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Drummond LB, Bezerra AP, Feldmann A, Gonçalves TMSV. Long-term assessment of the periodontal health of removable partial denture wearers: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(24)00448-7. [PMID: 39043477 DOI: 10.1016/j.prosdent.2024.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/25/2024]
Abstract
STATEMENT OF PROBLEM The long-term effects of wearing removable partial dentures (RPDs) remain unclear. PURPOSE This systematic review addressed the question "Is the long-term use of RPDs deleterious to the remaining teeth?" MATERIAL AND METHODS This review was guided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. Six databases and nonpeer-reviewed literature were searched in April 2024 without language or follow-up restrictions. Only clinical studies evaluating RPD long-term use were included. The risk of bias and evidence certainty were assessed (RoB 2.0; ROBINS-I; GRADE), and meta-analyses were conducted for survival rate and periodontal health (α=.05). RESULTS A total of 5577 records were identified, and 46 studies covering data from 4359 prostheses and 4072 participants (mean age 60 ±5.2 years) were included. A low to moderate risk of bias was found. A 5-year survival rate of 95.1% (ER=0.951; 95% CI=0.900 to 0.977; P<.001) and 91.7% (ER=0.917; 95% CI=0.870 to 0.948; P<.001) was found for cast-clasp RPD and RPDs retained by telescopic crowns respectively, with no difference between them (P=.71). Abutments (OR=1.99, 95% CI=1.32 to 3.01; P=.001) and nonvital teeth (HR=2.961; 95% CI=2.023 to 4.335; P<.001) presented a higher risk of extraction after 5 years. Tooth mobility (P=.98) and probing depth (P=.50) remained unchanged, while the gingival index increased (MD=0.477 (95% CI=0.12 to 0.83; P=.008). CONCLUSIONS A high survival rate was found for both cast-clasp RPD and RPDs retained by telescopic crowns, with few periodontal changes to the remaining teeth.
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Affiliation(s)
- Liliane Bonatto Drummond
- PhD student, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Adriana Pinto Bezerra
- PhD student, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Alexandra Feldmann
- PhD student, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
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Hinz S, Bömicke W, Bensel T. Cumulative 10-year performance of endodontically treated teeth with prosthetic restorations of base metal alloy double crowns with friction pins-a retrospective study. Clin Oral Investig 2023; 27:4411-4423. [PMID: 37212841 PMCID: PMC10415510 DOI: 10.1007/s00784-023-05060-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/02/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES This 120-month follow-up study aimed to investigate the complication rate of abutment teeth after endodontic pretreatment with base metal alloy double crowns with friction pins. MATERIALS AND METHODS A total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth (n = 459, 88.3% vital) were retrospectively analyzed between 2006 and 2022. Of the endodontically treated abutment teeth, 6.9% (n = 36) were additionally treated with post and core reconstructions. Cumulative complication rates were calculated using the Kaplan-Meier estimator and log-rank test. In addition, Cox regression analysis was performed. RESULTS The cumulative complication rate at 120 months for the entire set of abutment teeth was 39.6% (confidence interval [CI]: 33.0-46.2). Endodontically treated abutment teeth (33.8%; CI: 19.6-48.0) were found to have a significantly higher cumulative fracture rate than vital teeth (19.9%; CI: 13.9-25.9, p < 0.001). Endodontically treated teeth restored with post and core reconstructions (30.4%; CI: 13.2-47.6) showed a nonsignificant lower cumulative fracture rate than that of teeth with root fillings only (41.6%; CI: 16.4-66.8, p = 0.463). CONCLUSIONS Higher 120-month cumulative fracture rates were observed in endodontically treated teeth. Comparable performance was observed in teeth with post and core reconstructions compared to teeth with root fillings only. CLINICAL RELEVANCE If endodontically treated teeth are used as abutments for double crowns, the risk of complications from these teeth should be considered when planning treatment and communicating with the patient.
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Affiliation(s)
- Sebastian Hinz
- Department of Prosthetic Dentistry, University School of Dental Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 16, 06112, Halle, Germany.
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Tobias Bensel
- Institute for Research in International Assistance, Akkon University for Human Sciences, Colditzstraße 34-36, 12099, Berlin, Germany
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Goguta L, Frandes M, Candea A, Ille C, Jivanescu A. Impact of unilateral removable partial dentures versus removable partial dentures with major connector on oral health-related quality of life of elder patients: a clinical study. BMC Oral Health 2023; 23:182. [PMID: 36991435 PMCID: PMC10061744 DOI: 10.1186/s12903-023-02870-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/09/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE This study aimed to establish the survival rate of unilateral removable partial dentures (u-RPD) comparative with bilateral RPD (bi-RPD) with major connector in elder patients, as well as to determine both their treatment satisfaction and oral health. METHODS The study sample included 17 patients treated with u-RPD and 17 patients treated with bi-RPD with a major connector. The patients were followed over five years with recalls every 6 months. A 5- points Likert scale was used to determine the satisfaction of the patients. The Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to evaluate their oral health after each type of administrated treatment. The local oral examined aspects included the maintenance of the abutment teeth periodontal health, the fractures of the removable dentures, the fractures of the connectors, the chipping of the aesthetic material. Kaplan-Meier survival analysis was conducted to evaluate the performance of the two treatments. RESULTS The mean survival time in years was 4.882 ± 0.114, 95% CI (4.659; 5.106) and 4.882 ± 0.078, 95% CI (4.729; 5.036), for the u-RPD and the bi-RPD, respectively. The five-year survival rates for the two dentures were 94.1% for u-RPD vs. 88.2% for bi-RPD with a major connector, without a statistically significant difference between them (Log-rank test χ2(1) = 0.301, p = 0.584). The patients receiving u-RPD presented significantly higher satisfaction scores compared to the patients receiving bi-RPD, 4.88 ± 0.48 vs. 4.41 ± 0.62, Mann-Whitney U test, p = 0.026. CONCLUSION Patients receiving u-RPD presented higher levels of treatment satisfaction and better oral health than patients receiving bi-RPD. The survival rates of the treatments u-RPD and bi-RPD were similar.
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Affiliation(s)
- Luciana Goguta
- Department of Prosthodontics, Faculty of Dentistry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Mirela Frandes
- Department of Functional Sciences - Biostatistics and Medical Informatics, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
| | - Adrian Candea
- Department of Prosthodontics, Faculty of Dentistry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Codruta Ille
- Department of Prosthodontics, Faculty of Dentistry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Anca Jivanescu
- Department of Prosthodontics, Faculty of Dentistry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
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Technical Complications of Removable Partial Dentures in the Moderately Reduced Dentition: A Systematic Review. Dent J (Basel) 2023; 11:dj11020055. [PMID: 36826200 PMCID: PMC9955676 DOI: 10.3390/dj11020055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
The aim of this study was to conduct a systematic literature review with a subsequent meta-analysis on the technical complications and failures of removable partial denture (RPD) therapy in the moderately reduced dentition. A systematic literature search of established medical databases, last updated 06/2022, was conducted. RCTs and prospective and retrospective studies were included that had information on technical complications and failures of RPDs, at least 15 participants, an observation period of at least two years and a drop-out rate of less than 25%. Publications were selected on the title, abstract and full-text level by at least three of the participating authors. The evidence of the included studies was classified using the GRADE system. The bias risk was determined using the RoB2 tool and the ROBINS-I tool. Of 19,592 initial hits, 43 publications were included. Predominantly, retention of the prosthesis, retention loss of anchor crowns (decementations), fractures/repairs of frameworks, denture teeth, veneering or acrylic bases, and a need for relining were reported depending on prosthesis type and observation time. Focusing on technical complications and failures, only very heterogeneous data were found and publications with the highest quality level according to GRADE were scarce. Whenever possible, data on technical complications and failures should be reported separately when referencing the tooth, the prosthesis and the patient for comparability. Prostheses with differing anchorage types should be analyzed in different groups, as the respective complications and failures differ. A precise description of the kinds of complications and failures, as well as of the resulting follow-up treatment measures, should be given.
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Short Implants versus Standard Implants and Sinus Floor Elevation in Atrophic Posterior Maxilla: A Systematic Review and Meta-Analysis of Randomized Clinical Trials with ≥5 Years' Follow-Up. J Pers Med 2023; 13:jpm13020169. [PMID: 36836403 PMCID: PMC9960634 DOI: 10.3390/jpm13020169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Background and objectives: The aim of this systematic review with meta-analysis was to assess the performance of short implants in comparison with standard implants and sinus floor elevation in atrophic posterior maxilla. Materials and methods: The protocol of the study was registered in the PROSPERO database (CRD42022375320). An electronic search on three databases (PubMed, Scopus, Web of Science) was performed to find randomized clinical trials (RCTs) with ≥5 years' follow-up, published until December 2022. Risk of bias (ROB) was calculated using Cochrane ROB. A meta-analysis was performed for primary (implant survival rate, ISR) and secondary outcomes (marginal bone loss, MBL; biological and prosthetic complications). Results: Of 1619 articles, 5 RCTs met the inclusion criteria. The ISR showed a risk ratio (RR) of 0.97 [0.94, 1.00] (CI 95%), p = 0.07. The MBL indicated a WMD of -0.29 [-0.49, -0.09] (CI 95%), p = 0.005. Biological complications showed a RR of 0.46 [0.23, 0.91] (CI 95%), p = 0.03. Prosthetic complications showed a RR of 1.51 [0.64, 3.55] (CI 95%), p = 0.34. Conclusions: The available evidence suggests that short implants might be used as an alternative to standard implants and sinus floor elevation. After 5 years, in terms of ISR, standard implants and sinus floor elevation showed a higher survival rate comparted to short implants, although statistical significance was not achieved. Future RCTs with long-term follow-up are needed to draw a clear conclusion on the advantages of one method over another.
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Lone MA, Iqbal UA, Lone MM, Adnan S, Heboyan A, Ahmed N, Karobari MI, Marya A. Current Trends in Fixed Prosthodontics Education in Undergraduate Dental Colleges. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231193282. [PMID: 37614332 PMCID: PMC10443680 DOI: 10.1177/23821205231193282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/21/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES The objective of this study was to explore current trends in undergraduate fixed prosthodontics teaching at undergraduate dental level education. METHODS This cross-sectional descriptive study included close-ended questions to inquire about the teaching practices of fixed prosthodontics at Bachelor of Dental Surgery level education. Electronic copies of the survey forms were sent to the heads or directors of department of prosthodontics responsible for undergraduate dental students teaching and learning in various institutes of Sindh by the help of Google forms in December 2020. The form included questions on sociodemographic details and questions inquiring the theoretical and clinical teaching practices in undergraduate fixed prosthodontics course. Data was entered and analyzed using SPSS 25. Frequency distribution and percentages of categorical variables were recorded. RESULTS Out of total 18 dental institutes of Sindh, 15 returned the completely filled form, giving a response rate of 83.3%. Seven (46.7%) schools teach various fixed prosthesis in the preclinical years to their students. All 15 colleges carry out didactic teaching and provide exposure by live clinical demonstrations for various fixed prosthesis. Faculty of 12 (80%) dental colleges where fixed prostheses are being constructed in the dental outpatient department mentioned that their students observe or assist the clinical procedures during their clinical rotation; but none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years. CONCLUSION Didactic teaching and live clinical demonstrations of fixed prosthodontics is being carried out in all dental colleges of Sindh. Almost half of the dental schools teach crown preparation on phantom teeth during their preclinical course. Contrary to this, none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years. As these procedures are not included in the current undergraduate curriculum, recommendations should be forwarded to governing educational body of the country to include cases of fixed prosthesis in their skill set prior to their graduation.
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Affiliation(s)
- Muneeb Ahmed Lone
- Department of Prosthodontics, Dr Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Uzma Anam Iqbal
- Department of Prosthodontics, Dr Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Maham Muneeb Lone
- Department of Operative Dentistry Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Samira Adnan
- Department of Operative Dentistry Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Anand Marya
- Department of Orthodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
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Pordeus MD, Gasparetto GD, Machado LMR, Noritomi PY, Costa RMBD, Chappuis-Chocano AP, Venante HS, Junior JFS, Porto VC. A New Proposal for Calibrated Gauges for Removable Partial Dentures: A Finite Element Analysis. J Contemp Dent Pract 2022; 23:1230-1236. [PMID: 37125521 DOI: 10.5005/jp-journals-10024-3453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
AIM The aim of this study was to evaluate the stress distribution of a planned removable partial denture (RPD) using new proposals for calibrated gauges of 0.3 mm and 0.35 mm undercuts through the three-dimensional (3D) finite element methodology, and compare them with 0.25 mm and 0.5 mm gauges that are already existing in clinical practice. MATERIALS AND METHODS Kennedy class-I edentulous 3D models and their respective RPDs (InVesalius software; Rhinoceros and SolidWorks CAD) were created and exported to the finite element program HyperMesh 2019 for mesh configuration. In the following steps, axial loading (0º) of 40 N per point was performed, with 3 points on the molars and 2 points on the premolars, totaling 280 N unilaterally. The model was processed by the OptiStruct 2019 software and imported into the HyperView 2019 software to obtain the stress maps (MPa). RESULTS The use of 0.30 and 0.35 mm calibrated gauges presented tensions similar to those with the 0.25 mm gauge (gold standard) and caused no significant damage to biological structures. The use of a 0.5 mm undercut caused greater traction force in the periodontal ligament of the abutments. CONCLUSIONS The 0.35 mm undercut seems promising as it presented more favorable results in this simulation, on the other hand, a 0.5 mm undercut is greater than that necessary for retainers made of CoCr. CLINICAL SIGNIFICANCE This study aims to measure a new undercut gauge (0.35 mm) to increase the retention area in abutment teeth of removable partial dentures.
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Affiliation(s)
- Mariana Domingues Pordeus
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | | | | | | | - Ana Paula Chappuis-Chocano
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Helena Sandrini Venante
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Joel Ferreira Santiago Junior
- Centro Universitário Sagrado Coração, UNISAGRADO, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil, e-mail:
| | - Vinicius Carvalho Porto
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Hinz S, Bömicke W, Schweyen R, Bensel T. Ten-year clinical performance of non-precious metal double crowns with friction pins in severely reduced dentitions—a retrospective study. Clin Oral Investig 2022; 27:1623-1635. [PMID: 36414766 PMCID: PMC10102142 DOI: 10.1007/s00784-022-04788-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
Abstract
Objectives
This follow-up study aimed at collecting long-term data for removable partial dentures (RPDs) retained by double crowns with spark-eroded friction pins (DCP) and comparing them in the presence of severely reduced dentition (SRD) and non-SRD (NSRD, i.e. residual dentition with more than three abutment teeth) after a 10-year wearing period.
Materials and methods
A total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth were followed up between 2006 and 2022. The SRD group included 144 RPDs supported by 314 abutment teeth. The data collection was performed retrospectively. 10-year survival rates of RPDs and abutment teeth were determined using the Kaplan–Meier method and compared using the log-rank test for SRD and NSRD, among others. Cox regression analyses were conducted to isolate risk factors for the survival of both RPDs and abutment teeth.
Results
The 10-year cumulative survival rate of all abutment teeth was 65.6% with significantly lower values in the SRD group (53.5%) (p < 0.001). The survival rate for all RPDs was 65.5%. The SRD group showed lower survival rates (57.9%) (p = 0.004). The number and location of the abutment teeth had a significant influence on the survival rates of the RPDs and the abutment teeth. Age, sex, jaw, relining, and vitality had a significant influence on the abutment teeth survival rates.
Conclusions
RPDs showed an acceptable clinical survival rate after 10 years. The number, location, and vitality of abutment teeth were factors that influenced the survival of both RPDs and abutment teeth.
Clinical relevance
Consideration of the influencing factors found can help improve the prognostic assessment of double crown-retained dentures in the context of prosthetic therapy planning.
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Cimões R, Pinho RCM, Gurgel BCDV, Borges SB, Marcantonio Júnior E, Marcantonio CC, Melo MARDC, Piattelli A, Shibli JA. Impact of tooth loss due to periodontal disease on the prognosis of rehabilitation. Braz Oral Res 2021; 35:e101. [PMID: 34586215 DOI: 10.1590/1807-3107bor-2021.vol35.0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 01/21/2023] Open
Abstract
When periodontal disease is diagnosed, it is difficult to predict the clinical response of treatment of a tooth over time because the result of treatment is affected by several factors and will depend on the maintenance and support of periodontal treatment. Rehabilitation with removable dental prostheses, fixed prostheses, and dental implants makes it possible to restore the function and esthetics of patients with tooth loss due to periodontal disease. The predictive factors of tooth loss in periodontitis patients should be assessed by dentists to inform their clinical decision-making during dental treatment planning. This will provide detailed individualized information and level of risk of patients considered suitable for dental rehabilitation. Therefore, the aim of this article was to review the subject of "Impact of tooth loss due to periodontal disease on the prognosis of rehabilitation" and the effect of fixed, removable, and implant-supported prostheses in periodontal patients.
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Affiliation(s)
- Renata Cimões
- Universidade Federal de Pernambuco - UFPE, Health Sciences Centre, Department of Prosthesis and Oral and Maxillofacial Surgery, Recife, PE, Brazil
| | | | | | - Samuel Batista Borges
- Universidade Federal do Rio Grande do Norte - UFRN, Health Sciences Centre, Department of Dentistry, Natal, RN Brazil
| | - Elcio Marcantonio Júnior
- Universidade Estadual Paulista Júlio de Mesquita Filho - Unesp, Faculdade de Odontologia de Araraquara, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Camila Chierici Marcantonio
- Universidade Estadual Paulista Júlio de Mesquita Filho - Unesp, Faculdade de Odontologia de Araraquara, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | | | - Adriano Piattelli
- University of Chieti, Dental School, Department of Medical, Oral and Biotechnological Sciences, Chieti, Italy
| | - Jamil Awad Shibli
- Universidade de Guarulhos - UnG, Dental Research Division, Department of Periodontology and Oral Implantology, Guarulhos, SP, Brazil
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Kumar N, Koli DK, Jain V, Nanda A. Stress distribution and patient satisfaction in flexible and cast metal removable partial dentures: Finite element analysis and randomized pilot study. J Oral Biol Craniofac Res 2021; 11:478-485. [PMID: 34345583 DOI: 10.1016/j.jobcr.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/11/2021] [Accepted: 06/27/2021] [Indexed: 10/20/2022] Open
Abstract
Purpose To compare stress distribution in polyacetyl based flexible RPD (FRPD) with cast metal RPD (CRPD) by using three-dimensional finite element analysis (FEA) and patient satisfaction by using OHIP-14 questionnaire in participants with Kennedy's class I partially edentulous mandibular arch rehabilitated with CRPD and FRPD. Material and methods For FEA, 3D models of Kennedy's class I partially edentulous mandibular arch, CRPD in chrome-cobolt alloy, and polyacetyl based FRPD were geometrically modelled and subjected to a vertical load of 100 N bilaterally. The in vivo comparison of satisfaction was assessed by enrolling 22 participants with Kennedy's class I partially edentulous mandibular arch. After randomization, 11 participants were rehabilitated by CRPD (group C), and 11 participants by polyacetyl based FRPD (group F). OHIP-14 questionnaire in Hindi language was filled at 1 week and 1 year after denture insertion. Results Von Mises stress distribution in CRPD was maximum in mesial rest seat of the primary abutment (100 MPa) and minimum for edentulous ridge (7 MPa on bone and 6 MPa on mucosa). Von Mises stress distribution for polyaccetyl based FRPD was maximum in ridge (25 MPa) and minimum in periodontal ligament of the second premolar (3 MPa). Patient satisfaction in group F was significantly more than in group C at end of 1 year (P = .0158). Conclusion FRPD is useful in periodontally compromised abutment teeth and CRPD in resorbed ridge conditions. Patient satisfaction is more with polyacetyl based flexible RPD when compared with cast metal RPD at the end of 1 year.
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Affiliation(s)
- Niraj Kumar
- Department of Prosthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Dheeraj Kumar Koli
- Department of Prosthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Veena Jain
- Department of Prosthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Aditi Nanda
- Department of Prosthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
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Papathanasiou I, Papavasiliou G, Kamposiora P, Zoidis P. Effect of Staining Solutions on Color Stability, Gloss and Surface Roughness of Removable Partial Dental Prosthetic Polymers. J Prosthodont 2021; 31:65-71. [PMID: 33893704 DOI: 10.1111/jopr.13360] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To assess the effect of commonly used solutions on color stability, gloss, and surface roughness of removable partial dental prostheses polymers. MATERIALS AND METHODS Discs (n = 112) were made of a poly(etheretherketone) (PEEK) polymer, a polyamide, an acetal resin and a heat-cured poly(methylmethacrylate) PMMA acrylic resin polished according to manufacturers' instructions. Seven specimens of each material were immersed in coffee, red wine, coca cola and distilled water for 30 days at 37ο C. Changes of color (ΔΕ*) and color coordinates L*α*b* after immersion were calculated with a colorimeter. Changes in the values of gloss and surface roughness parameters (Sa, Sz, Str, Sdr, Sci, Svi) were also measured. Two-way ANOVA and pairwise comparisons were used to evaluate the effect of material and staining solution on parameter value alterations (α = 0.05). RESULTS The two-way ANOVA revealed that the interaction between material and staining solution significantly affected color changes after immersion [F(9,96) = 44.67, p < 0.001]. PEEK presented the lowest color change (ΔΕ* = 3.83 ± 2) while polyamide had the highest color change overall (ΔΕ* = 14.59 ± 8.65) (p < 0.001). Coffee caused the highest color (ΔΕ* = 13.08 ± 6.98) and gloss changes (ΔG = -6.36 ± 19.2 GU) among different solutions (p < 0.001). PEEK showed the highest alteration of gloss (ΔG = -11.31 ± 15.49 GU), with significant difference with the other three materials (p < 0.001). Insignificant interaction of material and immersing solution was found for surface roughness parameters (p > 0.05). CONCLUSIONS Among the materials tested, PEEK seemed to be the most stable material when subjected to common, everyday staining solutions. Therefore, PEEK could be a viable solution for an RPDP framework fabrication, expanding the material list of prosthetic options. Further research and clinical trials are required to confirm the above statement.
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Affiliation(s)
| | - George Papavasiliou
- Department of Prosthodontics, National and Kapodistrian University of Athens, Dental School, Athens, Greece
| | - Phophi Kamposiora
- Department of Prosthodontics, National and Kapodistrian University of Athens, Dental School, Athens, Greece
| | - Panagiotis Zoidis
- Division of Prosthodontics, Department of Restorative Dental sciences, University of Florida College of Dentistry, Gainesville, FL
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Walter MH, Marré B, Dreyhaupt J, Heydecke G, Rauch A, Mundt T, Hannak W, Kohal RJ, Kern M, Nothdurft F, Hartmann S, Böning K, Boldt J, Stark H, Edelhoff D, Wöstmann B, Wolfart S, Jahn F, Luthardt RG. Rehabilitation of shortened dental arches: A fifteen-year randomised trial. J Oral Rehabil 2021; 48:738-744. [PMID: 33713361 DOI: 10.1111/joor.13167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/04/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Few long-term studies on treatments in the shortened dental arch (SDA) are available. OBJECTIVE The objective of this trial was to analyse the long-term success of two different treatment concepts. METHODS Patients over 35 years of age with missing molars in one jaw and at least the canine and one premolar present on both sides were eligible. In the partial removable dental prosthesis (PRDP) group (N = 81), molars and missing second premolars were replaced by a precision attachment retained prosthesis. In the SDA group (N = 71), the dental arch ended with the second premolar that had to be present or replaced by a cantilever fixed dental prosthesis. Follow-up examinations were carried out over 15 years. RESULTS A comprehensive outcome variable comprised four failure categories for which Kaplan-Meier survival (success) analyses were conducted. Half of the patients exhibited a continuous preservation of the per protocol prosthetic status that remained totally unaffected by complications for more than 10 years. The event-free success rates for moderate or worse failure implied a loss of the per protocol prosthetic status. The respective survival rates fell below 50% at 14.2 years in the PRDP group and 14.3 years in the SDA group. In none of the analyses, a significant group difference was found. CONCLUSIONS In patients with an SDA condition, changes in the prosthetic status have to be expected. The affected proportion increases almost linearly from shortly after treatment and comprises the majority after 15 years. The influence of the examined treatments on success appears to be low.
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Affiliation(s)
- Michael Horst Walter
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Birgit Marré
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Guido Heydecke
- Department of Prosthodontics, University Medical Center Eppendorf, Hamburg, Germany
| | - Angelika Rauch
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany
| | - Torsten Mundt
- Department of Prosthodontics, Gerodontology and Biomaterials, Dental School, University of Greifswald, Greifswald, Germany
| | - Wolfgang Hannak
- Department of Prosthodontics, Geriatic Dentistry and Craniomandibular Disorders, Center for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin CC3 - Charité, Berlin, Germany
| | - Ralf Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Matthias Kern
- School of Dentistry, Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Kiel, Germany
| | - Frank Nothdurft
- Department of Prosthetic Dentistry and Dental Materials Science, Medical Center, Dental School and Clinics, Saarland University, Homburg, Germany
| | - Sinsa Hartmann
- Department of Prosthetic Dentistry, Johannes-Gutenberg University of Mainz, Mainz, Germany
| | - Klaus Böning
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Julian Boldt
- Department of Prosthetic Dentistry, Julius-Maximilians University of Würzburg, Würzburg, Germany
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and dental Materials Science, University of Bonn, Bonn, Germany
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Ludwig-Maximilians-University, Munich, Germany
| | - Bernd Wöstmann
- Department of Prosthetic Dentistry, Justus-Liebig University of Gießen, Gießen, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Florentine Jahn
- Department of Prosthetic Dentistry and Dental Material Science, Friedrich-Schiller University of Jena, Jena, Germany
| | - Ralph Gunnar Luthardt
- Department of Prosthetic Dentistry, Center of Dentistry, Universitätsklinikum Ulm, Ulm, Germany
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13
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Cost-Effectiveness Analysis of Rehabilitation Interventions for Teeth With Extensive Coronary Destruction. Value Health Reg Issues 2020; 23:122-130. [PMID: 33217715 DOI: 10.1016/j.vhri.2020.07.581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 05/05/2020] [Accepted: 07/07/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To perform a cost-effectiveness analysis of rehabilitation interventions for management of posterior teeth (molar) with extensive coronary destruction. METHODOLOGY An economic model by Markov simulated a hypothetical 10-year cohort with 1,000 patients requiring treatment for a molar tooth with pulp necrosis and extensive coronary destruction. This study adopted the perspective of a local manager from Specialized Center in Dentistry, based on the transfer from the Ministry of Health. Treatments were proposed: Tooth Extraction + Removable Partial Denture (TE+RPD); Root Canal Treatment + Intra-Radicular Restoration + Single Crown (RCT+RIR+SC); and Tooth Extraction + Dental Implant + Single Crown (TE+DI+SC). The costs were obtained from the SUS Integrated System of Procedures, Medicines and orthoses; prostheses and special materials table management (SIGTAP). Failure and survival rates were obtained from systematic reviews. The variable "years of survival" was an outcome of effectiveness. The probabilistic simulation considered the confidence interval of 95%, variation of parameters by 5% and annual discount rate of 5%. RESULTS TE+RPD intervention presented lower cost and effectiveness. The incremental cost-effectiveness ratio (ICER) of RCT+IRR+SC and TE+DI+SC interventions compared to TE+RPD were $13.06 and $9.92 per year of survival. Compared to RCT+IRR+SC, the TE+DI+SC intervention had an ICER=$26.90 per year of survival. The acceptability curve indicates that the choice of intervention depends on the willingness to pay. CONCLUSION The RCT+IRR+SC intervention presented a balance of cost-effectiveness. Rehabilitation with implants can be considered in view of the higher expectation of longevity and, especially, greater willingness to pay.
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Retentive Characteristics of a Polyetheretherketone Post-Core Restoration with Polyvinylsiloxane Attachments. Polymers (Basel) 2020; 12:polym12092005. [PMID: 32899168 PMCID: PMC7563112 DOI: 10.3390/polym12092005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 12/22/2022] Open
Abstract
A new application of a polyetheretherketone (PEEK) post-core restoration combined with polyvinylsiloxane (PVS) attachments was proposed and substantiated. This study aimed to evaluate retentive characteristics of the PEEK post-core restoration with PVS attachment systems. Specimens with PVS attachments were fabricated to evaluate retention force during 10,000 cyclic dislodgements. Additionally, the retention forces of PVS attachments with three different values of Shore hardness were further measured before and after aging treatments. The results of cyclic dislodgement test indicated a strong negative linear relationship between the cyclic times and retention force (p < 0.0001, r = −0.957). Furthermore, the retention forces of the PVS were significantly improved with Shore hardness increased, which was also affected by the aging treatment (F (2, 138) = 10.95, p < 0.0001). Therefore, the PEEK post-core restoration with PVS attachments exhibited the favorable retention force, which could be a promising alternative for dental prostheses.
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15
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Melo Sá TC, Rodrigues Limeira FI, Alpino Rodrigues RA, Melo de Sá JC, de Magalhães CS, Moreira AN, Yamauti M. Rehabilitation with Fixed Prosthodontics Associated with Removable Partial Prosthesis: A 5-Year Follow-Up Clinical Evaluation. Contemp Clin Dent 2020; 10:561-564. [PMID: 32308338 PMCID: PMC7150576 DOI: 10.4103/ccd.ccd_750_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Dental implants are a common and successful option for the rehabilitation of edentulous areas. However, there are some limitations to their use. The present clinical report describes a 5-year follow-up of maxillary rehabilitation using an attachment-retained removable partial denture (RPD) associated with fixed partial denture (FPD) units as an alternative to orthodontic treatment associated with orthognathic surgery and dental implant placement. Rehabilitation with fixed prosthodontics associated with a removable partial prosthesis was proposed. For greater precision and stability, a gold attachment was prepared. The patient was very satisfied with the rehabilitation and has been clinically followed for 5 years. In cases where the use of dental implants and/or conventional FPDs is limited or not indicate the association between an FPD and an RPD by means of attachments remains an important alternative to conventional clasp-retained RPDs.
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Affiliation(s)
- Tassiana Cançado Melo Sá
- Department of Restorative Dentistry, Graduate School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Ricardo Antonio Alpino Rodrigues
- Department of Restorative Dentistry, Graduate School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Júlio Celso Melo de Sá
- Department of Prosthodontics, Centro Universitário Newton Paiva, Belo Horizonte, MG, Brazil
| | | | - Allyson Nogueira Moreira
- Department of Restorative Dentistry, Graduate School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Monica Yamauti
- Department of Restorative Dentistry, Graduate School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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16
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Soltanzadeh P, Suprono MS, Kattadiyil MT, Goodacre C, Gregorius W. An In Vitro Investigation of Accuracy and Fit of Conventional and CAD/CAM Removable Partial Denture Frameworks. J Prosthodont 2018; 28:547-555. [PMID: 30407685 DOI: 10.1111/jopr.12997] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2018] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To evaluate the overall accuracy and fit of conventional versus computer-aided design/computer-aided manufactured (CAD/CAM) removable partial denture (RPD) frameworks based on standard tessellation language (STL) data analysis, and to evaluate the accuracy and fit of each component of the RPD framework. MATERIALS AND METHODS A maxillary metal framework was designed for a Kennedy class III Modification I arch. The master model was scanned and used to compare the fit and accuracy of RPD frameworks. Forty impressions (conventional and digital) of the master cast were made and divided into 4 groups based on fabrication method: group I, lost-wax technique (conventional technique), group II, CAD-printing, group III, CAD-printing from stone cast, and group IV, lost-wax technique from resin-printed model. RPD frameworks were fabricated in cobalt-chromium alloy. All frameworks were scanned, and the gap distance between the framework and scanned master model was measured at 8 locations. Color mapping was conducted using comprehensive metrology software. Data were statistically analyzed using the Kruskall-Wallis test, followed by the Bonferroni method for pairwise comparisons (α = 0.05). RESULTS Color mapping revealed distinct discrepancies in major connectors among the groups. When compared to 3D-printed frameworks, conventional cast frameworks fabricated using dental stone or printed resin models revealed significantly better fit (p < 0.05) particularly in the major connectors and guide plates. The biggest gap (0.33 mm ± 0.20 mm) was observed with the anterior strap of the major connector with the printed frameworks (groups II and III). The method of fabrication did not affect the adaptation of the rests or reciprocation plates. CONCLUSIONS Although both conventional and 3D-printing methods of framework fabrication revealed clinically acceptable adaptation, the conventional cast RPD groups revealed better overall fit and accuracy.
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Affiliation(s)
- Pooya Soltanzadeh
- Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA
| | - Montry S Suprono
- Advanced Education Program in Prosthodontics, and Center for Dental Research, Loma Linda University School of Dentistry, Loma Linda, CA
| | - Mathew T Kattadiyil
- Advanced Education Program in Prosthodontics, Loma Linda University School of Dentistry, Loma Linda, CA
| | - Charles Goodacre
- Advanced Education Program in Prosthodontics, Loma Linda University School of Dentistry, Loma Linda, CA
| | - Wendy Gregorius
- Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA
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Rinke S, Schneider L, Schulz X, Wiedemann V, Bürgers R, Rödiger M. Overdentures borne on less than four abutments with telescopic crowns: 5-year results of a retrospective clinical study. Clin Oral Investig 2018; 23:3153-3160. [PMID: 30377829 DOI: 10.1007/s00784-018-2734-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/23/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Retrospective evaluation of the clinical performance of tooth-supported overdentures retained by resilient telescopic crowns with occlusal clearance fit (ODRTC) in severely reduced dentition (1-3 remaining teeth). MATERIALS AND METHODS A total of 313 ODRTCs were inserted in an undergraduate prosthodontic program (University Medical Center, Goettingen, Germany) between 2000 und 2012. Data regarding 263 ODRTCs in 221 patients were reevaluated (observational period: 64.5 ± 34.8 months), and time-dependent survival and success rates (Kaplan-Meier-Estimator) were calculated. The number of the abutment teeth was analyzed as an influencing factor (Cox regression model (p < 0.05)). RESULTS The 5- and 8-year overdenture survival rates were 62% [CI: 0.55; 0.69] and 38% [CI: 0.30; 0.45]. The 5- and 8-year success-rates (biologically and technically event-free restorations) were 13% [CI: 0.09; 0.17] and 3% [CI: 0.01; 0.05]. On the abutment level, the 5- and 8-year survival rates were 55% [CI: 0.48; 0.62], and 34% [CI: 0.27; 0.42]. The number of abutment teeth significantly influenced the overdenture and abutment survival rates. Restorations with 1 or 2 abutments were significantly associated with an increased number of technical and biological complications (decementation of the primary crown, abutment fracture) compared to ODRTCs with 3 abutments. CONCLUSIONS The survival and success rates of ODRTCs are significantly influenced by the number of abutments. CLINICAL RELEVANCE For ODRTCs, reduced survival and success rates are expected, especially when only 1 or 2 abutment teeth are included.
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Affiliation(s)
- Sven Rinke
- Department of Prosthodontics, University Medical Center Goettingen, Georg-August-University, Robert-Koch-Str. 40, 37075, Goettingen, Germany
| | - Lea Schneider
- Department of Prosthodontics, University Medical Center Goettingen, Georg-August-University, Robert-Koch-Str. 40, 37075, Goettingen, Germany
| | - Xenia Schulz
- Department of Medical Statistics, Georg-August-University, Goettingen, Germany
| | - Vicky Wiedemann
- Department of Prosthodontics, University Medical Center Goettingen, Georg-August-University, Robert-Koch-Str. 40, 37075, Goettingen, Germany
| | - Ralf Bürgers
- Department of Prosthodontics, University Medical Center Goettingen, Georg-August-University, Robert-Koch-Str. 40, 37075, Goettingen, Germany
| | - Matthias Rödiger
- Department of Prosthodontics, University Medical Center Goettingen, Georg-August-University, Robert-Koch-Str. 40, 37075, Goettingen, Germany.
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18
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Moldovan O, Rudolph H, Luthardt RG. Biological complications of removable dental prostheses in the moderately reduced dentition: a systematic literature review. Clin Oral Investig 2018; 22:2439-2461. [PMID: 29959596 DOI: 10.1007/s00784-018-2522-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 06/11/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of the present study was a systematic review and subsequent meta-analysis on biological complications of removable prostheses in the moderately reduced dentition. MATERIALS AND METHODS A systematic literature search in established medical databases (MEDLINE, EMBASE, BIOSIS, SciSearch, Cochrane, FIZ Technik Web) and a hand search of relevant dental journals was conducted. The search terms were relevant MeSH terms, free search terms, and combinations of the two. The search included randomized controlled trials, prospective and retrospective studies with data on biological complications of removable dental prostheses in the moderately reduced dentition with at least 15 participants, an observation period of at least 2 years, and a drop-out rate of less than 25%. The selection of relevant publications was carried out at the title, abstract, and full-text level by at least two of the authors involved. The publications included were tabulated and analyzed. RESULTS Of the original 12,994 matches, 1923 were analyzed by title, 650 by abstract, and 111 according to the full text. A total of 42 publications were ultimately included. The following parameters were evaluated. TOOTH LOSS Results varied, depending on the observation period, between 0 and 18.1% for clasp-retained removable dental prostheses (RDPs), between 5.5 and 29% for attachment-retained RDPs, and between 5.5 and 51.7% for double crown-retained RDPs. CARIES Results varied, depending on the observation period, between 0 and 32.7% for clasp-retained RDPs, between 1.8 and 29% for attachment-retained RDPs, and between 1.8 and 16.4% for double crown-retained RDPs. ENDODONTIC TREATMENT Results varied, depending on the observation period, between 3.5 and 19.2% for clasp-retained RDPs, between 6.9 and 16.4% for attachment-retained RDPs, and between 0.6 and 13.9% for double crown-retained RDPs. TOOTH FRACTURE Results varied, depending on the observation period, between 1.7 and 5.3% for clasp-retained RDPs, between 12.7 and 40% for attachment-retained RDPs, and between 0.4 and 4.4% for double crown-retained RDPs. TOOTH MOBILITY There were no changes or improvements for clasp-retained RDPs. The better the pre-treatment and supportive care is, the smaller the differences are. For double crown-retained RDPs, a slight increase was found in one study. The results for the parameters probing depth and radiological bone loss were inconclusive. GINGIVAL RECESSION Gingival recession seemed to be favored by a mandibular sublingual bar. Compared to fixed restorations, removable restorations seemed to be associated with a more pronounced need for dental treatment. Stringent pre-treatment and supportive care reduced the complication rates. CONCLUSIONS Heterogeneous study designs and data analyses rendered a meta-analysis impossible, so that an evaluation at the highest level of evidence could not be performed. CLINICAL RELEVANCE Within the limitations of this study, it would be correct to state that removable dental prostheses require intensive maintenance. Suitable pre-treatment and supportive care can lower the complication rates, in the absence of which they constitute trigger factors for (additional) biological complications.
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Affiliation(s)
- Ovidiu Moldovan
- Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
- , Augsburg, Germany
| | - Heike Rudolph
- Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Ralph G Luthardt
- Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
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