Quality of communicating design features for cobalt chromium removable partial dentures in Riyadh, Saudi Arabia

Purpose:

This survey aimed to investigate quality of communicating design features for the construction of cobalt chromium removable partial dentures (RPDs) among dentists in Riyadh, Saudi Arabia.

Materials and methods:

A survey of nine commercial dental laboratories located in Riyadh was carried out. In each visit, master casts for cobalt chromium RPDs and dentists’ prescriptions were examined. A quality score for the provided instructions was developed and ranged from 0 to 4. A zero score means that no instructions were sent from the dentist for the design of the RPD. A score of 4 means that instructions were provided for the design of four main elements of the RPD, i.e., shape of major connector, type of direct retainers, position of direct retainers, position of dental rests.

Results:

162 dentists’ prescriptions for RPDs and related casts were assessed. The majority of RPD cases were designed by the dental technician alone (64.2%). Shape of the major connector was the most frequent element in dentists’ prescriptions (35.8%). The mean quality score of dentists’ instructions was 0.96 (sd=1.54). 18% of the provided instructions achieved quality score equal to 4. Prescriptions for Kennedy Class III cases achieved significantly higher mean quality score compared to Kennedy Class II cases (p<0.05). 16.7% of the evaluated casts had clearly defined rest seat preparation.

Conclusion:

The results of this survey indicate inadequate quality of communicating the design features of cobalt chromium RPDs among practicing dentists in Riyadh, Saudi Arabia. The reliance on the dental technician to design the cast RPDs seems to be high.

Aspects of Malpractice in Prosthodontics

Crowns, fixed partial dentures, and removable dentures are the popular prosthetic dental restorations in current dental practice. Prosthodontic rehabilitation of the mouth, particularly in advanced and complex cases, requires careful planning, adequate clinical skills, and exacting technical standards. While a successful outcome is the ultimate goal for any prosthodontic treatment, complications, injuries, dissatisfaction, and/or failure may occur. When such events develop as a result of negligence or violation of standards of care, they are considered under the term of malpractice and may incur ethical and medico-legal implications. This paper reviews and highlights some aspects of malpractice in prosthodontics. The current state of prosthodontic malpractice on a global level will also be evaluated. Standards of prosthodontic care, current literature of prosthodontic malpractice, where and how prosthodontic malpractice occurs, and recommendations for the future are presented. A thorough understanding of what is quality prosthodontic care and what disrupts this care can be a useful guard against professional litigation and may protect patients from poor quality of dental prosthetic care.

Reappraisal of the removable partial denture as a treatment option for the shortened dental arch

For patients with shortened dental arches, many treatment options are available. The existing situation can be maintained by stabilizing the present dentition and improving the occlusion without extending the arch. Alternatively, the shortened dental arch can be extended by either a free-end saddle removable partial denture, cantilevered fixed bridge, or by an implant-supported prosthesis. The free-end saddle removable partial denture can be considered a simple, non-invasive, and relatively cheap treatment option for the shortened dental arch. It was believed that such prosthodontic rehabilitation would be beneficial for the patients in terms of improving oral functions. However, the existing literature indicates that the prognosis of free-end saddle removable partial denture is not predictable, it is problematic, and its contribution to oral functions in patients with shortened dental arches is considered to be dubious. This paper reviews and summarizes the current literature about the outcome of extending the shortened dental arch by a free-end saddle removable partial denture. It also outlines factors that may affect the prognosis of this prosthetic treatment.