The effect of three different periodontal pre-treatment procedures on the success of telescopic removable partial dentures

Telescopic overdenture: Perio-prostho concern for advanced periodontitis

The crown- and sleeve-coping denture is a removable prosthesis that is supported by both selectively retained teeth and the residual ridge or mucosa. It is a versatile and successful means of achieving long-term restoration of a partially edentulous jaw. Insertion and removal of the denture and routine oral hygiene are easy to perform. The beneficial results of this form of treatment can be considered for a wide variety of clinical applications for the severely advanced periodontitis case. This paper presents a case report on the prosthetic rehabilitation of a partially edentulous patient with a telescopic overdenture for the mandible and complete denture for the maxilla.

Oral rehabilitation considerations for partially edentulous periodontal patients

Traditional tooth-supported and implant-supported fixed/removable restorations are currently used to replace teeth lost due to periodontal disease. This article reviews the existing literature for oral rehabilitation of partially edentulous periodontal patients with various designs of removable dental prosthesis (RDP), fixed dental prosthesis (FDP) and implant-supported single crown (SC), by addressing their (a) general features, (b) survival and complication rates, along with considerations for treatment planning in periodontal patients, and (c) preference by patients. To answer these issues, relevant articles were searched and critically analyzed, and their data were extracted. Data reviewed indicated that despite many advantages, implant-supported restorations have higher complication rates than tooth-supported restorations. Systematic reviews on conventional RDPs are lacking, but existing literature reviews provide limited evidence suggesting the use of RDPs with design modifications along with strict periodontal care in periodontal patients. Numerous systematic reviews on conventional FDPs and implant-supported restorations provide a moderate level of evidence favoring their survival in periodontal patients; however, for long-term success of these restorations, the patient's periodontal condition needs to be stabilized. In terms of patient preference, no restoration is superior, as they all are governed by their cost, advantages, and disadvantages. Thus, in the wake of existing weak evidence for prosthodontic rehabilitation of periodontal patients by these restorations (especially, conventional RDPs and for FDPs and SCs in implant-supported restorations), longitudinal studies with standardized treatment protocol and methodology are needed to evaluate and compare tooth-supported and implant-supported restorations in periodontal patients with regard to survival rates, cost, maintenance, and patient-centered outcomes.

Functional evaluation of oral rehabilitation with removable partial dentures after five years

Most removable partial denture (RPD) wearers are satisfied with their prostheses, but the factors that influence satisfaction and acceptance are still not determined.

OBJECTIVE

This study explored technical, biological, and satisfaction variables for the functioning of RPDs after five years, and compared the evaluation by the patient and by the clinician.

MATERIAL AND METHODS

Fifty adults (39 females, 11 males) were re-examined after five years of RPD service. Data were collected through clinical examination and a structured questionnaire to record the conditions of supporting soft tissues, prosthesis acceptance and technical characteristics, mastication, esthetics, comfort, hygiene, and need for professional intervention. Data were analyzed by descriptive statistics and Spearman correlation.

RESULTS

More than 50% of patients classified their RPDs as excellent regarding retention, mastication, esthetics, comfort, and hygiene. In the professional evaluation, retention and stability were considered excellent in more than 66% of cases, and hygiene of teeth and prostheses was considered good in 52% and 46%, respectively. The metallic framework and acrylic base were considered adapted in 92% of cases. Prosthesis acceptance was associated with retention, mastication, esthetics, hygiene, and comfort evaluated by the patient, and with retention, stability, and condition of the framework evaluated by the clinician. Retention and mastication/comfort evaluated by the patient had moderate positive correlation with retention and stability measured by the clinician. There was no association of hygiene evaluation by the patient and by the clinician.

CONCLUSIONS

After five years, the oral rehabilitation with RPDs was satisfactory for most cases. There was correspondence between retention/retention and mastication-comfort/stability variables evaluated by the patient and by the clinician. Oral and prosthesis hygiene were not related.