A field survey of the partially edentate elderly: Investigation of factors related to the usage rate of removable partial dentures

Oral health-related quality of life and reasons for discontinuing partial removable dental prosthesis usage: a cross-sectional study with one to seven years of follow-up

BACKGROUND

In partial edentulous individuals, a partial removable dental prosthesis (PRDP) is a common dental replacement option to improve oral function and quality of life. However, some patients discontinue using their denture over time. The aim of this study was to determine the prevalence and characteristics of partial edentulous patients who no longer wear their dentures, explore their reasons, and assess their oral health-related quality of life (OHRQoL).

METHODOLOGY

This cross-sectional study, conducted at Chulalongkorn University Dental School from 2013 to 2019, involved patients who received PRDP treatment. They were contacted via phone calls and asked about their denture usage. Eligible participants were patients who had stopped or rarely used their PRDPs. Data on oral status, health insurance, and PRDP variables were collected from hospital records. Telephone interviews were conducted to collect the initial reasons for seeking PRDP treatment, reasons for discontinuation, desire for a new PRDP, and OHRQoL. The Oral Impacts on Daily Performances index was used to assess the OHRQoL. The score was dichotomized into the absence or presence of oral impacts. Chi-square tests and multivariable binary logistic regression were employed to determine the associations between oral impacts and various factors in the participants who discontinued PRDP usage.

RESULTS

Among the 975 contacted participants, 175 (17.9%) discontinued using their PRDPs. Most of these individuals had at least 20 remaining natural teeth and/or 4 posterior occluding pairs. The primary initial reason for seeking PRDP treatment was often based on a dentist's suggestion. Although many participants reported no impact on OHRQoL and did not express the need for new PRDPs, those experiencing oral impacts were more likely to seek replacements.

CONCLUSIONS

With up to 7 years follow-up duration, individuals with partial edentulism and sufficient remaining functional dentition without oral impacts were more inclined to discontinue PRDP usage. Those with maxillary anterior teeth loss were less likely to discontinue using their PRDP. The primary initial reason for seeking PRDP treatment was often a dentists' suggestion. However, the individuals reporting oral impacts expressed their needs for new denture replacements. This highlights the significance of incorporating patient needs and preferences in prosthodontic decision-making.

Force exerted on maxillary anterior teeth in mandibular unilateral and bilateral distal extension partial edentulous situation

The purpose of this study was to determine the influence of mandibular unilateral and bilateral distal extension partial edentulous situation and the use of removable partial dental prostheses on the force exerted on maxillary anterior teeth. A commercially available jaw model with exchangeable teeth was used. Seven experimental conditions of mandibular distal extension edentulous situation were prepared and a distal extension removable partial dental prosthesis to replace missing posterior teeth was fabricated. The occlusal force was measured by inserting an occlusal force measuring film between the maxillary and mandibular teeth of the model. An occlusal load was applied and the forces and ratios were compared using the Kruskal-Wallis test and the Mann-Whitney U test (p < 0.05). As a result, the force exerted on the maxillary anterior teeth increased significantly as the number of remaining teeth decreased in unilateral and bilateral edentulous situation. The force exerted on the maxillary anterior teeth decreased significantly with use of a removable partial dental prosthesis. It is concluded that when the number of remaining teeth decreases in mandibular unilateral and bilateral distal extension partial edentulous situation, the burden on the maxillary anterior teeth increases. Our findings suggest that for patients with mandibular distal extension partial edentulous situation, using a removable partial dental prosthesis is effective in preserving the remaining teeth by reducing excessive force.

Number of Teeth and All-Cause and Cancer Mortality in a Japanese Community: The Takayama Study

BACKGROUND

The association between the number of teeth and mortality among community-dwelling people has been examined in many epidemiological studies. However, few Japanese studies have included cancer mortality as an endpoint. We prospectively investigated the association between number of remaining teeth and all-cause and cancer mortality in a Japanese community.

METHODS

This study included participants in the Takayama Study who were aged 35-70 years old at baseline in 1992. Information on the number of remaining teeth was obtained from 11,273 participants via questionnaire at the second survey in 2002. The response rate was 66.9%. Deaths and their causes were ascertained during 11.8 years of follow-up.

RESULTS

A total of 1,098 deaths (435 cancer-related and 235 cardiovascular-related) were identified during the follow-up period. After adjusting for covariates, participants with 0 to 9 teeth were at moderate but significantly increased risk of all-cause mortality (hazard ratio [HR] 1.19; 95% confidence interval [CI], 1.03-1.39) and cancer mortality (HR 1.31; 95% CI, 1.03-1.67) compared to those with 20 or more teeth. With regard to cancer site, a significant association was observed for lung cancer (HR for 0-9 teeth vs. 20 or more teeth, 1.75; 95% CI, 1.08-2.83). This association was somewhat strengthened among never-smokers (HR 3.56; 95% CI, 1.02-12.45).

CONCLUSIONS

We observed that a lower number of remaining teeth was significantly associated with increased risk from all-cause and lung cancer mortality. Further studies on the number of teeth and lung and other types of cancer are needed.

Epidemiological Data and Survival Rate of Removable Partial Dentures

INTRODUCTION

The use of removable partial denture (RPD) is considered as low-cost and common treatment option to rehabilitate edentulous areas.

AIM

This study aimed to investigate the epidemiological data of patients rehabilitated with removable partial denture (RPD) in order to assess treatment survival rate and failures.

MATERIALS AND METHODS

Epidemiological data and medical records of patients treated with RPD between 2007 and 2012 at the RPD discipline of a Brazilian University (Aracatuba Dental School- UNESP) were evaluated as well as dental records of patients who underwent RPD treatments (fabrication or repairs) between 2000 and 2010. Factors such as gender, age, presence of systemic disease, main complaint, edentulous arch, period and cause of denture replacement and the prosthesis characteristics were recorded. The chi-square test was used to assess the differences between the variables and the Kaplan Meyer to assess the survival of the RPDs evaluated.

RESULTS

A total of 324 maxillary RPD and 432 mandibular RPD were fabricated. Most of the patients were women aging 41 to 60-year-old. The number of mandibular RPD Kennedy class I (26%) was statistically higher for the maxillary arch (p<.05). There was no association between main complaint to gender or the presence of systemic disease. The lingual plate was the most common major connector used in the mandible (32%). The main reason for altering the design of replaced RPDs were changes during treatment plan.

CONCLUSION

The number of patients who require RPD is large; most of RPDs are Kennedy Class I. A good treatment plan is very important for achieving a positive treatment outcome, and it is strictly related to the survival rate.