Periodontal status of teeth in contact with denture in removable partial denture wearers

Metagenomic Characterization and Comparative Analysis of Removable Denture-Wearing and Non-Denture-Wearing Individuals in Healthy and Diseased Periodontal Conditions

Removable denture wearers are at an increased risk of developing periodontal diseases due to biofilm deposition and microbial colonization on the denture surface. This study aimed to characterize and compare the metagenomic composition of saliva in denture wearers with different periodontal statuses. Twenty-four community-dwelling elders were recruited and grouped into denture wearers with active periodontitis (APD), non-denture wearers with active periodontitis (APXD), denture wearers with stable periodontal health conditions (SPCD), and non-denture wearers with stable periodontal health conditions (SPCXD). Saliva samples were collected and underwent Type IIB restriction-site-associated DNA for microbiome (2bRAD-M) metagenomic sequencing to characterize the species-resolved microbial composition. Alpha diversity analysis based on the Shannon index revealed no significant difference between groups. Beta diversity analysis using the Jaccard distance matrix was nearly significantly different between denture-wearing and non-denture-wearing groups (p = 0.075). Some respiratory pathogens, including Streptococcus agalactiae and Streptococcus pneumoniae, were detected as the top 30 species in saliva samples. Additionally, LEfSe analysis revealed a substantial presence of pathogenic bacteria in denture groups. In the cohort of saliva samples collected from community-dwelling elders, a remarkable abundance of certain opportunistic pathogens was detected in the microbial community.

A Systematic Review of Patient Satisfaction With Removable Partial Dentures (RPDs)

Removable partial dentures (RPDs) offer a broad range of aesthetics and restorative functions for partially edentulous patients. This systematic review examines patients' satisfaction rates and the factors that influence RPD satisfaction. This systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Handbook for Systematic Reviews. A systematic literature search was done on PubMed, Scopus, and Google Scholar using preset inclusion criteria. A total of 923 non-duplicate articles were screened, and 35 were included in this review. Among the included studies, RPDs generally exhibited high satisfaction rates, with reported rates ranging between 50% and 81%. Several factors influenced satisfaction. Age played a major role, with older adults expressing higher satisfaction. Gender differences were also noted, especially in appearance satisfaction where women were more satisfied with RPDs than men. Prior experience with RPDs correlated positively with overall satisfaction. The number and location of missing teeth, as well as the type of RPD (metal vs. flexible), significantly influenced satisfaction levels. Flexible dentures were more satisfactory than metal RPDs. Attachments, such as magnetic attachments and implants, increased satisfaction. Patient complaints, encompassing pain, aesthetics, and cleanliness, were identified as common sources of dissatisfaction. The results underscore the significance of customizing RPD treatment to individual needs, considering factors that influence RPD satisfaction. Recognizing the importance of influential factors such as age, gender RPD experience, etc., for clinicians seeking to optimize patient outcomes in RPD therapy is crucial.

Satisfaction with resilient denture liner versus acrylic resin telescopic prostheses for patients with ectodermal dysplasia: A nonrandomized crossover clinical trial

STATEMENT OF PROBLEM

Patients with ectodermal dysplasia are characterized by anodontia or oligodontia. How their challenging prosthodontic rehabilitation might be optimized is unclear.

PURPOSE

The purpose of this crossover study was to evaluate the effect of resilient denture liner versus acrylic resin copings in complete overdentures for patients with ectodermal dysplasia. Outcome measures included patient satisfaction, retention, and periodontal health of the abutment tooth.

MATERIAL AND METHODS

Ten partially edentulous participants diagnosed with ectodermal dysplasia were recruited from the Faculty of Dentistry, Cairo University, Egypt, and enrolled in this crossover clinical trial. All participants received acrylic resin coping-retained maxillary complete overdentures (group N, stage 1). The acrylic resin copings were then replaced by a resilient denture liner (group S, stage 2). Patient satisfaction, retention, and periodontal health parameters were evaluated 1 week and 3 months after the completion of each stage. Patient satisfaction was assessed with a validated, reliable questionnaire. The results of the periodontal probing depths were tested with repeated measures ANOVA followed by the Bonferroni correction for pairwise comparisons. Tooth mobility, patient satisfaction, retention, and gingival index were tested by using the Wilcoxon signed ranked test. Ordinal data as the sixth and seventh domains of patient satisfaction were tested by using the McNemar test for paired comparisons (α=.05).

RESULTS

Three months after overdenture delivery, a statistically significant difference was found between the groups regarding retention (P=.025), probing depth (P<.001), and gingival index (P=.011) favoring the acrylic resin coping-retained overdentures. Results of tooth mobility (P=.035), overall attitude (P=.041), ease of eating (P=.023), denture comfort (P=.024), and degree of teasing (P=.038) on wearing the denture showed a statistically significant difference between the groups, favoring the resilient denture liner.

CONCLUSIONS

In children with oligodontia and ectodermal dysplasia, the resilient denture liner-retained maxillary complete overdenture enhanced patient satisfaction and tooth mobility of anterior teeth, while minimally jeopardizing the periodontal condition of the abutment teeth.

Periodontal health in shortened dental arches: A 10-year RCT

PURPOSE

This analysis focused on periodontal health in shortened dental arches (SDAs).

METHODS

In a randomized controlled clinical trial, patients with missing molars in one jaw and at least one premolar and canine on both sides were eligible for participation. In the partial removable dental prosthesis (PRDP) group (n = 79), molars were replaced with a precision attachment retained PRDP. In the SDA group (n == 71), the SDA up to the second premolars was either left as is or restored with fixed dental prostheses. Outcome variables were vertical clinical attachment loss (CAL-V), pocket probing depth (PPD), bleeding on probing (BOP) and plaque index (PLI). For CAL-V and PPD, the changes at six measuring points per tooth were analyzed. For BOP and PLI, patient related rates were calculated for each point in time. Statistical methods included linear regression analyses.

RESULTS

In the intention-to-treat (ITT) analysis for CAL-V in the study jaw, the 10 year patient related mean changes were 0.66 mm in the PRDP group and -0.13 mm in the SDA group. The resulting mean patient related group difference of 0.79 mm (95% CI: 0.20 mm-1.38 mm) was significant (p = 0.01). There were no significant differences in the ITT analyses for PPD. For BOP and PLI, significant group differences with more favorable results for the SDA group were found.

CONCLUSIONS

In view of lacking substantial differences for CAL-V and PPD, the overall differences were considered of minor clinical relevance. The results add confirmatory evidence to the shortened dental arch concept and its clinical viability (controlled-trials.com ISRCTN97265367).

Dentists' Attitudes in Jordan towards the Shortened Dental Arch Concept: A Cross-Sectional Study

Aims

To assess the awareness, knowledge, attitudes, and application of the shortened dental arch (SDA) concept by dentists in Jordan.

Materials and Methods

In this cross-sectional survey, a questionnaire was disseminated to a random sample of 150 dentists working in private practices, university hospitals, or governmental institutes. The chi-square (X ² ) test was used to examine associations.

Results

One hundred and six dentists responded (70.7% response rate). Fifty-five were females. 82.1% were aware of the SDA concept. The fewer the years of experience, the more likely the dentists were aware of the SDA concept (X ² , P=0.024) and the more likely they learned about it through undergraduate education (X ² , P < 0.001). In a hypothetical clinical situation of a patient >50 years of age with missing molar teeth, 45.3% agreed that the molars should be replaced, while 54.7% did not agree. Improving mastication was the main reason for agreeing (81.6%), while having reduced functional benefit was the main reason for disagreeing (64.9%). The treatment modality most commonly recommended was implants fixed partial dentures (84.9%). Of those aware of SDA, 67.8% agreed it could have a useful place in treatment planning within Jordan. Cost reduction for patients was the main reason for this answer, as reported by 51% of those who agreed. 26.4% did not apply SDA for any of their patients, while 50.6% applied it for <10% of their patients.

Conclusion

The majority of the dentists was aware of the SDA concept and had a positive attitude towards it; however, few of them applied it in their practice.

Assessment of Periodontal Disease Among the Dental Prosthetic and Nonprosthetic Wearers in an Adult Rural Population in Mangalore Taluk, South India

Background

Oral health as an integral part of general health. Rural population neglect oral health as they lack awareness on oral diseases and also due to inadequate availability of dental services. There is a very high prevalence of chronic inflammatory periodontal disease in the rural Indian population, which is left untreated. Hence, this cross-sectional survey was taken up in the rural area of Mangalore taluk, Karnataka, India.

Materials and Methods

A cross-sectional survey was carried out on 1312 participants aged 18 years and older. The prevalence of periodontal disease among the dental prosthetic and nonprosthetic wearers was assessed. The World Health Organization format was used to record the periodontal status and loss of attachment. Data collected were analyzed using chi-square test. P < 0.05 was considered as significant.

Result

Of the 1312 included subjects, 520 were males (39.6%) and 792 were females (60.3%). Periodontal status showed that calculus was found to be high among all age groups. When the prevalence of periodontal disease was assessed among the prosthetic wearers, it was found that subjects wearing removable partial denture showed increased prevalence of periodontal pocket depth and attachment loss irrespective of age group, gender, and educational qualification.

Conclusion

Lack of awareness among the individuals regarding periodontal diseases has been associated with consistently higher prevalence of periodontal diseases and treatment needs. Demographical studies need to be carried out at regular intervals, thus helping in planning the treatment needs nationwide for better oral health care in rural population.

Patient's Satisfaction with Removable Partial Dentures: A Retrospective Case Series

This retrospective clinical study aimed to assess patient’s satisfaction with removable partial dentures (RPDs), as retention, chewing ability, aesthetics during the observation period.

Assessment of Periodontal and Hygiene Conditions of Removable Partial Dentures in Individuals With Clefts

OBJECTIVE

To assess hygiene conditions in removable partial dentures (RPDs) and to compare the periodontal status between abutment and nonabutment teeth in clefts patients.

DESIGN

Cross-sectional.

SETTINGS

Tertiary referral hospital.

PARTICIPANTS

Forty-five patients of both genders, aged 20 to 75 years, who were upper RPD wearers for at least 2 years, with cleft lip, alveolus, and/or palate who attended follow-up appointments between 2010 and 2012.

INTERVENTIONS

The clinical periodontal parameters assessed on abutment teeth (experimental group) and nonabutment teeth (control group) were probing depth, clinical attachment level (CAL), plaque index, and gingival index (GI). The RPDs were evaluated under the following parameters: hygiene conditions and type of clasp on abutment. Both groups were analyzed using Mann-Whitney, Kruskal-Wallis, and Dunn's statistical test. Statistical significance was set at P < .05.

RESULTS

One hundred sixty-six abutment teeth and 168 nonabutment teeth were evaluated in 45 patients. A statistically significant difference was found between the groups for the CAL parameter (P = .03). With regard to the prostheses' hygiene conditions through the Tarbet index parameter, of the 186 quadrants evaluated, 143 scored 2 and 3. Ackers' clasps were the most frequent clasps (n = 111). A statistically significant difference was found for the GI parameter (P = .03).

CONCLUSIONS

It was possible to conclude, in this cross-sectional study, that in general terms, the use of RPDs did not interfere in the periodontal conditions of abutment teeth; however, most prostheses presented poor hygiene and high quantity of dental plaque.

Rehabilitation of long-span Kennedy class IV partially edentulous patient with a custom attachment-retained prosthesis

The rehabilitation of a patient in the Kennedy class IV situation demands biomechanical balance and aesthetic improvement. The long-span condition complicates the problem because of the unavailability of sufficient number of abutments to support the prosthesis. Conventional removable prosthesis and fixed partial denture are not advised for the same reason. This report describes a novel technique for the fabrication of a custom attachment to retain prosthesis. An acrylic resin removable partial denture (RPD) is retained by a custom attachment. The patrix part of the custom attachment is fabricated using molar bands, prefabricated circumferential clasp, and straight die pins. The matrix part of the attachment is constituted by the plastic sleeves of the straight die pins, which are embedded inside the tissue-fitting surface of the prosthesis. This article describes an inexpensive custom attachment for rehabilitating the long-span Kennedy class IV situation. The entire technique is reversible, inexpensive, and demands less skill compared to semi-precision and precision attachments.

Failures in the rehabilitation treatment with removable partial dentures

BACKGROUND

Despite being functional and having aesthetic benefits, the acceptance of patients regarding the use of removable partial dentures (RPDs) has been low. In part, this is due to the deleterious effects that causes discomfort to the patient. Success depends not only on the care expended by the patient, including daily care and oral hygiene, but also on common goals set by their professional and clinical staff, aiming beyond aesthetics, to incorporate issues of functionality and the well-being of patients.

METHODS AND RESULTS

For rehabilitation treatment with RPDs to reach the desired level of success without damaging the support structure, all the steps (diagnose, cavity preparation, adaptation of the metal structures, functional of distal extension and posterior follow-up) in the rehabilitative treatment should be carefully developed. A literature review was carried out, searching through MEDLINE (PubMed) articles published between 1965 and December 2012 including clinical trials and reviews about the use of RPDs.

CONCLUSIONS

This study describes factors that lead to failures and complications in oral rehabilitation through the use of RPDs and suggests possible solutions.

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.

Clinical evaluation of abutment teeth of removable partial denture by means of the Periotest method

Prosthodontics should be one of the means of establishing conditions for the maintenance of periodontal health. The forces applied to the abutment teeth and their effects are very important considerations in the design and construction of the removable partial dentures. This 6-month follow-up clinical study evaluated the degree of mobility of abutment teeth of distal extension and tooth supported removable partial dentures by using Periotest. Two types of clasp design were selected for evaluation. In cases with unilateral and bilateral distal-extension, a clasp design including a T clasp of Roach retentive arm, a rigid reciprocal arm and a mesial rest were used. For the abutments of tooth-supported removable partial dentures, a second clasp design with a cast circumferential buccal retentive arm, a rigid reciprocal clasp arm and a rest adjacent to the edentulous ridges was selected. A total of 68 abutment teeth was analysed. Periotest values were made at the time of denture placement (control) and at 1, 3 and 6 months after the denture placement. The statistical analysis was performed using Friedman test. All analysis was performed at a 0.05 level of significance. The results revelled that no significant changes in tooth mobility were observed during the 6-months follow-up (P > 0.05). In conclusion, our findings suggest that adequate oral hygiene instructions, careful prosthetic treatment planning and regular recall appointments play an important role in preventing changes in abutment tooth mobility caused by removable partial denture placement.

Tooth loss in treated periodontitis patients responsible for their supportive care arrangements

AIM

To identify risk indicators associated with tooth loss and periodontitis in treated patients responsible for arranging supportive periodontal care (SPC).

MATERIALS AND METHODS

Ninety-seven Chinese subjects (34-77 years) who showed favourable responses to periodontal therapy provided in a teaching hospital 5-12 years previously were recalled. They were advised to seek regular SPC on discharge. Background information, general health status, smoking, oral hygiene habits, follow-up dental care, tooth loss, and periodontal parameters were investigated. Multiple regression analysis was performed.

RESULTS

Two hundred and fifty-six teeth had been lost, 195 because of self-reported periodontal reasons. Up to 26.8% sites were with pockets > or =6 mm. Positive correlations were found between total/periodontal tooth loss and (i) smoking pack-years, (ii) time spent on oral hygiene, (iii) years since therapy's conclusion, (iv) age, and negative correlations with (v) inter-dental brush use, and (vi) education levels. Tooth loss by arch was correlated with wearing of removable partial denture in that arch. Percentage sites with pockets > or =6 mm were significantly negatively correlated with percentage sites without bleeding on probing.

CONCLUSIONS

Smokers, more elderly patients, removable partial denture wearers, and patients with lower education levels or not using inter-dental brushes ought to be targeted for clinic-based SPC.

An evaluation of the effects of two distal extension removable partial denture designs on tooth stabilization and periodontal health

A 30-month follow-up study was conducted on 36 patients to evaluate the effects of the lingual plate as a major connector in distally extended removable partial dentures (RPDs) on tooth stabilization. At the same time, the study evaluated the effects of lingual plate-type RPDs and lingual bar-type RPDs on periodontal health. The most striking finding of the study was that, with the exception of gingival recession (GR), periodontal conditions improved with both types of RPDs. At the end of 30 months, there were significant differences in plaque index, GR and tooth mobility (TM) values between treatment groups (P < 0.05). Plaque accumulation was greater in the lingual plate treatment group; however, this did not result in periodontal breakdown. There were no statistically significant differences between treatment groups with respect to pocket depth, gingival index or attachment loss (P > 0.05). Moreover, patients treated with lingual plate-type RPDs demonstrated less TM when compared with patients treated with lingual bar-type RPDs at the end of 30 months follow-up. Overall study findings established that with adequate checks on oral and denture hygiene at regular intervals, patients with RPDs may even experience improved periodontal health. Moreover, the clinical interpretation of decreased TM observed in patients treated with lingual plate-type RPDs may be questionable as the plaque accumulation was greater in the lingual plate treatment group inspite of periodic recalls.

Oral health in relation to wearing removable dentures provided by dentists, denturists and laboratory technicians

The aim of this study was to evaluate the oral health of elderly Finnish men wearing removable dentures supplied either by dentists, denturists or laboratory technicians. From a sample of 550 men, 362 subjects were both interviewed and clinically examined. The subjects were asked a range of questions related to their oral health and dentures. Clinical examinations were carried out by one dentist using well-defined criteria and without knowing the information the respective subjects had given in the interview. The 242 denture wearers had a higher frequency (P < 0.001) of mucous membrane lesions (78.7%) than the 120 non-wearers (27.5%). Differences between the denture providers were small, although subjects with dentures provided by dentists had less often most of the recorded mucous membrane lesions than other denture wearers. Coating of tongue and cheilitis angularis were the most commonly encountered lesions. High levels of yeast growth were observed more frequently (P < 0.02) among subjects who had obtained their dentures from dentists (41.3%) than from either denturists (17.1%) or laboratory technicians (18.2%). Among dentate subjects, the average number of remaining teeth was higher (P < 0.05) among those who had obtained their dentures from dentists (8.7) than among subjects wearing dentures from denturists (5.9) or laboratory technicians (6.2). Subjects wearing dentures supplied by dentists had slightly better oral health than other denture wearers. The observed differences can be at least partly explained by dentists' patients having higher number of remaining teeth and also more frequent check-up visits.

Treatment with removable partial dentures: a longitudinal study. Part I

The aim of this study was to evaluate the effectiveness of an oral rehabilitation by removable partial denture (RPD). Between 1983 and 1994, 629 patients were provided with an RPD at the Dental School of the Université catholique de Louvain. All the RPDs were constructed with a cobalt-chromium framework. All the treatments were provided by dental students under the supervision of clinical instructors. At recall time (1998-2000), 269 patients could not be reached neither by telephone nor by mail and 27 had died. Consequently, 333 patients were called for clinical examination and 254 of these (76.3%) actually attended. For a total of 292 RPDs fitted for these 254 patients, 218 (74.7%) were still being worn at the time of the check-up. Seventy-four dentures were considered to be 'failures', either because they were replaced by another RPD or by a complete denture, or because they had actually never been worn. The statistical analysis (Mantel-Haenszel and Kaplan-Meier) shows that the number of failures is significantly higher at the lower jaw compared with the upper jaw. Most of the failures are attributable to RPDs with free-end saddles and, in particular, to class I mandibular dentures. The patients are wearing their denture(s) mostly continuously (63.6%) and award a high degree of satisfaction to their denture. In general, the results recorded may be considered as very satisfactory, all the more so as we have no regular recall procedures established at our school and as check-up asked for spontaneously by the patients in the course of the period of observation are most of the time occasional or non-existent.

Esthetic provisional replacement of a single anterior tooth during the implant healing phase: a clinical report

Replacement of a missing anterior tooth with an implant-assisted restoration rather than a fixed partial denture is considered common practice. Implant placement with a 2-stage surgical approach in the anterior area of the mouth may be imperative and require an esthetic provisional replacement for the missing tooth during the healing phase. This provisional restoration should help optimize the health of hard and soft tissues around the implant without exerting pressure on the residual ridge and maintain the position of the adjacent and opposing teeth. This clinical report presents a technique for fabricating an anterior fixed provisional restoration with composite reinforced with a leno-woven polyethylene ribbon.

Assessing the difference between sociodental and normative approaches to assessing prosthetic dental treatment needs in dentate older people

OBJECTIVE

To illustrate differences in assessed need using normative and sociodental approaches to assess prosthetic treatment needs of dentate older people.

DESIGN

A cross-sectional study using non-random sample.

SETTING

Metropolitan area of Chiang Mai, Thailand.

SUBJECTS

707 older individuals, 549 of the total sample were dentate, living independently, aged 60 to 74 years.

RESULTS

The dentate population examined consisted of 289 classified as 'normal health' and 44 with a nutritional problem. Of the total population, 60% (333) had a normative need for partial dentures. Excluding the 44 with a nutritional problem, 50% (146) of the NTM group had 'impact-related treatment need' and of the latter 146, 69% (102) had a high propensity for health behaviour. 41% of the 102 who had 'impact-related' and 'propensity related treatment need' had 'accessible treatment need'. That is 14.5 per 100 of those with normative need. The gap between normative and 'accessible need' was greater among those with 'general health related treatment need' due to underweight. Of the 44 with a NTM and had a health problem, 45% (20) had a 'propensity related treatment need'. 40% of the group with a 'propensity related treatment need' had 'accessible treatment need'. Overall of the 44 older people with a normative need for a prosthesis and who had a health problem, only 2.4% had 'accessible treatment need' mainly due to lack of finance. If the treatment were subsidised then 45% of those with 'propensity related treatment need' would be eligible for treatment.

CONCLUSION

Large differences of estimated treatment need were found between a sociodental and a normative approach to assess prosthetic dental treatment needs of older Thai people.

Alternate framework designs for removable partial dentures

STATEMENT OF PROBLEM

The removable partial denture is usually less appreciated than the fixed partial denture by both patients and prosthodontists. This negative attitude could be due to problems associated with the wearing of a removable partial denture and concern essentially with comfort, esthetics, masticatory function, occlusal stability, and maintenance of oral hygiene. Such problems could be limited if treatment planning is made carefully, according to simplified and logical principles for framework design, and if oral hygiene and the fit of the dentures are regularly controlled.

PURPOSE

This article reviews the factors associated with the prognosis of treatment with removable partial dentures. Furthermore, the article describes framework design applied in different clinical situations and compares them with more conventional designs. It seems important to consider a framework design that privileges comfort, esthetics, and oral hygiene rather than to follow mechanical rules that are entirely theoretical and have not been confirmed scientifically or clinically.