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Asociación entre la pérdida de dientes y la mortalidad en pacientes con artritis reumatoide
Andi Xu1, Chunhong Zhang1, Honghua Lv1
1Department of Immunology and Rheumatology, Lishui Central Hospital and Fifth Affiliated Hospital of Wenzhou Medical University, China.
British dental journal
|August 23, 2025
Resumen
En pacientes con artritis reumatoide (AR), la pérdida de dientes está relacionada con un aumento de la mortalidad. Sin embargo, el riesgo de mortalidad cardiovascular disminuye después de diez o más dientes perdidos.
Área de la Ciencia:
- Reumatología
- Cardiología
- Salud pública dental
Sus antecedentes:
- La artritis reumatoide (AR) es una enfermedad autoinmune sistémica asociada con un mayor riesgo de enfermedad cardiovascular (ECV).
- La salud oral, específicamente la pérdida de dientes, se ha investigado por su asociación con los resultados de salud sistémica.
- La relación entre el grado de pérdida de dientes y la mortalidad en pacientes con AR sigue siendo incompleta.
Objetivo del estudio:
- Investigar la asociación entre el número de dientes perdidos y la mortalidad por cualquier causa y cardiovascular en pacientes con artritis reumatoide (AR).
Principales métodos:
- Se utilizaron datos de las Encuestas Nacionales de Examen de Salud y Nutrición (1999-2004 y 2011-2014) para pacientes con AR mayores de 18 años.
- Incluye exámenes orales detallados para evaluar el número de dientes faltantes.
- Utilizó modelos de regresión de Cox y splines cúbicas restringidas para analizar el riesgo de mortalidad asociado con la pérdida de dientes.
Principales resultados:
- Se siguió a una cohorte de 1.720 pacientes con AR, con 627 muertes (191 cardiovasculares).
- Cada diente extra faltante se correlacionó con un aumento del 2% en el riesgo de mortalidad por cualquier causa.
- Los pacientes con 15 a 28 dientes perdidos tenían un riesgo de mortalidad por todas las causas y cardiovascular significativamente mayor en comparación con aquellos sin dientes perdidos.
- Curiosamente, en pacientes con más de 10 dientes perdidos, el riesgo de mortalidad cardiovascular disminuyó en un 14% por cada diente perdido adicional.
Conclusiones:
- La pérdida de dientes en pacientes con AR se asocia con un aumento de la mortalidad por cualquier causa.
- El riesgo de mortalidad cardiovascular aumenta con la pérdida de dientes cuando el número de dientes faltantes es inferior a diez.
- Se observa una disminución paradójica en el riesgo de mortalidad cardiovascular con una mayor pérdida de dientes cuando el número de dientes faltantes es de diez o más.
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