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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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Schierz O, Lee CH, John MT, Rauch A, Reissmann DR, Kohal R, Marrè B, Böning K, Walter MH, Luthardt RG, Rudolph H, Mundt T, Hannak W, Heydecke G, Kern M, Hartmann S, Boldt J, Stark H, Edelhoff D, Wöstmann B, Wolfart S, Jahn F. HOW TO IDENTIFY SUBGROUPS IN LONGITUDINAL CLINICAL DATA: TREATMENT RESPONSE PATTERNS IN PATIENTS WITH A SHORTENED DENTAL ARCH. J Evid Based Dent Pract 2023; 23:101794. [PMID: 36707170 DOI: 10.1016/j.jebdp.2022.101794] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/03/2022] [Accepted: 09/14/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND When dental patients seek care, treatments are not always successful,that is patients' oral health problems are not always eliminated or substantially reduced. Identifying these patients (treatment non-responders) is essential for clinical decision-making. Group-based trajectory modeling (GBTM) is rarely used in dentistry, but a promising statistical technique to identify non-responders in particular and clinical distinct patient groups in general in longitudinal data sets. AIM Using group-based trajectory modeling, this study aimed to demonstrate how to identify oral health-related quality of life (OHRQoL) treatment response patterns by the example of patients with a shortened dental arch (SDA). METHODS This paper is a secondary data analysis of a randomized controlled clinical trial. In this trial SDA patients received partial removable dental prostheses replacing missing teeth up to the first molars (N = 79) either or the dental arch ended with the second premolar that was present or replaced by a cantilever fixed dental prosthesis (N = 71). Up to ten follow-up examinations (1-2, 6, 12, 24, 36, 48, 60, 96, 120, and 180 months post-treatment) continued for 15 years. The outcome OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). Exploratory GBTM was performed to identify treatment response patterns. RESULTS Two response patterns could be identified - "responders" and "non-responders." Responders' OHRQoL improved substantially and stayed primarily stable over the 15 years. Non-responders' OHRQoL did not improve considerably over time or worsened. While the SDA treatments were not related to the 2 response patterns, higher levels of functional, pain-related, psychological impairment in particular, and severely impaired OHRQoL in general predicted a non-responding OHRQoL pattern after treatment. Supplementary, a 3 pattern approach has been evaluated. CONCLUSIONS Clustering patients according to certain longitudinal characteristics after treatment is generally important, but specifically identifying treatment in non-responders is central. With the increasing availability of OHRQoL data in clinical research and regular patient care, GBTM has become a powerful tool to investigate which dental treatment works for which patients.
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Affiliation(s)
- Oliver Schierz
- Department of Prosthodontics and Materials Science, Medical Faculty University of Leipzig, Leipzig, Germany
| | - Chi Hyun Lee
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA
| | - Mike T John
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN
| | - Angelika Rauch
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg, Germany
| | - Daniel R Reissmann
- Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ralf Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Birgit Marrè
- Department of Prosthetic Dentistry, Technische Universität Dresden, University Hospital Carl Gustav Carus Dental School, Dresden, Germany
| | - Klaus Böning
- Department of Prosthetic Dentistry, Technische Universität Dresden, University Hospital Carl Gustav Carus Dental School, Dresden, Germany
| | - Michael H Walter
- Department of Prosthetic Dentistry, Technische Universität Dresden, University Hospital Carl Gustav Carus Dental School, Dresden, Germany
| | - Ralph Gunnar Luthardt
- Department of Prosthetic Dentistry, Center of Dentistry, Universitätsklinikum Ulm, Ulm, Germany
| | - Heike Rudolph
- Department of Prosthetic Dentistry, Center of Dentistry, Universitätsklinikum Ulm, Ulm, Germany
| | - Torsten Mundt
- Department of Prosthodontics, Gerodontology and Biomaterials, Dental School, University of Greifswald, Greifswald, Germany
| | - Wolfgang Hannak
- Charité, Center for Dental and Craniofacial Sciences, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin, Berlin, Germany
| | - Guido Heydecke
- University Medical Center Eppendorf, Department of Prosthodontics, Hamburg, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - Sinsa Hartmann
- Department of Prosthetic Dentistry, Johannes-Gutenberg University of Mainz, Mainz, Germany
| | - Julian Boldt
- Department of Prosthetic Dentistry, Julius-Maximilians University of Wuerzburg, Wuerzburg, 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
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Curtis DA, Lin GH, Rajendran Y, Gessese T, Suryadevara J, Kapila YL. Treatment planning considerations in the older adult with periodontal disease. Periodontol 2000 2021; 87:157-165. [PMID: 34463978 DOI: 10.1111/prd.12383] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Periodontal health in the elderly is influenced by numerous factors, including systemic conditions, patient compliance, age-associated changes, and restorative procedures. The numerous comorbidities seen in the elderly necessitate individualized approaches for treatment planning. In this paper, we review how age, comorbidities, oral hygiene, and restorative dental procedures collectively influence the treatment and management of the periodontium in the elderly. The elderly population is predicted to double in 30 years, which will have an economic impact the dental profession needs to plan for. Preventative and noninvasive treatment, supportive periodontal therapy, and patient-specific maintenance plans are imperative to maintaining oral health in the older population. Multiple coexisting changes, including xerostomia, altered wound healing, altered bone physiology, altered microbiome, and diminished plaque control, can add complexity to periodontal management. Considerations of the patient's general health, the selected periodontal treatment plan, and the selected completed restorative procedures need to be considered. The influence of caries, fixed prosthodontics, partial dentures, shortened dental arch, and implant therapy can have unintended impacts on periodontal health in the elderly. Adverse periodontal outcomes in the elderly can be minimized by carefully assessing the patient's medical history, impact of medications, functional needs, properly finishing and contouring restorations to avoid plaque accumulation, and designing restorations to allow access for hygiene. Partial dentures can be a source of plaque accumulation leading to periodontal disease, caries, and recession around abutment teeth. A shortened dental arch should be considered as a functional and cost-effective alternative to partial dentures. With dental implants, the patient's tissue phenotype, keratinized tissue quantity, risk of peri-implantitis, and patient access for maintaining adequate oral hygiene are all important to consider. Implant risk-assessment tools show promise by providing a systematic approach for early diagnosis to avoid future complications.
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Affiliation(s)
- Donald A Curtis
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Guo-Hao Lin
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Yogalakshmi Rajendran
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Tsegazeab Gessese
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Jyotirmaie Suryadevara
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA.,Navy Dental Corps, Naval Medical Leader and Professional Development Command, Bethesda, Maryland, USA
| | - Yvonne L Kapila
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
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Lo Russo L, Chochlidakis K, Caradonna G, Molinelli F, Guida L, Ercoli C. Removable Partial Dentures with Polyetheretherketone Framework: The Influence on Residual Ridge Stability. J Prosthodont 2021; 31:333-340. [PMID: 34288219 DOI: 10.1111/jopr.13408] [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] [Accepted: 07/16/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To provide, in a clinical case-control study, 1-year data on edentulous residual ridge dimensional changes for patients wearing removable partial dentures (RPD) with Polyetheretherketone (PEEK) framework, fabricated with a digital workflow, and a control group of untreated patients. MATERIALS AND METHODS Ten patients were treated with PEEK RPD, and six controls were studied. Intraoral scans at baseline (T0) and after a median period of 1 year (T1) were superimposed, trimmed, and reoriented (T0r and T1r), moved to a metrology software, and realigned. A curve (C0) was then traced on T0r, along the residual ridge crest; its projection (C1) on T1r was obtained. The mean distance C0-C1 was the dependent variable of interest and represented the 1-year changes in the height of the edentulous ridge. In addition, mean 3D distance between T0 and T1 at each edentulous area was measured. Differences in these outcomes measured between RPD treated and control groups were statistically assessed. RESULTS Twenty-six and 14 edentulous areas were investigated in the RPD treated and control groups, respectively. No significant differences were observed for potentially confounding variables, such as median follow-up time (12.5 vs. 13 months, respectively), the alignment accuracy between T0r and T1r (0.01 mm vs. 0 mm, respectively), the median number of remaining teeth (6 vs. 8.5, respectively), and the median length of edentulous areas (25.5 mm vs. 22.8 mm, respectively). For the outcomes of interest, no statistically significant difference was seen in the mean distance between C0 and C1 (i.e., changes in residual ridge height: -0.39 ± 0.52 mm vs. -0.52 ± 0.54 mm, respectively) or in the mean 3D distance at corresponding points of the denture bearing areas (-0.3 ± 0.46 mm vs. -0.4 ± 0.35, respectively). CONCLUSIONS Although 1 year is a relatively short observation period, this clinical study shows that there are no short-term differences in edentulous residual ridge height and overall dimensions between patients wearing PEEK RPD, fabricated with a digital workflow, and controls without an RPD.
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Affiliation(s)
- Lucio Lo Russo
- Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, Foggia, Italy
| | - Konstantinos Chochlidakis
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Giammarco Caradonna
- Dental Officer, Dental Health Unit, MARINFERM, Italian Navy, La Spezia, Italy
| | | | - Laura Guida
- Private practitioner, Salus Oris srl, Vallesaccarda, AV, Italy
| | - Carlo Ercoli
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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Walter MH, Dreyhaupt J, Mundt T, Kohal R, Kern M, Rauch A, Nothdurft F, Hartmann S, Böning K, Boldt J, Stark H, Edelhoff D, Wöstmann B, Luthardt RG, Hannak W, Wolfart S, Heydecke G, Jahn F, Pospiech P, Marré B. Periodontal health in shortened dental arches: A 10-year RCT. J Prosthodont Res 2020; 64:498-505. [PMID: 32063531 DOI: 10.1016/j.jpor.2020.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/18/2019] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Abstract
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).
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Affiliation(s)
- Michael H Walter
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany.
| | - Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, Ulm University, Schwabstraße 13, Ulm 89075, Germany
| | - Torsten Mundt
- Department of Prosthodontics, Gerodontology and Biomaterials, Dental School, University of Greifswald, Rotgerberstr. 8, Greifswald 17487, Germany
| | - Ralf Kohal
- Department of Prosthetic Dentistry, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, Freiburg im Breisgau 79106, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Christian-Albrechts-Platz 4, Kiel 24118, Germany
| | - Angelika Rauch
- Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstr. 18, Leipzig 04103, Germany
| | - Frank Nothdurft
- Department of Prosthetic Dentistry and Dental Materials Science, Medical Center, Dental School and Clinics, Saarland University, Campus Homburg, Kirrberger Str. 100, Homburg/Saar 66421, Germany
| | - Sinsa Hartmann
- Department of Prosthetic Dentistry, Johannes-Gutenberg University of Mainz, Langenbeckstr. 1, Mainz 55131, Germany
| | - Klaus Böning
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
| | - Julian Boldt
- Department of Prosthetic Dentistry, Julius-Maximilians University of Würzburg, Pleicherwall 2, Würzburg 97070, Germany
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and dental Materials Science, University of Bonn, Welschnonnenstr.17, Bonn 53111, Germany
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Ludwig-Maximilians-University, Goethestraße 70, Munich 80336, Germany
| | - Bernd Wöstmann
- Department of Prosthetic Dentistry, Justus-Liebig University of Gießen, Rudolf-Buchheim-Str. 8, Gießen 35392, Germany
| | - Ralph Gunnar Luthardt
- Department of Prosthetic Dentistry, Center of Dentistry, Universitätsklinikum Ulm, Albert-Einstein-Allee 11, Ulm 89081, Germany
| | - Wolfgang Hannak
- Charité - Universitätsmedizin Berlin, CC3 - Charité, Center for Dental and Craniofacial Sciences, Department of Prosthodontics, Geriatic Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin, Aßmannshauser Straße 4-6, Berlin 14197, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, Aachen 52074, Germany
| | - Guido Heydecke
- Department of Prosthodontics, University Medical Center Eppendorf, Zahnärztliche Prothetik, Martinistr. 52, Hamburg 20246, Germany
| | - Florentine Jahn
- Department of Prosthetic Dentistry and Dental Material Science, Friedrich-Schiller University of Jena, Poliklinik für Zahnärztliche Prothetik und Werkstoffkunde, An der Alten Post 4, Jena 07743, Germany
| | | | - Birgit Marré
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
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McLister C, Donnelly M, Cardwell CR, Moore C, O’Neill C, Brocklehurst P, McKenna G. Effectiveness of prosthodontic interventions and survival of remaining teeth in adult patients with shortened dental arches—A systematic review. J Dent 2018; 78:31-39. [DOI: 10.1016/j.jdent.2018.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 02/09/2018] [Accepted: 02/19/2018] [Indexed: 11/29/2022] Open
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Impact of oral rehabilitation on the quality of life of partially dentate elders in a randomised controlled clinical trial: 2 year follow-up. PLoS One 2018; 13:e0203349. [PMID: 30307966 PMCID: PMC6181283 DOI: 10.1371/journal.pone.0203349] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 08/19/2018] [Indexed: 11/24/2022] Open
Abstract
Objective This randomised clinical trial aimed to compare the impact of two different tooth replacement strategies for partially dentate older patients namely; removable partial dentures (RPDs) and functionally orientated treatment based on the shortened dental arch (SDA) concept, on Oral Health-related Quality of Life (OHrQOL). Methods 89 patients completed a randomised clinical trial. Patients were recruited in two centres: Cork University Dental Hospital (CUDH) and a Geriatric Day Hospital (SFDH). 44 patients were randomly allocated to the RPD group and 45 to the SDA group where adhesive bridgework was used to provide 10 pairs of occluding contacts. The impact of treatment on OHrQOL was used as the primary outcome measure. Each patient completed the Oral Health Impact Profile (OHIP-14) at baseline, 1, 6, 12 and 24 months after treatment. Results Both treatment groups reported improvements in OHIP-14 scores at 24 months (p<0.05). For the SDA group OHIP-14 scores improved by 8.0 scale points at 12 months (p<0.001) and 5.9 scale points at 24 months (p<0.05). For the RPD group OHIP-14 scores improved by 5.7 scale points at 12 months (p<0.05) and 4.2 scale points at 24 months (p<0.05). Analysis using ANCOVA showed that there were significant between group differences recorded in both treatment centres. 24 months after intervention the SDA group recorded better OHIP-14 scores by an average of 2.9 points in CUDH (p<0.0001) and by an average of 7.9 points in SFDH (p<0.0001) compared to the RPD group. Conclusions Patients in the SDA group maintained their improvements in OHrQOL scores throughout the 24 month study period. For the RPD group the initial improvement in OHrQOL score began to diminish after 6 months, particularly for those treated in SFDH. Thus, the benefits of functionally orientated treatment increased over time, particularly for the older, more systemically unwell cohort in SFDH.
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Kern JS, Wolfart S, Hilgers RD, Marré B, Scheller H, Strub J, Böning K, Hannak W, Luthardt RG, Heydecke G, Huppertz J, Pospiech P, Wöstmann B, Stark H, Mundt T, Jahn F, Kern M, Edelhoff D, Walter MH. The randomized shortened dental arch study: influence of two different treatments on interdental spacing over 5 years. Clin Oral Investig 2016; 21:1945-1951. [PMID: 27785586 DOI: 10.1007/s00784-016-1981-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 10/12/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Being a secondary outcome in a multicenter randomized controlled trial, the present analysis focused on interdental spacing in the shortened dental arch (SDA). The aim was to evaluate changes in interdental spacing in dependence of two different treatments after an observation period of up to 5 years. MATERIAL AND METHODS Patients were either treated with a partial removable dental prosthesis (PRDP) for molar replacement (PRDP group) or according to the SDA concept aiming at a premolar occlusion (SDA group) in a randomized manner. Interdental spacing in the anterior region was measured with gauges and categorized as "0" (<0.1 mm), "1" (<0.5 mm), "2" (0.5-1 mm), and "3" (>1 mm). The statistical analysis was performed with analysis of variance models followed by linear contrast. RESULTS Ninety-one patients (SDA n = 41, PRDP n = 50) were included. Changes of interdental spacing were detected in 70.7 % of all cases. A significant difference between the mean score changes was found in the mandible comparing the PRDP group and the SDA group. The respective mean score changes from baseline to 5 years were 0.23 (SD 0.49) for the PRDP group and 0.02 (SD 0.30) for the SDA group (p = 0.023). CONCLUSIONS Major interdental spacing could be observed in neither of the groups. The SDA concept resulted in a slightly better outcome. CLINICAL RELEVANCE When deciding whether to replace missing molars, the present results give further support to the SDA concept.
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Affiliation(s)
- Jaana-Sophia Kern
- Department of Prosthodontics and Biomaterials, Center for Implantology, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Center for Implantology, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Ralf-Dieter Hilgers
- Department for Medical Statistics, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Birgit Marré
- Department of Prosthetic Dentistry, University Hospital Carl Gustav Carus, Dental School, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Herbert Scheller
- Department of Prosthetic Dentistry, Johannes-Gutenberg University of Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Jörg Strub
- Department of Prosthetic Dentistry, Albert-Ludwig University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Klaus Böning
- Department of Prosthetic Dentistry, University Hospital Carl Gustav Carus, Dental School, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Wolfgang Hannak
- Center for Dental and Craniofacial Sciences Department of Prosthodontics, Geriatic Dentistry and Craniomandibular Disorders, Charité Universitätsmedizin Berlin, CC3, Campus Benjamin Franklin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Ralph G Luthardt
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Guido Heydecke
- Department of Prosthodontics, University Medical Center Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Jan Huppertz
- Department of Prosthetic Dentistry, Julius-Maximilians University of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Peter Pospiech
- Center for Dental and Craniofacial Sciences Department of Prosthodontics, Geriatic Dentistry and Craniomandibular Disorders, Charité Universitätsmedizin Berlin, CC3, Campus Benjamin Franklin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Bernd Wöstmann
- Department of Prosthetic Dentistry, Justus-Liebig University of Giessen, Schlangenzahl 14, 35392, Gießen, Germany
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany
| | - Torsten Mundt
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Rotgerberstr. 8, 17487, Greifswald, Germany
| | - Florentine Jahn
- Department of Prosthetic Dentistry and Dental Material Science, Friedrich-Schiller University of Jena, An der alten Post 4, 07740, Jena, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Daniel Edelhoff
- Department of Prosthodontics, University Hospital of Munich, Goethestr. 70, 80336, Munich, Germany
| | - Michael H Walter
- Department of Prosthetic Dentistry, University Hospital Carl Gustav Carus, Dental School, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
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