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Bukleta MS, Selmani M, Bukleta D. Comparison of the impact of two types of removable partial dentures on the periodontal health of the remaining teeth: A prospective clinical study. Clin Exp Dent Res 2023; 9:557-567. [PMID: 37070360 PMCID: PMC10441596 DOI: 10.1002/cre2.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/14/2023] [Accepted: 03/12/2023] [Indexed: 04/19/2023] Open
Abstract
OBJECTIVE To evaluate and compare the impact of two removable partial dentures (acrylic removable partial denture [ARPD] and metallic removable partial denture [MRPD]) on periodontal tissues of the remaining teeth in the first 12 months of denture use. MATERIALS AND METHODS This prospective clinical study included 40 patients, of which 20 received ARPDs, 20 received MRPDs, nine in the maxilla, and 11 in the mandible each. The patients were 45-65 years old; 24 were females, and 16 were males. Patients' demographic details, clinical indicators of periodontal complications, and biochemical measurement of Hs-C-reactive protein (CRP) and alkaline phosphatase (ALP) were considered. One-way analysis of covariance and Friedman were used to measure the differences in clinical periodontal parameters between the two types of dentures. RESULTS The significant findings were: Plaque index (PLAQ) scores for abutment teeth were higher in MRPD wearers (mean = 12.15) than ARPD wearers (mean = 10.45), whereas ARPD users had significantly higher mean bleeding on probing (BOP) values (mean = 1.5) than MRPD users (mean = 0.00); mobility of abutment teeth showed no significant differences; timeline comparisons showed a significant increase in the percentage of nonabutment teeth mobility in ARPD users (p = .028) compared with MRPD users over the same follow-up period (p = .102). CONCLUSIONS For a short-term period of 1 year, periodontal and mobility parameters have no significant impact on the abutment and nonabutment teeth of ARPD and MRPD users. Moreover, biochemical markers (CRP and ALP) for periodontal inflammation exhibited no significant difference in both types of dentures.
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Affiliation(s)
- Manushaqe S. Bukleta
- College of Medical Science, Faculty of Dentistry“Rezonanca”PristinaKosovo
- Dental ClinicMdent Family DentistryPristinaKosovo
| | | | - Dashnor Bukleta
- College of Medical Science, Faculty of Dentistry“Rezonanca”PristinaKosovo
- Dental ClinicMdent Family DentistryPristinaKosovo
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Gotfredsen K, Rimborg S, Stavropoulos A. Efficacy and risks of removable partial prosthesis in periodontitis patients: A systematic review. J Clin Periodontol 2021; 49 Suppl 24:167-181. [PMID: 34761421 DOI: 10.1111/jcpe.13519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/27/2021] [Accepted: 06/08/2021] [Indexed: 01/24/2023]
Abstract
AIM The aim of this systematic review was to answer the following focused question: "In partially edentulous patients with periodontitis, are removable dental prostheses (RDPs) more efficacious than no prosthetic treatment, treatment to a shortened dental arch (SDA), or tooth-supported fixed dental prostheses (FDPs)?" MATERIALS AND METHODS A systematic literature search was performed electronically for the period 1966-2020. Two authors independently assessed the studies for eligibility according to the PRISMA guidelines. Risk assessment was performed using RoB 2.0 and the Newcastle-Ottawa Scale. RESULTS Two retrospective studies indicated that RDPs increased the risk of tooth loss compared to FDPs in patients with a history of periodontitis. Prospective studies found that RDPs could be maintained without any significant periodontal destruction on a long-term basis. Owing to the heterogeneity of the data, no meta-analysis could be performed. Several studies indicated that RDP increased plaque accumulation. RDPs had only a limited effect on masticatory efficiency and nutritional status. RDPs may improve oral-health-related quality of life (OHRQoL), but to a lesser extent compared with that of patients treated to an SDA. CONCLUSIONS There is no strong evidence that RDPs per se will cause periodontal destruction including tooth loss. RDPs do not inevitably improve masticatory efficiency but improve OHRQoL, although less than for patients treated with FDPs including resin-bonded FDPs.
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Affiliation(s)
- Klaus Gotfredsen
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Susie Rimborg
- Copenhagen University Library, Faculty Library of Natural and Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Andreas Stavropoulos
- Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland.,Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
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Kim JH. Swallowed partial denture in severe intellectual disability patient. BMJ Case Rep 2021; 14:14/1/e239945. [PMID: 33462063 PMCID: PMC7813299 DOI: 10.1136/bcr-2020-239945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Swallowed partial dentures in elderly patients is an emergency situation that requires a swift response. Here, we report a case involving a patient with severe intellectual disability who swallowed his denture, which lodged at the oesophagus inlet. After failure of endoscopic removal, denture with clasp was removed using long forceps through intraoral approach under intravenous sedation. At the pharynx and oesophagus inlet level, removal of foreign body via intraoral approach should be preferentially considered over open surgery for faster patient recovery.
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Affiliation(s)
- Ji-Hoon Kim
- Otorhinolaryngology, National Health Insurance Corporation Ilsan Hospital, Goyang, The Republic of Korea
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4
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Turgut Cankaya Z, Yurdakos A, Gokalp Kalabay P. The association between denture care and oral hygiene habits, oral hygiene knowledge and periodontal status of geriatric patients wearing removable partial dentures. Eur Oral Res 2020; 54:9-15. [PMID: 32518905 PMCID: PMC7252529 DOI: 10.26650/eor.20200048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose: This study aims to evaluate the association of the denture care with oral hygiene
habits, knowledge and periodontal status geriatric patients wearing removable
partial denture (RPD) and to compare the relationship between denture cleaning
and tooth brushing frequency. Patients and methods: In total, 553 participants wearing RPD for at least 6 months and aged 65–86 years
were asked to complete a questionnaire following the clinical examination. Chisquare
analysis and Fisher’s exact test utilized to analyze the data. Results: A significant relationship was found between the frequency of smoking, denture
age, overnight denture wearing, denture stomatitis and denture cleaning (p<0.05).
54.10% of the participants reporting that they did not have information about
denture care had poor denture cleaning. Among patients brushing once per day,
26.34% had a good level of denture cleaning; whereas, this was 39.40% for those
brushing three times in a day. Conclusion: The type of advice (verbal or written) and oral hygiene habits demonstrated a
more significant impact on the cleaning level of dentures than the socioeconomic
level, smoking, overnight use, denture age. The success of denture maintenance
might depend on the patients’ knowledge of denture care and hygiene habits and
geriatric patients’ motivation.
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Affiliation(s)
- Zeynep Turgut Cankaya
- University of Gazi, Faculty of Dentistry, Department of Periodontology, Ankara,Turkey
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5
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Ercoli C, Caton JG. Dental prostheses and tooth-related factors. J Periodontol 2019; 89 Suppl 1:S223-S236. [PMID: 29926939 DOI: 10.1002/jper.16-0569] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 09/01/2017] [Accepted: 09/09/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVES This narrative review summarizes the current evidence about the role that the fabrication and presence of dental prostheses and tooth-related factors have on the initiation and progression of gingivitis and periodontitis. FINDINGS Placement of restoration margins within the junctional epithelium and supracrestal connective tissue attachment can be associated with gingival inflammation and, potentially, recession. The presence of fixed prostheses finish lines within the gingival sulcus or the wearing of partial, removable dental prostheses does not cause gingivitis if patients are compliant with self-performed plaque control and periodic maintenance. However, hypersensitivity reactions to the prosthesis dental material can be present. Procedures adopted for the fabrication of dental restorations and fixed prostheses have the potential to cause traumatic loss of periodontal supporting tissues. Tooth anatomic factors, root abnormalities, and fractures can act as plaque-retentive factors and increase the likelihood of gingivitis and periodontitis. CONCLUSIONS Tooth anatomic factors, such as root abnormalities and fractures, and tooth relationships in the dental arch and with the opposing dentition can enhance plaque retention. Restoration margins located within the gingival sulcus do not cause gingivitis if patients are compliant with self-performed plaque control and periodic maintenance. Tooth-supported and/or tooth-retained restorations and their design, fabrication, delivery, and materials have often been associated with plaque retention and loss of attachment. Hypersensitivity reactions can occur to dental materials. Restoration margins placed within the junctional epithelium and supracrestal connective tissue attachment can be associated with inflammation and, potentially, recession. However, the evidence in several of the reviewed areas, especially related to the biologic mechanisms by which these factors affect the periodontium, is not conclusive. This highlights the need for additional well-controlled animal studies to elucidate biologic mechanisms, as well as longitudinal prospective human trials. Adequate periodontal assessment and treatment, appropriate instructions, and motivation in self-performed plaque control and compliance to maintenance protocols appear to be the most important factors to limit or avoid potential negative effects on the periodontium caused by fixed and removable prostheses.
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Affiliation(s)
- Carlo Ercoli
- Departments of Periodontics and Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Jack G Caton
- Department of Periodontics, Eastman Institute for Oral Health, University of Rochester
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6
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Ercoli C, Caton JG. Dental prostheses and tooth-related factors. J Clin Periodontol 2019; 45 Suppl 20:S207-S218. [PMID: 29926482 DOI: 10.1111/jcpe.12950] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 09/01/2017] [Accepted: 09/09/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This narrative review summarizes the current evidence about the role that the fabrication and presence of dental prostheses and tooth-related factors have on the initiation and progression of gingivitis and periodontitis. FINDINGS Placement of restoration margins within the junctional epithelium and supracrestal connective tissue attachment can be associated with gingival inflammation and, potentially, recession. The presence of fixed prostheses finish lines within the gingival sulcus or the wearing of partial, removable dental prostheses does not cause gingivitis if patients are compliant with self-performed plaque control and periodic maintenance. However, hypersensitivity reactions to the prosthesis dental material can be present. Procedures adopted for the fabrication of dental restorations and fixed prostheses have the potential to cause traumatic loss of periodontal supporting tissues. Tooth anatomic factors, root abnormalities, and fractures can act as plaque-retentive factors and increase the likelihood of gingivitis and periodontitis. CONCLUSIONS Tooth anatomic factors, such as root abnormalities and fractures, and tooth relationships in the dental arch and with the opposing dentition can enhance plaque retention. Restoration margins located within the gingival sulcus do not cause gingivitis if patients are compliant with self-performed plaque control and periodic maintenance. Tooth-supported and/or tooth-retained restorations and their design, fabrication, delivery, and materials have often been associated with plaque retention and loss of attachment. Hypersensitivity reactions can occur to dental materials. Restoration margins placed within the junctional epithelium and supracrestal connective tissue attachment can be associated with inflammation and, potentially, recession. However, the evidence in several of the reviewed areas, especially related to the biologic mechanisms by which these factors affect the periodontium, is not conclusive. This highlights the need for additional well-controlled animal studies to elucidate biologic mechanisms, as well as longitudinal prospective human trials. Adequate periodontal assessment and treatment, appropriate instructions, and motivation in self-performed plaque control and compliance to maintenance protocols appear to be the most important factors to limit or avoid potential negative effects on the periodontium caused by fixed and removable prostheses.
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Affiliation(s)
- Carlo Ercoli
- Departments of Periodontics and Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Jack G Caton
- Department of Periodontics, Eastman Institute for Oral Health, University of Rochester
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Shetty MS, Jain S, Prabhu UM, Kamath AG, Dandekeri S, Ragher M, Shetty SK. Assessment of Periodontal Disease Among the Dental Prosthetic and Nonprosthetic Wearers in an Adult Rural Population in Mangalore Taluk, South India. J Pharm Bioallied Sci 2019; 11:S175-S179. [PMID: 31198332 PMCID: PMC6555382 DOI: 10.4103/jpbs.jpbs_286_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- Mallika Sadanand Shetty
- Department of Prosthodontics, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, India
| | - Saurabh Jain
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Uma M Prabhu
- Department of Prosthodontics, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, India
| | - Akshata G Kamath
- Department of Periodontics, Century International Institute of Dental Sciences and Research Centre, Kasargod, Kerala, India
| | - Savitha Dandekeri
- Department of Prosthodontics, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, India
| | - Mallikarjuna Ragher
- Department of Prosthodontics, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, India
| | - Sanath K Shetty
- Department of Prosthodontics, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, India
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Moldovan O, Rudolph H, Luthardt RG. Biological complications of removable dental prostheses in the moderately reduced dentition: a systematic literature review. Clin Oral Investig 2018; 22:2439-2461. [PMID: 29959596 DOI: 10.1007/s00784-018-2522-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 06/11/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of the present study was a systematic review and subsequent meta-analysis on biological complications of removable prostheses in the moderately reduced dentition. MATERIALS AND METHODS A systematic literature search in established medical databases (MEDLINE, EMBASE, BIOSIS, SciSearch, Cochrane, FIZ Technik Web) and a hand search of relevant dental journals was conducted. The search terms were relevant MeSH terms, free search terms, and combinations of the two. The search included randomized controlled trials, prospective and retrospective studies with data on biological complications of removable dental prostheses in the moderately reduced dentition with at least 15 participants, an observation period of at least 2 years, and a drop-out rate of less than 25%. The selection of relevant publications was carried out at the title, abstract, and full-text level by at least two of the authors involved. The publications included were tabulated and analyzed. RESULTS Of the original 12,994 matches, 1923 were analyzed by title, 650 by abstract, and 111 according to the full text. A total of 42 publications were ultimately included. The following parameters were evaluated. TOOTH LOSS Results varied, depending on the observation period, between 0 and 18.1% for clasp-retained removable dental prostheses (RDPs), between 5.5 and 29% for attachment-retained RDPs, and between 5.5 and 51.7% for double crown-retained RDPs. CARIES Results varied, depending on the observation period, between 0 and 32.7% for clasp-retained RDPs, between 1.8 and 29% for attachment-retained RDPs, and between 1.8 and 16.4% for double crown-retained RDPs. ENDODONTIC TREATMENT Results varied, depending on the observation period, between 3.5 and 19.2% for clasp-retained RDPs, between 6.9 and 16.4% for attachment-retained RDPs, and between 0.6 and 13.9% for double crown-retained RDPs. TOOTH FRACTURE Results varied, depending on the observation period, between 1.7 and 5.3% for clasp-retained RDPs, between 12.7 and 40% for attachment-retained RDPs, and between 0.4 and 4.4% for double crown-retained RDPs. TOOTH MOBILITY There were no changes or improvements for clasp-retained RDPs. The better the pre-treatment and supportive care is, the smaller the differences are. For double crown-retained RDPs, a slight increase was found in one study. The results for the parameters probing depth and radiological bone loss were inconclusive. GINGIVAL RECESSION Gingival recession seemed to be favored by a mandibular sublingual bar. Compared to fixed restorations, removable restorations seemed to be associated with a more pronounced need for dental treatment. Stringent pre-treatment and supportive care reduced the complication rates. CONCLUSIONS Heterogeneous study designs and data analyses rendered a meta-analysis impossible, so that an evaluation at the highest level of evidence could not be performed. CLINICAL RELEVANCE Within the limitations of this study, it would be correct to state that removable dental prostheses require intensive maintenance. Suitable pre-treatment and supportive care can lower the complication rates, in the absence of which they constitute trigger factors for (additional) biological complications.
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Affiliation(s)
- Ovidiu Moldovan
- Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
- , Augsburg, Germany
| | - Heike Rudolph
- Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Ralph G Luthardt
- Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
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Khan S, Chikte UM, Omar R. Outcomes with a posterior reduced dental arch: a randomised controlled trial. J Oral Rehabil 2017; 44:870-878. [DOI: 10.1111/joor.12549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2017] [Indexed: 11/27/2022]
Affiliation(s)
- S. Khan
- Department of Restorative Dentistry; Faculty of Dentistry; University of the Western Cape; Cape Town South Africa
| | - U. M. Chikte
- Department of Community Health; Faculty of Health Sciences; University of Stellenbosch; Cape Town South Africa
| | - R. Omar
- Department of Prosthodontics; Faculty of Dentistry; Kuwait University; Safat Kuwait
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Costa L, do Nascimento C, de Souza VOP, Pedrazzi V. Microbiological and clinical assessment of the abutment and non-abutment teeth of partial removable denture wearers. Arch Oral Biol 2017; 75:74-80. [DOI: 10.1016/j.archoralbio.2016.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 10/31/2016] [Accepted: 11/01/2016] [Indexed: 10/20/2022]
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de Almeida ALPF, Catalani DT, Garcia de Oliveira PC, Soares S, Tunes FSM, Neppelenbroek KH. Assessment of Periodontal and Hygiene Conditions of Removable Partial Dentures in Individuals With Clefts. Cleft Palate Craniofac J 2016; 53:727-731. [PMID: 26406559 DOI: 10.1597/15-072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
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.
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Comparing the effects of titanium alloy and chrome cobalt in removable partial denture connectors on tooth mobility, bone loss and tissue reaction. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.sjdr.2016.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Payne AGT, Tawse-Smith A, Wismeijer D, De Silva RK, Ma S. Multicentre prospective evaluation of implant-assisted mandibular removable partial dentures: surgical and prosthodontic outcomes. Clin Oral Implants Res 2016; 28:116-125. [DOI: 10.1111/clr.12769] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2015] [Indexed: 12/27/2022]
Affiliation(s)
| | - Andrew Tawse-Smith
- Oral Implantology Research Group; Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
- Oral Implant Research; Colegio Odontologico; Institucion Universitaria; Colegios de Colombia; Bogota Colombia
| | - Daniel Wismeijer
- Department of Oral Function and Restorative Dentistry; Section of Oral Implantology and Prosthetic Dentistry; Academic Center for Dentistry Amsterdam (ACTA); Amsterdam the Netherlands
| | - Rohana K. De Silva
- Oral Implantology Research Group; Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Sunyoung Ma
- Oral Implantology Research Group; Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
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Abstract
Individuals with Parkinson's disease present a challenge to dental clinicians as this degenerative disease leads to problems accessing care and maintaining an adequate level of oral health. This article provides an overview of the implications of Parkinson's disease on oral health and explores the role of dental implants in the management of such patients.
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Khan S, Musekiwa A, Chikte UME, Omar R. Differences in functional outcomes for adult patients with prosthodontically-treated and -untreated shortened dental arches: a systematic review. PLoS One 2014; 9:e101143. [PMID: 24992473 PMCID: PMC4081502 DOI: 10.1371/journal.pone.0101143] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 06/03/2014] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED This review examined differences in functional outcomes and patient satisfaction when shortened dental arches are left untreated compared to their restoration to complete arch lengths with different prosthodontic interventions. METHODS A protocol was developed according to the criteria for a systematic review. All relevant databases were searched to identify appropriate clinical trials regardless of language or publication status. Predetermined eligibility criteria were applied, trial quality assessed and data extracted for each study. Relevant outcomes assessed were: functioning ability, patient satisfaction and harmful effects on oral structures. RESULTS Searches yielded 101 articles: 81 from electronic databases and 20 from reference lists of retrieved articles (PEARLing searches). Sixty-nine citations were assessed for eligibility after removing 32 duplicate records. After reading titles and abstracts, a total of 41 records were excluded and the full-texts of the remaining 28 records were read. Only 21 records were included for the SR because 7 records were excluded after reading the full-text reports. These 21 records report the outcomes of four randomized controlled trials (RCTs) and one non-randomized clinical trial (CT) which were pre-specified and used for this review. No on-going studies were found and no eligible studies were excluded for failure to report the reviewer's pre-specified outcomes. Outcomes were reported in the retrieved 21 articles. A narrative explanation of the pre-specified outcomes is reported for the 3 comparison groups (which were based on the different interventions used for the individual clinical trials). The shortened dental arch as a treatment option is encouraging in terms of functioning, patient satisfaction and cost-effectiveness. By using only high quality studies it was expected that the results would be more reliable when making conclusions and recommendations, but some of the included studies had to be downgraded due to methodological errors.
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Affiliation(s)
- Saadika Khan
- Department of Restorative Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Alfred Musekiwa
- Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Usuf M. E. Chikte
- Department of Interdisciplinary Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Ridwaan Omar
- Head of Prosthodontics, Faculty of Dentistry, Kuwait University, Safat, Kuwait
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Relevance of variations in the opposing dentition for the functionality of fixed and removable partial dentures: a systematic review. Int J Dent 2012. [PMID: 23193407 PMCID: PMC3501960 DOI: 10.1155/2012/876023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of this systematic review was to evaluate the functionality of fixed and removable partial dentures as test interventions in relation to variations in the opposing dentition and their prosthetic restoration. The abstracts identified in the respective databases were screened independently by two investigators. RCTs and uncontrolled studies were considered, provided the patients were included consecutively and the confounding variables were adequately monitored. Seventeen papers were included. The study and publication quality was assessed using a “biometric quality” tool showing an overall poor quality. The reported outcomes, such as survival rates, were in each case obtained from a single study. Two possible trends could be deduced for the endpoint longevity: (a) the first trend in favor of removable partial dentures, compared to fixed partial dentures, with a fully edentulous opposing arch fitted with a removable prosthesis; (b) the second trend in favor of implant-supported partial dentures, compared to conventionally fixed partial dentures, with natural opposing dentition or with a removable partial denture in the opposing arch. No evidence could be generated as to whether, and if so how, variations in the opposing dentition have a bearing on the decision to fit a partially edentulous arch with a fixed or removable partial denture.
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Dhingra K. Oral rehabilitation considerations for partially edentulous periodontal patients. J Prosthodont 2012; 21:494-513. [PMID: 22681519 DOI: 10.1111/j.1532-849x.2012.00864.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Kunaal Dhingra
- Department of Periodontics, NSVK. Sri Venkateshwara Dental College, Bangalore, Karnataka, India.
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Pjetursson BE, Zwahlen M, Lang NP. Quality of reporting of clinical studies to assess and compare performance of implant-supported restorations. J Clin Periodontol 2012; 39 Suppl 12:139-59. [DOI: 10.1111/j.1600-051x.2011.01828.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine; University of Bern; Bern; Switzerland
| | - Niklaus P. Lang
- Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR; China
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Stegelmann K, Dirheimer M, Ludwig E, Moldovan O, Rudolph H, Luthardt RG, Just BA. Case-control study on the survival of abutment teeth of partially dentate patients. Clin Oral Investig 2011; 16:1685-91. [PMID: 22200967 DOI: 10.1007/s00784-011-0661-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 12/11/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVES Due to the scarce amount of data available, a retrospective analysis of patients treated with removable dental prostheses (RDPs) was performed. The aim of the trial was to evaluate the rate of repairs and failures of attachment-retained RDPs (AR-RDPs) compared to clasp-retained RDPs (CR-RDPs) with respect to cofactors (e.g., type of loading). In this respect, two hypotheses were proposed: AR-RDPs are more prone to repairs than CR-RDPs, and AR-RDPs are more prone to fail than CR-RDPs. MATERIALS AND METHOD Two hundred three patients treated with 135 AR-RDPs and 68 CR-RDPs between 1994 and 2006 were evaluated in this trial. The dental treatment was carried out in the clinical training course of senior students. Kaplan-Meier estimates were calculated for the primary end point (repairs) and for the secondary end point (failures). RESULTS The survival of CR-RDPs and AR-RDPs did show significant differences regarding repairs (p = 0.034) but not with regard to failures (p = 0.169). Prostheses of the non-axially loaded group showed no significant differences in the frequency of repairs and failures. CONCLUSIONS Technical complications occurred more frequently in the CR-RDP group. Taking the higher observation time in the AR-RDP group into account, CR-RDPs are more prone to repairs, especially to those with technical background (e.g., fracture of the metal framework). CLINICAL RELEVANCE The use of crowns with rod attachments on tilted teeth seems to be an appropriate treatment approach in order to simplify removable dental prosthesis design.
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Affiliation(s)
- K Stegelmann
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University Hospital, Albert-Einstein-Allee 11, 89081 Ulm, Germany.
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Preshaw PM, Walls AWG, Jakubovics NS, Moynihan PJ, Jepson NJA, Loewy Z. Association of removable partial denture use with oral and systemic health. J Dent 2011; 39:711-9. [PMID: 21924317 DOI: 10.1016/j.jdent.2011.08.018] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 08/26/2011] [Accepted: 08/30/2011] [Indexed: 11/20/2022] Open
Affiliation(s)
- P M Preshaw
- School of Dental Sciences, Newcastle University, UK.
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21
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A systematic review of prosthetic restoration in patients with shortened dental arches. JAPANESE DENTAL SCIENCE REVIEW 2011. [DOI: 10.1016/j.jdsr.2011.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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22
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FUEKI K, IGARASHI Y, MAEDA Y, BABA K, KOYANO K, AKAGAWA Y, SASAKI K, KUBOKI T, KASUGAI S, GARRETT NR. Factors related to prosthetic restoration in patients with shortened dental arches: a multicentre study. J Oral Rehabil 2010; 38:525-32. [DOI: 10.1111/j.1365-2842.2010.02183.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Hirotomi T, Yoshihara A, Ogawa H, Miyazaki H. Tooth-related risk factors for periodontal disease in community-dwelling elderly people. J Clin Periodontol 2010; 37:494-500. [DOI: 10.1111/j.1600-051x.2010.01565.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Luthardt RG, Marré B, Heinecke A, Gerss J, Aggstaller H, Busche E, Dressler P, Gitt I, Hannak W, Hartmann S, Heydecke G, Jahn F, Kern M, Mundt T, Pospiech P, Stark H, Wöstmann B, Walter MH. The Randomized Shortened Dental Arch study (RaSDA): design and protocol. Trials 2010; 11:15. [PMID: 20170481 PMCID: PMC2843681 DOI: 10.1186/1745-6215-11-15] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 02/19/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Various treatment options for the prosthetic treatment of jaws where all molars are lost are under discussion. Besides the placement of implants, two main treatment types can be distinguished: replacement of the missing molars with removable dental prostheses and non-replacement of the molars, i.e. preservation of the shortened dental arch. Evidence is lacking regarding the long-term outcome and the clinical performance of these approaches. High treatment costs and the long time required for the treatment impede respective clinical trials. METHODS/DESIGN This 14-center randomized controlled investigator-initiated trial is ongoing. Last patient out will be in 2010. Patients over 35 years of age with all molars missing in one jaw and with at least both canines and one premolar left on each side were eligible. One group received a treatment with removable dental prostheses for molar replacement (treatment A). The other group received a treatment limited to the replacement of all missing anterior and premolar teeth using fixed bridges (treatment B). A pilot trial with 32 patients was carried out. Two hundred and fifteen patients were enrolled in the main trial where 109 patients were randomized for treatment A and 106 for treatment B. The primary outcome measure is further tooth loss during the 5-year follow-up. The secondary outcome measures encompassed clinical, technical and subjective variables. The study is funded by the Deutsche Forschungsgemeinschaft (German Research Foundation, DFG WA 831/2-1, 2-2, 2-3, 2-4, 2-5). DISCUSSION The particular value of this trial is the adaptation of common design components to the very specific features of complex dental prosthetic treatments. The pilot trial proved to be indispensable because it led to a number of adjustments in the study protocol that considerably improved the practicability. The expected results are of high clinical relevance and will show the efficacy of two common treatment approaches in terms of oral health. An array of secondary outcome measures will deliver valuable supplementary information. If the results can be implemented in the clinical practice, the daily dental care should strongly profit thereof. TRIAL REGISTRATION The trial is registered at ClinicalTrials.gov under ISRCTN68590603 (pilot trial) and ISRCTN97265367 (main trial).
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Affiliation(s)
- Ralph G Luthardt
- Clinic of Prosthetic Dentistry, Ulm University, University Hospital, Department of Dentistry, Ulm, Germany.
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25
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Ribeiro DG, Pavarina AC, Giampaolo ET, Machado AL, Jorge JH, Garcia PPNS. Effect of oral hygiene education and motivation on removable partial denture wearers: longitudinal study. Gerodontology 2009; 26:150-6. [DOI: 10.1111/j.1741-2358.2008.00272.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Sato F, Koyama S, Takahiro C, Kadowaki K, Kawata T, Sasaki K. Changes in Periodontal Conditions of Remaining Teeth Five Years after RPD Placement. ACTA ACUST UNITED AC 2009. [DOI: 10.2186/ajps.1.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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27
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Effect of severely reduced bone support on the stress field developed within the connectors of three types of cross-arch fixed partial dentures. J Prosthet Dent 2009; 101:54-65. [DOI: 10.1016/s0022-3913(08)60292-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Pjetursson BE, Brägger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clin Oral Implants Res 2007; 18 Suppl 3:97-113. [PMID: 17594374 DOI: 10.1111/j.1600-0501.2007.01439.x] [Citation(s) in RCA: 446] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective of this systematic review was to assess and compare the 5- and 10-year survival of different types of tooth-supported and implant-supported fixed dental prosthesis (FDPs) and single crowns (SCs) and to describe the incidence of biological and technical complications. METHODS Three electronic searches complemented by manual searching were conducted to identify prospective and retrospective cohort studies on FDPs and SCs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using random-effects Poisson's regression models to obtain summary estimates of 5- and 10-year survival proportions. RESULTS Meta-analysis of the included studies indicated an estimated 5-year survival of conventional tooth-supported FDPs of 93.8%, cantilever FDPs of 91.4%, solely implant-supported FDPs of 95.2%, combined tooth-implant-supported FDPs of 95.5% and implant-supported SCs of 94.5%. Moreover, after 10 years of function the estimated survival decreased to 89.2% for conventional FDPs, to 80.3% for cantilever FDPs, to 86.7% for implant-supported FDPs, to 77.8% for combined tooth-implant-supported FDPs and to 89.4% for implant-supported SCs. Despite high survival rates, 38.7% the patients with implant-supported FDPs had some complications after the 5-year observation period. This is compared with 15.7% for conventional FDPs and 20.6% for cantilever FDPs, respectively. For conventional tooth-supported FDPs, the most frequent complications were biological complications like caries and loss of pulp vitality. Compared with tooth-supported FDPs, the incidence of technical complications was significantly higher for the implant-supported reconstructions. The most frequent technical complications were fractures of the veneer material (ceramic fractures or chipping), abutment or screw loosening and loss of retention. CONCLUSION On the basis of the results of the present systematic review, planning of prosthetic rehabilitations should preferentially include conventional end abutment tooth-supported FDPs, solely implant-supported FDPs or implant-supported SCs. Only for reasons of anatomical structures or patient-centered preferences and as a second option should cantilever tooth-supported FDPs or FDPs supported by combination of implants and teeth be chosen.
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Lulic M, Brägger U, Lang NP, Zwahlen M, Salvi GE. Ante's (1926) law revisited: a systematic review on survival rates and complications of fixed dental prostheses (FDPs) on severely reduced periodontal tissue support. Clin Oral Implants Res 2007; 18 Suppl 3:63-72. [PMID: 17594371 DOI: 10.1111/j.1600-0501.2007.01438.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND In subjects suffering from generalized severe periodontitis, only a few teeth may be treated and used as abutments for fixed dental prostheses (FDPs). OBJECTIVE To systematically review the impact of severely reduced, but healthy periodontal tissue support on the survival rate and complications of FDPs after a mean follow-up time of at least 5 years. SEARCH STRATEGY Publications considered for inclusion were searched in MEDLINE (PubMed) and relevant journals were hand searched. The search was performed in duplicate and was limited to human studies published in the dental literature from 1966 up to and including September 2006. Only publications in English, in peer-reviewed journals, were considered. Abstracts were excluded. SELECTION CRITERIA Prospective and retrospective cohort studies were included. The primary outcome measure included survival rates of FDPs and abutment teeth, whereas biological and technical complications of FDPs and abutment teeth represented secondary outcome measures. DATA ANALYSIS Summary estimates of survival rates and of biological and technical complications were calculated after 5 and 10 years. RESULTS The search provided 860 titles of which six publications were included. A total of 579 FDPs were incorporated and followed up to 25 years. Meta-analysis yielded an estimated FDP survival rate of 96.4% [95% confidence interval (95% CI): 94.6-97.6%] after five and of 92.9% (95% CI: 89.5-95.3%) after 10 years, respectively. After 10 years, the estimated rate of abutment teeth without endodontic complications amounted to 93% (95% CI: 62.6-98.9%). The 10-year estimated rate of caries-free abutment teeth was 98.1% (95% CI: 88.2-99.7%). FDPs without loss of retention were estimated to occur in 95.4% (95% CI: 92.6-97.2%) of cases after 10 years. CONCLUSIONS These results showed that (i) masticatory function could be established and maintained in subjects receiving FDPs on abutment teeth with severely reduced but healthy periodontal tissue support and (ii) FDPs survival rates compared favourably with those of FDPs incorporated in subjects without severely periodontally compromised dentitions.
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Affiliation(s)
- Martina Lulic
- Department of Periodontology & Fixed Prosthodontics, School of Dental Medicine, University of Berne, Berne, Switzerland
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30
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Witter DJ, Palenstein Helderman WH, Creugers NHJ, Käyser AF. The shortened dental arch concept and its implications for oral health care. Community Dent Oral Epidemiol 2007. [DOI: 10.1111/j.1600-0528.1999.tb02018.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Akaltan F, Kaynak D. An evaluation of the effects of two distal extension removable partial denture designs on tooth stabilization and periodontal health. J Oral Rehabil 2005; 32:823-9. [PMID: 16202046 DOI: 10.1111/j.1365-2842.2005.01511.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- F Akaltan
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Beşevler 06500, Ankara, Turkey.
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Chai J, Chu FCS, Newsome PRH, Chow TW. Retrospective survival analysis of 3-unit fixed-fixed and 2-unit cantilevered fixed partial dentures. J Oral Rehabil 2005; 32:759-65. [PMID: 16159355 DOI: 10.1111/j.1365-2842.2005.01495.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To evaluate the cumulative survival (CS) rates of fixed partial dentures (FPDs) retained by full-veneer retainers, and those of resin-bonded FPDs provided by graduating dental students for the replacement of a single missing tooth. In 168 patients, 61 3-unit fixed-fixed FPDs and 25 2-unit cantilevered FPDs retained by full-veneer retainers, and 77 3-unit fixed-fixed resin-bonded FPDs and 47 2-unit cantilevered resin-bonded FPDs, were examined for their retention and integrity. The periodontal health, endodontic status and coronal tissues of all abutment teeth were also evaluated. The survival rates of these various designs were analysed with the Kaplan-Meier method. The mean age of all FPDs was 31 months. At 48 months after their insertion, 3-unit FPDs retained by full-veneer retainers had a CS rate of 82%, followed by 2-unit resin-bonded FPDs at 81%, 2-unit FPDs retained by full-veneer retainers at 77%, and 3-unit resin-bonded FPDs at 63%. No significant difference was found between the four designs (P>0.05). Up to both 48 and 60 months, the most common causes of failure were endodontic for FPDs retained by full-veneer retainers, and dislodgement for resin-bonded FPDs. The 3-unit fixed-fixed FPDs retained by full-veneer retainers had the most favourable prognosis after 48 months for replacing a single missing tooth, but the difference between designs was not statistically significant.
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Affiliation(s)
- J Chai
- Northwestern University, Evanston, IL, USA
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Maeda Y, Sogo M, Tsutsumi S. Efficacy of a posterior implant support for extra shortened dental arches: a biomechanical model analysis. J Oral Rehabil 2005; 32:656-60. [PMID: 16102078 DOI: 10.1111/j.1365-2842.2005.01478.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to test the efficacy of utilizing implants underneath distal free-end denture bases to establish a stable occlusal support for extreme shortened dental arches (ESDA). The authors constructed a two-dimensional finite element model of the ESDA where only lower anterior teeth remain. Posterior occlusal support was provided by a fixed partial denture with an osseointegrated implant (IFPD), fixed cantilever partial denture (CFPD), or a removable partial denture with or without an implant underneath (IRPD and RPD). A dentate mandible model was the control. When muscle vectors simulating clenching force were applied, stress levels on the temporal bone surface area under each configuration were compared, to evaluate the efficacy in establishing the occlusal support. The largest stress increase in temporal bone was found in the ESDA situation followed by the RPD. The least amount of stress increase was found with the IFPD followed by IRPD when the implant was placed in the molar region. The stress increase with IRPD was about 20-45% of the amount with RPD. Our results suggest that IFPD provides most favourable and stable occlusal support, however, IRPD with a single posterior implant also provide stable occlusal support with reducing the stress levels in the temporomandibular joint.
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Affiliation(s)
- Y Maeda
- Division for Interdisciplinary Dentistry, Osaka University Faculty of Dentistry, Osaka, Japan.
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Abstract
The purpose of this study was to investigate, by means of the finite element method the mechanical behaviour of three designs of fixed partial denture (FPD) for the replacement of the maxillary first premolar in shortened dental arch therapy. Two-dimensional, linear, static finite element analyses were carried out to investigate the biomechanics of the FPDs and their supporting structures under different scenarios of occlusal loading. Displacement and stress distribution for each design of FPD were examined, with particular attention being paid to the stress variations along the retainer-abutment--and the periodontal ligament-bone interfaces. The results indicated that displacement and maximum principal stresses in the fixed-fixed, three-unit FPD were substantially less than those in the two-unit cantilever FPDs. Of the two cantilever FPDs investigated, the distal cantilever design was found to suffer less displacement and stresses than the mesial cantilever design under similar conditions of loading. The highest values for maximum principal stress in the cantilever FPDs were found within the connector between the pontic and the retainer, and within the periodontal ligament and adjacent bone on the aspect of the retainer away from the pontic.
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Affiliation(s)
- S A Romeed
- Department Oral Surgery, St John's, Chelmsford, Essex, UK.
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Tuominen R. Oral health in relation to wearing removable dentures provided by dentists, denturists and laboratory technicians. J Oral Rehabil 2003; 30:743-8. [PMID: 12791162 DOI: 10.1046/j.1365-2842.2003.01141.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
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.
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Affiliation(s)
- R Tuominen
- Department of Public Health, University of Helsinki, Helsinki, Finland.
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Vanzeveren C, D'Hoore W, Bercy P, Leloup G. Treatment with removable partial dentures: a longitudinal study. Part II. J Oral Rehabil 2003; 30:459-69. [PMID: 12752924 DOI: 10.1046/j.1365-2842.2003.01107.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
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 checked 1893 persistent teeth were listed, with 804 serving as abutments; more than half (57.6%) of these were crowned, for which 51 debondings were recorded. For the period of observation we listed 79 abutments lost (37 at the upper jaw and 42 at the lower jaw), i.e. 9.8% of the total number of abutments. No relation could be established between the type of the abutments (natural or crowned teeth) and the losses observed (Test of Mantel-Haenszel: P=0.9496). In the upper jaw, the percentage of abutments lost was significantly higher in the presence of free-end edentulous areas as compared with bounded edentulous areas (Test of Mantel-Haenszel: P=0.0002); this difference does not appear for the lower jaws (P=0.9558). If we deduct the 25 abutments related with the 11 non-worn RPDs and the 79 abutments lost, no change becomes apparent for 92.2% of the maxillary abutments and for 85.8% of the mandibular abutments. For the 1089 other teeth, we observed the loss of 40 teeth and the appearance of caries or new fillings for 95 teeth. The fractures of cast clasps represent 3.4%.
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Affiliation(s)
- C Vanzeveren
- Department of Prosthetic Dentistry, Dental School, Université catholique de Louvain, Brussels, Belgium.
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Witter DJ, van Palenstein Helderman WH, Creugers NH, Käyser AF. The shortened dental arch concept and its implications for oral health care. Community Dent Oral Epidemiol 1999; 27:249-58. [PMID: 10403084 DOI: 10.1111/j.1600-0528.1998.tb02018.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The minimum number of teeth needed to satisfy functional demands has been the subject of several studies. However, since functional demands--and consequently the number of teeth needed--can vary from individual to individual, this minimum number cannot be defined exactly. In general, occlusion of a complete dental arch is preferable. However, this goal might be neither attainable, for general, dental or financial reasons, nor necessary. Many studies demonstrate that shortened dental arches comprising the anterior and premolar regions can meet the requirements of a functional dentition. Consequently, when priorities have to be set, restorative therapy should be aimed at preserving the most strategic parts of the dental arch: the anterior and premolar regions. This also implies that in cases of a shortened dental arch, the prompt replacement of absent posterior molars by free-end removable partial dentures leads to overtreatment and discomfort. The shortened dental arch concept is based on circumstantial evidence: it does not contradict current theories of occlusion and fits well with a problem-solving approach. The concept offers some important advantages and may be considered a strategy to reduce the need for complex restorative treatment in the posterior regions of the mouth.
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Affiliation(s)
- D J Witter
- Department of Occlusal Reconstruction and Oral Function, College of Dental Science, Medical Faculty, University of Nijmegen, The Netherlands.
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Abstract
STATEMENT OF PROBLEM Complete, fixed partial, removable partial, and implant-supported dentures have been used to comfortably and esthetically replace missing teeth. However, it is not certain what effect these prostheses have on the residual ridge. PURPOSE This article compares various prosthetic treatments to restore completely and partially edentulous mouths for their ability to preserve residual alveolar bone. MATERIAL AND METHODS A review of the literature was performed to discuss the effects of tooth replacement on residual alveolar bone. RESULTS The literature seems to indicate that the presence of a dental prosthesis affects the size and form of the residual alveolar ridge and bone. CONCLUSION An implant-supported fixed prosthesis to restore missing teeth in partially or completely edentulous jaws seems to be the best means of preserving residual alveolar bone.
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Affiliation(s)
- C C Wyatt
- Faculty of Dentistry, University of British Columbia, Vancouver, Canada
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Abstract
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.
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Affiliation(s)
- E Budtz-Jorgensen
- Division of Gerodontology and Prosthodontics, Section of Dental Medicine, University of Geneva, Switzerland
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Budtz-Jörgensen E. Restoration of the partially edentulous mouth--a comparison of overdentures, removable partial dentures, fixed partial dentures and implant treatment. J Dent 1996; 24:237-44. [PMID: 8783527 DOI: 10.1016/0300-5712(95)00075-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Loss of posterior teeth may result in the loss of neuromuscular stability of the mandible, reduced masticatory efficiency, loss of vertical dimension of occlusion and poor aesthetics. Prosthetic rehabilitation should aim at restoring the vertical dimension and increasing the occlusal contact area in the premolar/molar region. Overdentures are particularly indicated in patients with a severe loss of periodontal attachment, uncertain periodontal prognosis and complicated functional or aesthetic conditions. Removable partial dentures are particularly indicated in Kennedy Class I cases when there is need for a simple and economic solution. Placement of a removable partial denture with occlusal overlays is a simple way to restore occlusal face height. Cross-arch cantilevered fixed partial dentures are primarily indicated for stabilization of periodontally weakened abutments. Short unilateral or bilateral bridges are a solution in patients who refuse removable appliances and who cannot afford more extensive rehabilitation with fixed prosthodontics. Rehabilitation with a fixed partial denture supported by means of osseointegrated implants is the optimal solution in Kennedy Class II cases provided that the bone conditions are appropriate. For any prosthetic treatment, a definite recall system should be established depending on the patient's degree of cooperation, caries susceptibility, periodontal status and the rate of residual ridge resorption. This is essential in order to obtain a satisfactory prognosis. In a patient with poor oral hygiene, the best solution, with regard to the prognosis of the remaining teeth, is to abstain from any prosthetic treatment. METHODS This manuscript reviews the current literature to identify treatment options for the Kennedy Class I and II partially edentulous patient.
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Affiliation(s)
- E Budtz-Jörgensen
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Switzerland
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Bassi F, Mantecchini G, Carossa S, Preti G. Oral conditions and aptitude to receive implants in patients with removable partial dentures: a cross-sectional study. part I. oral conditions. J Oral Rehabil 1996; 23:50-4. [PMID: 8850161 DOI: 10.1111/j.1365-2842.1996.tb00811.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The relationship between a removable partial denture (RPD) and damage caused to residual oral structures is the subject of on-going research. A group of patients wearing RPD, treated in the same way in the same department, were recalled to evaluate their oral hygiene and to compare the clinical condition of abutment teeth with that of non-abutment teeth. The study shows that most patients were unable to maintain high standards of oral hygiene. In the group of patients with non-optimal hygiene the clinical condition of abutment teeth was worse than that of non-abutment teeth. In the group of patients with optimal oral hygiene the condition of abutment teeth and non-abutment teeth was almost identical. To increase the standards of oral hygiene it is strongly advisable to recall and follow up patients on a regular basis.
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Affiliation(s)
- F Bassi
- Department of Prosthodontics, University of Turin, Italy
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Yi SW, Ericsson I, Carlsson GE, Wennström JL. Long-term follow-up of cross-arch fixed partial dentures in patients with advanced periodontal destruction. Evaluation of the supporting tissues. Acta Odontol Scand 1995; 53:242-8. [PMID: 7484107 DOI: 10.3109/00016359509005980] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The aim of the study was to evaluate the periodontal conditions in patients treated more than 10 years ago for advanced periodontal disease and rehabilitated with cross-arch fixed partial dentures (FPDs). Of 50 randomly selected patients, 34 subjects carrying 43 FPDs agreed to participate in a clinical and radiographic follow-up examination. The FPDs were divided into three groups on the basis of prosthesis design (end abutments, unilateral cantilever, and bilateral cantilevers) and amount of supporting tissues at the time of bridge installation. Seventy per cent of the FPDs were found to be unchanged, whereas the rest had been modified due to various complications leading to extraction of one or more of the abutment teeth. Six FPDs (14%) had been partially replaced by FPDs anchored to osseointegrated dental implants. A total of 21 (8%) of the original 274 abutment teeth had been extracted. Longitudinal changes in the amount of periodontal support were minimal over the average of 15 years of follow-up. FPD design or initial amount of supporting tissues was found not to have significant influence on longitudinal changes in periodontal conditions. It was concluded that combined periodontal and prosthodontic treatment of patients with advanced loss of periodontal support may provide a high rate of long-term successful outcome, provided proper adequate periodontal and prosthetic treatment and maintenance care are given.
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Affiliation(s)
- S W Yi
- Department of Periodontology, Faculty of Odontology, Göteborg University, Sweden
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Budtz-Jörgensen E. Prognosis of overdenture abutments in elderly patients with controlled oral hygiene. A 5 year study. J Oral Rehabil 1995; 22:3-8. [PMID: 7897556 DOI: 10.1111/j.1365-2842.1995.tb00203.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The effect of controlled oral hygiene was studied in 31 elderly overdenture patients involving 72 abutments over a period of 5 years. Intensive instruction and motivation in oral hygiene care were carried out prior to prosthodontic treatment and two to four times yearly during the study period. The initial dental and periodontal conditions were very poor, with a mean loss of proximal bone adjacent to the abutments of 61%. During the study period, it was possible to maintain mean plaque index scores of 0.45-0.73 and mean gingival index scores of 0.89-0.95 adjacent to the abutments. There was no relationship between the patients' initial plaque index score and the oral and denture hygiene observed during the study. There was spontaneous regression of 4-5 mm periodontal pockets, whereas deeper pockets persisted. Seven abutments were extracted due to periodontal complications. Caries was a minor problem which could be controlled by hygienic measures, topical fluoride or fillings. The present study has shown that it was possible to maintain teeth as overdenture abutments to a large extent in elderly patients initially having a poor dental and periodontal status.
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Affiliation(s)
- E Budtz-Jörgensen
- Department of Gerodontology and Removable Prosthodontics, Section de Médecine Dentaire, Geneva, Switzerland
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Witter DJ, De Haan AF, Käyser AF, Van Rossum GM. A 6-year follow-up study of oral function in shortened dental arches. Part II: Craniomandibular dysfunction and oral comfort. J Oral Rehabil 1994; 21:353-66. [PMID: 7965347 DOI: 10.1111/j.1365-2842.1994.tb01150.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In this clinical 6-year follow-up study subjects with shortened dental arches (SDA, n = 55), characterized by the absence of molar support, are compared with subjects with complete dental arches (CDA, n = 52) with respect to items concerning craniomandibular dysfunction and oral comfort. In addition, a small group of subjects with SDA and removable partial dentures in the lower jaw (SDA + RPD, n = 19) is included in this study. Oral comfort is defined using the following criteria: (i) absence of pain and distress, meaning the absence of signs and symptoms of craniomandibular dysfunction: (ii) chewing ability; and (iii) appreciation of the appearance of the dentition in relation to absent posterior teeth. Additionally, complaints about the free-end RPD are described. It is concluded that: (i) a SDA (consisting of 3-5 occlusal units, OU) is not a risk factor for CMD and is able to provide long-term sufficient oral comfort; and (ii) free-end RPD (in the lower jaw) in SDA do not prevent CMD and do not improve oral function in terms of oral comfort.
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Affiliation(s)
- D J Witter
- Department of Oral Function and Prosthetic Dentistry, School of Dentistry, Nijmegen, The Netherlands
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Witter DJ, de Haan AF, Käyser AF, van Rossum GM. A 6-year follow-up study of oral function in shortened dental arches. Part I: Occlusal stability. J Oral Rehabil 1994; 21:113-25. [PMID: 8182494 DOI: 10.1111/j.1365-2842.1994.tb01131.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In this clinical 6-year follow-up study subjects with shortened dental arches (SDA, n = 55), characterized by the absence of molar support, are compared with subjects with complete dental arches (CDA, n = 52) with respect to occlusal stability. In addition, a small group of subjects with SDA and removable partial dentures in the lower jaw (SDA+RPD, n = 19) is included in this study. The aim of this study was to describe effects regarding occlusal stability in subjects with SDA during a 6-year period. The applied parameters for occlusal stability are: number of occlusal contacts in the anterior region, overbite, interdental spacing and alveolar bone support. The results of this study show that: (i) SDA do provide durable occlusal stability; (ii) free-end RPD do not contribute to occlusal stability in SDA; and (iii) SDA with periodontally involved teeth show continuing periodontal breakdown.
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Affiliation(s)
- D J Witter
- Department of Oral Function and Prosthetic Dentistry, School of Dentistry, Nijmegen, The Netherlands
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Fernandes CP, Psarras V, Freitas LB, Ahlgren J. Jaw-closing muscles: electromyographic activity of human subjects with reduced periodontal support. J Oral Rehabil 1994; 21:165-75. [PMID: 8182498 DOI: 10.1111/j.1365-2842.1994.tb01135.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The aim of this study was to compare the electromyographic (EMG) activity of jaw-closing muscles of individuals with normal and reduced periodontal bone support. Fourteen adult subjects with more than 24 remaining teeth and low levels of periodontal inflammation, were selected for the study. Subjects of the control group had 90% of the periodontal bone support left, while other subjects presented a reduction of 52% of the original periodontal bone. Chewing experiments were performed using silicone tablets, carrots and white bread. The EMG of masseter and anterior temporal muscles was performed bilaterally, using bipolar surface electrodes, and the EMG amplitude was full wave rectified, integrated and the area extension under the curve was used to access muscle activity. The results of the chewing experiments did not show any statistically significant difference in the EMG activity of the study groups, irrespective of the chewing stuff. The height of periodontal bone support did not seem to influence the electroactivity of jaw-closing muscles, indicating that reduced periodontal support might equally be able to withstand masticatory loads. Hence, individuals with reduced periodontal bone support revealed a similar EMG activity compared to subjects with normal periodontal bone support.
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Affiliation(s)
- C P Fernandes
- Department of Prosthetic Dentistry, Lund University, School of Dentistry, Malmö, Sweden
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Yusof Z, Isa Z. Periodontal status of teeth in contact with denture in removable partial denture wearers. J Oral Rehabil 1994; 21:77-86. [PMID: 8133391 DOI: 10.1111/j.1365-2842.1994.tb01126.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The aims of the study were to determine the periodontal status of the teeth in contact with removable partial dentures (RPDs) and to compare them with other teeth in the opposing arch not related to any prosthesis. The periodontal status was also assessed in relation to the age of the dentures. Four hundred and twenty-seven patients treated with RPDs from 1981 to 1986 were recalled for examination. Prior to prosthetic treatment they were given periodontal treatment and fillings when required. Initially all were given oral hygiene instructions and motivation. They were reviewed regularly only on a short-term basis. Eighteen patients were suitable for the present study comprising of eight males and 10 females whose mean age was 41 years. The RPDs were in use from 1.5 to 8 years (mean 4.6 years). The following parameters were assessed: Plaque index (P1I), Gingival index (GI), loss of attachment (LA) and tooth mobility. The wearing of RPDs resulted in higher P1I, GI and LA compared to the controls and these differences were statistically significant. There was an increased frequency of higher P1I, GI and LA with the increase in denture age. Minor changes in tooth mobility were observed. It was concluded that the wearing of RPDs was detrimental to periodontal health in patients whose oral hygiene was less than adequate.
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Affiliation(s)
- Z Yusof
- Department of Oral Medicine, Oral Pathology and Periodontology, Dental Faculty, University of Malaya, Kuala Lumpur, Malaysia
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48
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Abstract
This study evaluated fixed partial dentures bonded with resin to dentin on posterior teeth with minimal tooth preparation. The patients included were missing at least one premolar or first molar. The abutment teeth next to the modification spaces were moderately restored with MOD or class II restorations on most of the teeth. A total of 20 patients with 23 fixed partial dentures were included in the study. After removal of existing restorations, the abutment teeth were prepared to eliminate undercuts on the perimeter of the preparations. Undercut areas within the preparation were not filled but were blocked out later in the laboratory. The fixed partial dentures employed inlays as retainers for a metal ceramic pontic. The metal framework was cast in a high noble gold alloy. The areas of the retainers to be bonded were treated with the Kulzer Silicoater method. Immediately before cementation, enamel was etched and exposed dentin was treated with Gluma. Kerr's resin bonded bridge cement was used for cementation. Patients were recalled after periods of 1 week, 1 month, 6 months, 1 year, 2 years, and 4 years for evaluation. None of the restorations lost retention and no major adverse effects were observed in the 4-year follow-up period.
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Affiliation(s)
- F Isidor
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Royal Dental College, Aarhus, Denmark
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Budtz-Jørgensen E, Isidor F. A 5-year longitudinal study of cantilevered fixed partial dentures compared with removable partial dentures in a geriatric population. J Prosthet Dent 1990; 64:42-7. [PMID: 2200879 DOI: 10.1016/0022-3913(90)90151-2] [Citation(s) in RCA: 100] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Prosthesis function and dental conditions were observed for 5 years in 27 elderly patients treated with mandibular cantilevered fixed partial dentures (FPDs) and in 26 elderly patients treated with distal-extension removal partial dentures (RPDs). All patients were treated with a complete upper denture. The patients were assigned randomly into two treatment groups that had the same composition with regard to sex, age, and distribution of teeth. The patients were under supervised oral hygiene and prosthodontic care. Clinical examination of prostheses, masticatory system, periodontal status, and caries was carried out yearly. Oral hygiene was good, and the periodontal status was maintained in both groups. Caries was observed six times more frequently in the RPD group than in the group with fixed restorations, however. Occlusal and functional conditions deteriorated in the RPD group only. Eight of 42 fixed partial dentures (19%) failed; of these, six were recemented with composite resin. Generally the need for dental and prosthetic follow-up treatment was more pronounced in the RPD group than in the FPD group.
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Affiliation(s)
- E Budtz-Jørgensen
- Division de Prosthèse Adjointe et d'Occlusodontie Prosthetique, Université de Genève, Switzerland
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