
RESULTS: Prevalence of Dental Implant was 3.8% (95% CI: 2.9%, 4.6%). Mean age of participants was 52.4(SD= 19.3) years in the implant group and 49.26 (SD=18.6) years in the non-implant group. The prevalence of ever been told of bone loss around teeth is 40% lower (95% CI: 0.1%, 2.6%) in the implant group as compared to non- implant group while adjusting for treatment with gum disease and age group at screening. Hence this study shows that there is no significant association between alveolar bone level with implant placement and other independent variables such as floss usage checking blood sugar level and giving up cigarette with implant placement.
CONCLUSION: The association between alveolar bone level with age and presence of implant remains uncertain.

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