Biological complications of removable dental prostheses in the moderately reduced dentition: a systematic literature review

New measure of functional tooth loss for successful Oral ageing: a cross-sectional study

BACKGROUND

This cross-sectional study evaluated the impacts of functional tooth loss on oral health-related quality of life (OHRQoL) among elderly people compared with the impacts of several common indicators of oral health. Additionally, the cut-off of functional tooth loss needed for a better OHRQoL was investigated to establish a new measure for successful oral ageing.

METHODS

Data from people aged 65-74 were extracted from the Fourth National Oral Health Survey in Sichuan, China. Functional tooth loss was defined as both natural tooth loss and nonfunctional teeth, such as third molars, residual roots, and removable dentures. The cut-offs of tooth loss were first identified as 12, based on the previous definition of functional dentition (≥20 natural teeth except the third molars), and 14, 16, or 18 for further investigation. OHRQoL was evaluated by the standardized Geriatric Oral Health Assessment Index (sGOHAI) score. Logistic regression was performed to estimate the impacts on OHRQoL. Additionally, subgroup analyses were conducted using the stratified chi-square test to explore the effect of functional tooth loss at each position.

RESULTS

The mean GOHAI score of the 744 participants was 48.25 ± 7.62. Elderly people who had lost ≤12 functional teeth had greater odds of reporting a higher sGOHAI score than those who had lost more functional teeth (odds ratio (OR) 1.49, 95% confidence interval (CI) 1.05-2.11). No significant difference in the sGOHAI score was detected between people who had lost 13-16 functional teeth and those who had lost ≤12 functional teeth (0.61, 0.35-1.07). The loss of second premolars and first and second molars had great impacts on the sGOHAI score when ≤12 or ≤ 16 functional teeth had been lost.

CONCLUSIONS

Compared with natural tooth loss, functional dentition and occluding pairs, functional tooth loss can be a better indicator of OHRQoL in the elderly population. Sixteen remaining functional teeth seem to be sufficient to maintain good OHRQoL and successful oral ageing despite that number being previously acknowledged as ≥20 teeth.

Fit and Retention of Cobalt-Chromium Removable Partial Denture Frameworks Fabricated with Selective Laser Melting

PURPOSE

To evaluate fit and retention of cobalt-chromium removable partial denture (RPD) frameworks fabricated with selective laser melting (SLM).

METHODS

Three types of framework for clasp-retained RPDs were virtually designed and fabricated using SLM (n = 30). For comparison, 30 additional frameworks were produced using conventional lost-wax casting. A biomechanical model was created, incorporating extracted teeth mounted on flexible metal posts. Using this model, horizontal constraint forces resulting from a misfit were measured using strain gauges, while vertical forces were not recorded. The constraint force components and resultant forces were determined for all abutment teeth, and the maximum retention force during RPD removal from the model was also assessed. For statistical evaluation, the two fabrication methods were analyzed by calculating the means and standard deviations.

RESULTS

The average horizontal constraint forces showed similar values for both fabrication methods (SLM: 3.5 ± 1.0 N, casting: 3.4 ± 1.6 N). The overall scatter of data for cast RPDs was greater compared to those fabricated using SLM, indicating a better reproducibility of the SLM process. With regard to retention, the intended retention force of 5-10 N per abutment tooth was not attained in one of the cast groups, while it was consistently achieved in all SLM groups.

CONCLUSIONS

This in vitro study found that SLM is a promising option for the manufacture of cobalt-chromium RPD frameworks in terms of fit and retention.

Postinsertion adjustment appointments and their association with cast removable partial denture survival

STATEMENT OF PROBLEM

Successful outcomes with cast removable partial dentures (RPDs) are dependent on adequate fabrication and adjustments at the delivery appointment. Evaluation of the number and frequency of postinsertion follow-up appointments helps determine whether the prosthesis continues to fit comfortably and whether function and esthetics continue to be satisfactory. Reports on the number of appointments and frequency and type of adjustments required for RPDs following insertion are sparse.

PURPOSE

The purpose of this university-based population study was to determine the number of appointments and type of adjustments following RPD insertion and their association with patient demographics, type of RPD, and denture survival.

MATERIAL AND METHODS

This retrospective clinical study examined the records of 257 patients at the University of Toronto, Faculty Dentistry, wearing 308 RPDs inserted between 2013 and 2014 with a 5-year follow-up. The outcome measures investigated included postinsertion appointments, type of adjustments, and denture survival.

RESULTS

A total of 48.1% of the dentures (19.5% tissue supported; and 28.6% tooth supported) were maxillary, and 51.9% (34.7% tissue supported; and 17.2% tooth supported) mandibular. Most patients (68.9%) had 1 to 3 postinsertion appointments, with 78.6% having no major adjustments. Twenty-six dentures failed (failure rate 8.4%), with the failure-free time estimated at 4.58 years (95% confidence interval (CI) 4.42-4.73 years, Kaplan-Meier survival analysis). Failed dentures were significantly associated with more minor adjustments (Mean (M)=4.12, SD=3.90, Kruskal-Wallis (K-W) P=.027; OR=1.18; 95% CI 1.05-1.32, P=.006). More minor adjustments were needed for mandibular dentures (multivariable Poisson regression (MPR) P=.003) compared with maxillary dentures. More major adjustments were needed for maxillary dentures (MPR P=.030) compared with mandibular dentures. More minor and major adjustments were needed for dentures that were remade from within 5 years to beyond 10 years compared with first time denture wearers (MPR P<.001). Patients with musculoskeletal disorders required a significantly higher number of minor adjustments (M=3.67, MPR P<.001) and appointments (M=3.87, MPR P<.001) than those without these disorders.

CONCLUSIONS

The 5-year survival of RPDs following insertion was estimated at 91.6%. Most patients required 1 to 3 appointments after insertion. Mandibular RPDs required significantly more minor adjustments, and maxillary RPDs more major adjustments. More minor and major adjustments were needed for dentures that were remade at any time previously compared with first time denture wearers.

Cumulative 10-year performance of endodontically treated teeth with prosthetic restorations of base metal alloy double crowns with friction pins-a retrospective study

OBJECTIVES

This 120-month follow-up study aimed to investigate the complication rate of abutment teeth after endodontic pretreatment with base metal alloy double crowns with friction pins.

MATERIALS AND METHODS

A total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth (n = 459, 88.3% vital) were retrospectively analyzed between 2006 and 2022. Of the endodontically treated abutment teeth, 6.9% (n = 36) were additionally treated with post and core reconstructions. Cumulative complication rates were calculated using the Kaplan-Meier estimator and log-rank test. In addition, Cox regression analysis was performed.

RESULTS

The cumulative complication rate at 120 months for the entire set of abutment teeth was 39.6% (confidence interval [CI]: 33.0-46.2). Endodontically treated abutment teeth (33.8%; CI: 19.6-48.0) were found to have a significantly higher cumulative fracture rate than vital teeth (19.9%; CI: 13.9-25.9, p < 0.001). Endodontically treated teeth restored with post and core reconstructions (30.4%; CI: 13.2-47.6) showed a nonsignificant lower cumulative fracture rate than that of teeth with root fillings only (41.6%; CI: 16.4-66.8, p = 0.463).

CONCLUSIONS

Higher 120-month cumulative fracture rates were observed in endodontically treated teeth. Comparable performance was observed in teeth with post and core reconstructions compared to teeth with root fillings only.

CLINICAL RELEVANCE

If endodontically treated teeth are used as abutments for double crowns, the risk of complications from these teeth should be considered when planning treatment and communicating with the patient.

Technical Complications of Removable Partial Dentures in the Moderately Reduced Dentition: A Systematic Review

The aim of this study was to conduct a systematic literature review with a subsequent meta-analysis on the technical complications and failures of removable partial denture (RPD) therapy in the moderately reduced dentition. A systematic literature search of established medical databases, last updated 06/2022, was conducted. RCTs and prospective and retrospective studies were included that had information on technical complications and failures of RPDs, at least 15 participants, an observation period of at least two years and a drop-out rate of less than 25%. Publications were selected on the title, abstract and full-text level by at least three of the participating authors. The evidence of the included studies was classified using the GRADE system. The bias risk was determined using the RoB2 tool and the ROBINS-I tool. Of 19,592 initial hits, 43 publications were included. Predominantly, retention of the prosthesis, retention loss of anchor crowns (decementations), fractures/repairs of frameworks, denture teeth, veneering or acrylic bases, and a need for relining were reported depending on prosthesis type and observation time. Focusing on technical complications and failures, only very heterogeneous data were found and publications with the highest quality level according to GRADE were scarce. Whenever possible, data on technical complications and failures should be reported separately when referencing the tooth, the prosthesis and the patient for comparability. Prostheses with differing anchorage types should be analyzed in different groups, as the respective complications and failures differ. A precise description of the kinds of complications and failures, as well as of the resulting follow-up treatment measures, should be given.

Double-Crown Prosthesis Retention Using Polyetherketoneketone (PEKK): An In Vitro Study

PURPOSE

To assess the retentive force of telescopic crowns using polyetherketoneketone (PEKK) high-performance polymer in relation to conventional materials over a long period of time in an in vitro setting.

MATERIALS AND METHODS

Thirty-six sets of primary and secondary crowns were fabricated as per the double crown-retained prostheses approach. Six samples were included in each of the five test groups (1: zirconia/PEKK [Zr/PEKK]; 2: titanium/PEKK [Ti/PEKK]; 3: cobalt-chrome/PEKK [CoCr/PEKK]; 4: PEKK/PEKK; and 5: gold/PEKK [Au/PEKK]) and the single control group (gold/galvano-gold [Au/GA]). The insertion-removal test was performed for 20,000 cycles, and the surface condition was observed. Retentive forces were analyzed using two-way ANOVA (α<0.05).

RESULTS

The retention forces in groups Zr/PEKK and Ti/PEKK significantly decreased over time (group 1: p = 0.035 and group 2: p = 0.001), whereas retentive force increased significantly in groups PEKK/PEKK, Au/PEKK, and control (group 4: p = 0.001, group 5: p = 0.008, and control: p = 0.042). Similar wear was observed on the primary crown in groups PEKK/PEKK, gold/PEKK, and control.

CONCLUSIONS

Groups PEKK/PEKK and Au/PEKK showed a transition of retentive force similar to the control group. Groups PEKK/PEKK and Au/PEKK had similar wear on the surface compared to control. Therefore, PEKK has a promising clinical potential.

Oral health-related quality of life (OHRQoL) after rehabilitation with removable partial dentures (RPDs): A systematic review and meta-analysis

OBJECTIVES

To summarise evidence on the change in oral health-related quality of life (OHRQoL) before and after rehabilitation with removable partial dentures (RPDs) amongst partially edentulous adults.

DATA

Studies assessing OHRQoL amongst patients aged ≥18 years, before and after rehabilitation with RPDs of any type and design, were included. The quality of included studies was evaluated using the Cochrane risk of bias tools. Meta-analysis was conducted using a random-effect model.

SOURCES

MEDLINE, EMBASE and CENTRAL, up to March 29, 2022.

STUDY SELECTION AND RESULTS

Thirteen studies were eligible and eight were included in the meta-analysis. The studies had moderate to serious risk of bias. There was a very low level of certainty that OHRQoL, as measured using OHIP-14, improved 3 months after RPDs were fitted (222 participants, MD: -12.0, 95% CI: -16.1, -7.9, p<0.001) and after 6 months (101 participants, MD: -10.5, 95% CI: -16.4, -4.6, p<0.001). At 12 months post-treatment, RPD rehabilitation did not result in statistically significant improvement in OHIP-14 scores (62 participants, MD: -12.7, 95% CI: -26.1, 0.6, p = 0.06). However, the assessment using OHIP-49 at 12 months showed significant improvement (87 participants, MD: -34.8, 95% CI: -41.9, -27.7, p<0.001), with low certainty of evidence.

CONCLUSIONS

Based on the limited evidence available, this review found that RPD rehabilitation appear to improve OHRQoL in the short term up to 6 months, with a very low level of certainty. The long-term effect of RPD treatment on OHRQoL after 12 months is inconclusive. There is currently insufficient evidence on the effect of RPD treatment on OHRQoL. This review highlights the need for more and better quality studies.

CLINICAL SIGNIFICANCE

Data on RPD outcomes are summarised, aiding clinicians in providing evidence-based patient-centred care that matches patients' needs and expectations. Recommendations for future research were also highlighted.

REGISTRATION

PROSPERO CRD42022328606.

Ten-year clinical performance of non-precious metal double crowns with friction pins in severely reduced dentitions—a retrospective study

Objectives

This follow-up study aimed at collecting long-term data for removable partial dentures (RPDs) retained by double crowns with spark-eroded friction pins (DCP) and comparing them in the presence of severely reduced dentition (SRD) and non-SRD (NSRD, i.e. residual dentition with more than three abutment teeth) after a 10-year wearing period.

Materials and methods

A total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth were followed up between 2006 and 2022. The SRD group included 144 RPDs supported by 314 abutment teeth. The data collection was performed retrospectively. 10-year survival rates of RPDs and abutment teeth were determined using the Kaplan–Meier method and compared using the log-rank test for SRD and NSRD, among others. Cox regression analyses were conducted to isolate risk factors for the survival of both RPDs and abutment teeth.

Results

The 10-year cumulative survival rate of all abutment teeth was 65.6% with significantly lower values in the SRD group (53.5%) (p < 0.001). The survival rate for all RPDs was 65.5%. The SRD group showed lower survival rates (57.9%) (p = 0.004). The number and location of the abutment teeth had a significant influence on the survival rates of the RPDs and the abutment teeth. Age, sex, jaw, relining, and vitality had a significant influence on the abutment teeth survival rates.

Conclusions

RPDs showed an acceptable clinical survival rate after 10 years. The number, location, and vitality of abutment teeth were factors that influenced the survival of both RPDs and abutment teeth.

Clinical relevance

Consideration of the influencing factors found can help improve the prognostic assessment of double crown-retained dentures in the context of prosthetic therapy planning.

Non-Precious Metal Alloy Double Crown-Retained Removable Partial Dentures: A Cross-Sectional In Vivo Investigation

(1) Background: An alternative material to precious metal alloys are non-precious metal alloys. The material properties of these are different and, therefore, their clinical, biological and mechanical behaviors may also differ. Hence, the purpose of this in vivo investigation was to analyze the clinical and patient-reported outcomes of patients restored with non-precious metal alloy double crown-retained removable partial dentures (NP-D-RPDs). (2) Methods: Partially edentulous patients were restored with non-precious metal alloy partially veneered NP-D-RPDs. Survival rates, success rates, failures and patient-reported outcomes were investigated and statistically evaluated. (3) Results: A total of 61 patients (65.6 ± 10.8 years) were included and clinically and radiographically examined. The mean follow-up time was 25.2 ± 16.5 months. In total, 82 NP-D-RPDs and 268 abutment teeth were examined. The overall survival rate of the NP-D-RPDs was 100% after a mean follow-up time of 2.1 years. The overall success rate was 68.3%. The overall satisfaction with the NP-D-RPDs was 94.3%. (4) Conclusions: Non-precious metal alloy partially veneered NP-D-RPDs seem to be an efficient alternative to precious metal alloy RPDs with excellent patient-reported outcomes.

Impact of rehabilitation versus edentulism on systemic health and quality of life in patients affected by periodontitis: A systematic review and meta-analysis

AIM

To investigate the effect of rehabilitation in fully/partially edentulous patients with stage IV periodontitis on oral-health-related quality of life (OHRQoL) and systemic health.

MATERIALS AND METHODS

A systematic electronic and manual search was conducted. Three authors independently reviewed, selected, and extracted the data. Outcomes were OHRQoL (Oral Health Impact Profile 14 [OHIP-14] and OHIP-49, General Oral Health Assessment Index [GOHAI], visual analogue scale, symptoms registration) and systemic health-related outcomes (incidence and prevalence of systemic diseases, values of systemic disease indicators). Qualitative data were synthesized for OHRQoL and systemic health-related outcomes. Meta-analysis was conducted on available quantitative data.

RESULTS

The search identified 59 articles (6724 subjects in total). OHRQoL improved across all the studies, irrespective of the number of missing teeth, their location, or treatment modality. Meta-analysis showed significant improvement of OHIP-49 (36.86, p < .01) in manuscripts including subjects affected by periodontitis, consistently with the remaining literature (reduction of score points post rehabilitation: OHIP-14 = 10.52, OHIP-49 = 56.02, GOHAI = 5.40, p < .01 for all). Non-rehabilitated subjects exhibited inferior cognitive status, higher medication intake, and frailty. However, our data are limited and should be interpreted with caution.

CONCLUSIONS

Oral rehabilitation improves OHRQoL and, potentially, systemic health in edentulous patients. It is unclear whether these findings may be extrapolated to patients with stage IV periodontitis.

Impact of tooth loss due to periodontal disease on the prognosis of rehabilitation

When periodontal disease is diagnosed, it is difficult to predict the clinical response of treatment of a tooth over time because the result of treatment is affected by several factors and will depend on the maintenance and support of periodontal treatment. Rehabilitation with removable dental prostheses, fixed prostheses, and dental implants makes it possible to restore the function and esthetics of patients with tooth loss due to periodontal disease. The predictive factors of tooth loss in periodontitis patients should be assessed by dentists to inform their clinical decision-making during dental treatment planning. This will provide detailed individualized information and level of risk of patients considered suitable for dental rehabilitation. Therefore, the aim of this article was to review the subject of "Impact of tooth loss due to periodontal disease on the prognosis of rehabilitation" and the effect of fixed, removable, and implant-supported prostheses in periodontal patients.

Interdisciplinary treatment of a patient with amelogenesis imperfecta: Case report with a 35-year follow-up

OBJECTIVE

This case will illustrate the interdisciplinary management of an adolescent female patient with amelogenesis imperfecta (AI). It will contrast this approach and compare it to the previous "multidisciplinary" treatment rendered before the patient was referred for a second opinion.

CLINICAL CONSIDERATIONS

The patient had a family history of AI affecting all of her permanent teeth. There were many impacted teeth. The majority of her family and relatives afflicted by this opted for dentures. The patient had undergone 2 years of treatment and was told that her "braces would be removed next week." Her new dentist was concerned because the case was not ready to restore.

CONCLUSION

He recommended referral to another orthodontist for a second opinion and formulation of an interdisciplinary treatment plan that would include a periodontist, endodontist, and restorative dentist. The patient's family accepted the second opinion referral and restarted treatment with an interdisciplinary team. The restorative dentist was the quarterback for this integrated and sequenced approach. The case was ultimately restored. A 35 year follow-up shows stability with a caries free, periodontally healthy, esthetic result.

Biological and technical complications in root cap-retained overdentures after 3-15 years in situ: a retrospective clinical study

OBJECTIVES

This retrospective clinical study investigates the frequency of biological and technical complications in patients rehabilitated by natural root-retained overdentures (RODs) with cast post-and-cores (root caps) wearing precision attachments and analyses factors influencing complication rates (e.g. oral hygiene routines).

MATERIALS AND METHODS

Patients formerly treated with RODs were invited for a cost-free clinical visit to evaluate their intraoral status. Furthermore, they were interviewed and patient records were screened for complications occurring since denture delivery. Statistical models include descriptive analyses, Fisher's exact test, odds ratios, and a multivariate regression model.

RESULTS

A total of 114 patients wearing 128 RODs with a total of 280 abutment teeth were evaluated (mean service time: 7.9 years). Technical complications occurred in 68.8% of the RODs, with matrix loosening being the most frequent complication (50.1%). Biological complications occurred in 53.9% of all RODs, with the presence of denture stomatitis being the most common biological complication (38.3%). The presence of denture stomatitis was significantly higher in the maxilla relative to the mandible (p = 0.0029), in subjects cleaning their dentures less than twice a day (p < 0.001), in subjects regularly using CHX-containing products (p = 0.036) and in subjects with a plaque index > 40% (p < 0.001).

CONCLUSIONS

Root cap-retained overdentures with precision attachments are a viable treatment option in partially dentate subjects, even over long-term periods. However, high complication rates should be expected.

CLINICAL RELEVANCE

Establishing good oral hygiene is a decisive factor in preventing complications in RODs. Furthermore, CHX-containing products may not be recommended for routine domestic use.

Mechanical Evaluation of Implant-Assisted Removable Partial Dentures in Kennedy Class I Patients: Finite Element Design Considerations

The main purpose of this work was to construct a clinically valid numerical model of a mandibular Kennedy class I patient rehabilitated with a conventional removable partial denture and another two with implant-assisted removable partial dentures at two different implant locations. The selected patient was classified as ASA I and its mandible geometry reconstruction was performed by the conversion of the Cone-Beam computed Tomography (CBCT) scan raw medical data into a 3D model and subsequent conversion to a CAD file by reverse engineering methods. The soft tissue and removable denture geometries were also included in the CAD model as well as implants, ball attachments and matrix. Moreover, periodontal ligament was modelled by offsetting the mesh of the root surface of each tooth. The finite element results showed that the installation of a dental implant in each of the bilateral edentulous regions helps providing support and retention to the extension bases of the Removable Partial Denture (RPD) and significantly reduces the vertical and anterior-posterior displacements, regardless of its position.

Cost-Effectiveness Analysis of Rehabilitation Interventions for Teeth With Extensive Coronary Destruction

OBJECTIVE

To perform a cost-effectiveness analysis of rehabilitation interventions for management of posterior teeth (molar) with extensive coronary destruction.

METHODOLOGY

An economic model by Markov simulated a hypothetical 10-year cohort with 1,000 patients requiring treatment for a molar tooth with pulp necrosis and extensive coronary destruction. This study adopted the perspective of a local manager from Specialized Center in Dentistry, based on the transfer from the Ministry of Health. Treatments were proposed: Tooth Extraction + Removable Partial Denture (TE+RPD); Root Canal Treatment + Intra-Radicular Restoration + Single Crown (RCT+RIR+SC); and Tooth Extraction + Dental Implant + Single Crown (TE+DI+SC). The costs were obtained from the SUS Integrated System of Procedures, Medicines and orthoses; prostheses and special materials table management (SIGTAP). Failure and survival rates were obtained from systematic reviews. The variable "years of survival" was an outcome of effectiveness. The probabilistic simulation considered the confidence interval of 95%, variation of parameters by 5% and annual discount rate of 5%.

RESULTS

TE+RPD intervention presented lower cost and effectiveness. The incremental cost-effectiveness ratio (ICER) of RCT+IRR+SC and TE+DI+SC interventions compared to TE+RPD were $13.06 and $9.92 per year of survival. Compared to RCT+IRR+SC, the TE+DI+SC intervention had an ICER=$26.90 per year of survival. The acceptability curve indicates that the choice of intervention depends on the willingness to pay.

CONCLUSION

The RCT+IRR+SC intervention presented a balance of cost-effectiveness. Rehabilitation with implants can be considered in view of the higher expectation of longevity and, especially, greater willingness to pay.

Retentive Characteristics of a Polyetheretherketone Post-Core Restoration with Polyvinylsiloxane Attachments

A new application of a polyetheretherketone (PEEK) post-core restoration combined with polyvinylsiloxane (PVS) attachments was proposed and substantiated. This study aimed to evaluate retentive characteristics of the PEEK post-core restoration with PVS attachment systems. Specimens with PVS attachments were fabricated to evaluate retention force during 10,000 cyclic dislodgements. Additionally, the retention forces of PVS attachments with three different values of Shore hardness were further measured before and after aging treatments. The results of cyclic dislodgement test indicated a strong negative linear relationship between the cyclic times and retention force (p < 0.0001, r = −0.957). Furthermore, the retention forces of the PVS were significantly improved with Shore hardness increased, which was also affected by the aging treatment (F (2, 138) = 10.95, p < 0.0001). Therefore, the PEEK post-core restoration with PVS attachments exhibited the favorable retention force, which could be a promising alternative for dental prostheses.

A Glass Fiber-Reinforced Resin Composite Splint to Stabilize and Replace Teeth in a Periodontally Compromised Patient

Combined periodontal and prosthodontic treatment demands of patients require a structured coordination of pretreatments and an adequate choice of restorations. This is especially true if multiple teeth are missing and insufficient crown-root ratios are obvious. A 40-year-old patient with a severe periodontitis (Stage IV, Grade C) was treated with active, nonsurgical periodontal therapy. Afterwards, a supportive periodontal therapy was provided with a recall interval of three to four months. Due to a high tooth mobility of the anterior teeth in the upper jaw and a missing left canine, a combination of a resin composite (Signum composite, Kulzer, Hanau, Germany) and a unidirectional glass prepreg fiber (Tender Fiber Quattro, MICERIUM, Avegno, Italy) was utilized to fabricate a splint in a labside approach to stabilize the remaining teeth. Moreover, an artificial denture tooth was adhesively luted to the splint. A temporary polymer-based material (Vita CAD-Temp, VITA Zahnfabrik, Bad Säckingen, Germany) was selected to supply the posterior teeth of the patient with a 3-unit fixed dental prosthesis (FDP), and both restorations were adhesively cemented. 19 months after insertion, a fracture of the fiber-reinforced resin composite splint occurred that was intraorally repaired. In spite of the fracture of the splint, all materials were functionally and esthetically stable over the follow-up period of 22 months.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Frequency of Complete and Removable Partial Denture Treatment in the Primary Health Centres in Three Different Regions of Kosovo from 2002 to 2013

Introduction

Edentulism and prosthodontic care are very common, especially in the elderly. The study investigated the treatment with complete dentures (CDs) and acrylic removable partial dentures (ARPDs) among people receiving new prosthodontic treatment in the Primary Health Centres of the three regions in Kosovo from 2002 to 2013.

Methods

The data on ARPDs delivery and CDs delivery was obtained from the archives of primary health centres from three Kosovo regions (Prizren, Peje, Ferizaj) from 2002 to 2013. The data was analysed concerning year of treatment, type of dentures, jaw, age, gender and urban or rural origin of the patients. The trend of treatment was determined, and the binomial logistic regression model was used for predicting odds of ARPD versus CD treatment by year of treatment and patient characteristics.

Results

From 2002 to 2013, 9,478 patients received 11,655 CDs and 4,401 ARPDs. Delivery of CDs significantly increased by 57.45 dentures per year (R2=0.609) and delivery of ARPDs by 30.39 dentures per year (R2=0.569). Each year the odds for ARPD versus CD increased by 4.2% (95% CI: 3.0%-5.4%). Younger patients have higher odds for ARPD rather than CD and odds for ARPD are decreasing as the age of patients rises. The gender, residence, and jaw all had a significant impact on prosthodontic treatment too.

Conclusions

In Primary Health Centres of Kosovo, there is a trend for higher frequencies of both dentures (more obvious for ARPD), and the frequency is highly dependent on the age of patients.