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Walter MH, Dreyhaupt J, Mundt T, Kohal R, Kern M, Rauch A, Nothdurft F, Hartmann S, Böning K, Boldt J, Stark H, Edelhoff D, Wöstmann B, Luthardt RG, Hannak W, Wolfart S, Heydecke G, Jahn F, Pospiech P, Marré B. Periodontal health in shortened dental arches: A 10-year RCT. J Prosthodont Res 2020; 64:498-505. [PMID: 32063531 DOI: 10.1016/j.jpor.2020.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/18/2019] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE This analysis focused on periodontal health in shortened dental arches (SDAs). METHODS In a randomized controlled clinical trial, patients with missing molars in one jaw and at least one premolar and canine on both sides were eligible for participation. In the partial removable dental prosthesis (PRDP) group (n = 79), molars were replaced with a precision attachment retained PRDP. In the SDA group (n == 71), the SDA up to the second premolars was either left as is or restored with fixed dental prostheses. Outcome variables were vertical clinical attachment loss (CAL-V), pocket probing depth (PPD), bleeding on probing (BOP) and plaque index (PLI). For CAL-V and PPD, the changes at six measuring points per tooth were analyzed. For BOP and PLI, patient related rates were calculated for each point in time. Statistical methods included linear regression analyses. RESULTS In the intention-to-treat (ITT) analysis for CAL-V in the study jaw, the 10 year patient related mean changes were 0.66 mm in the PRDP group and -0.13 mm in the SDA group. The resulting mean patient related group difference of 0.79 mm (95% CI: 0.20 mm-1.38 mm) was significant (p = 0.01). There were no significant differences in the ITT analyses for PPD. For BOP and PLI, significant group differences with more favorable results for the SDA group were found. CONCLUSIONS In view of lacking substantial differences for CAL-V and PPD, the overall differences were considered of minor clinical relevance. The results add confirmatory evidence to the shortened dental arch concept and its clinical viability (controlled-trials.com ISRCTN97265367).
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Affiliation(s)
- Michael H Walter
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany.
| | - Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, Ulm University, Schwabstraße 13, Ulm 89075, Germany
| | - Torsten Mundt
- Department of Prosthodontics, Gerodontology and Biomaterials, Dental School, University of Greifswald, Rotgerberstr. 8, Greifswald 17487, Germany
| | - Ralf Kohal
- Department of Prosthetic Dentistry, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, Freiburg im Breisgau 79106, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Christian-Albrechts-Platz 4, Kiel 24118, Germany
| | - Angelika Rauch
- Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstr. 18, Leipzig 04103, Germany
| | - Frank Nothdurft
- Department of Prosthetic Dentistry and Dental Materials Science, Medical Center, Dental School and Clinics, Saarland University, Campus Homburg, Kirrberger Str. 100, Homburg/Saar 66421, Germany
| | - Sinsa Hartmann
- Department of Prosthetic Dentistry, Johannes-Gutenberg University of Mainz, Langenbeckstr. 1, Mainz 55131, Germany
| | - Klaus Böning
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
| | - Julian Boldt
- Department of Prosthetic Dentistry, Julius-Maximilians University of Würzburg, Pleicherwall 2, Würzburg 97070, Germany
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and dental Materials Science, University of Bonn, Welschnonnenstr.17, Bonn 53111, Germany
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Ludwig-Maximilians-University, Goethestraße 70, Munich 80336, Germany
| | - Bernd Wöstmann
- Department of Prosthetic Dentistry, Justus-Liebig University of Gießen, Rudolf-Buchheim-Str. 8, Gießen 35392, Germany
| | - Ralph Gunnar Luthardt
- Department of Prosthetic Dentistry, Center of Dentistry, Universitätsklinikum Ulm, Albert-Einstein-Allee 11, Ulm 89081, Germany
| | - Wolfgang Hannak
- Charité - Universitätsmedizin Berlin, CC3 - Charité, Center for Dental and Craniofacial Sciences, Department of Prosthodontics, Geriatic Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin, Aßmannshauser Straße 4-6, Berlin 14197, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, Aachen 52074, Germany
| | - Guido Heydecke
- Department of Prosthodontics, University Medical Center Eppendorf, Zahnärztliche Prothetik, Martinistr. 52, Hamburg 20246, Germany
| | - Florentine Jahn
- Department of Prosthetic Dentistry and Dental Material Science, Friedrich-Schiller University of Jena, Poliklinik für Zahnärztliche Prothetik und Werkstoffkunde, An der Alten Post 4, Jena 07743, Germany
| | | | - Birgit Marré
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
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Dentists' Attitudes in Jordan towards the Shortened Dental Arch Concept: A Cross-Sectional Study. Int J Dent 2019; 2019:4163851. [PMID: 31885586 PMCID: PMC6914905 DOI: 10.1155/2019/4163851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/21/2019] [Indexed: 11/18/2022] Open
Abstract
Aims To assess the awareness, knowledge, attitudes, and application of the shortened dental arch (SDA) concept by dentists in Jordan. Materials and Methods In this cross-sectional survey, a questionnaire was disseminated to a random sample of 150 dentists working in private practices, university hospitals, or governmental institutes. The chi-square (X 2 ) test was used to examine associations. Results One hundred and six dentists responded (70.7% response rate). Fifty-five were females. 82.1% were aware of the SDA concept. The fewer the years of experience, the more likely the dentists were aware of the SDA concept (X 2 , P=0.024) and the more likely they learned about it through undergraduate education (X 2 , P < 0.001). In a hypothetical clinical situation of a patient >50 years of age with missing molar teeth, 45.3% agreed that the molars should be replaced, while 54.7% did not agree. Improving mastication was the main reason for agreeing (81.6%), while having reduced functional benefit was the main reason for disagreeing (64.9%). The treatment modality most commonly recommended was implants fixed partial dentures (84.9%). Of those aware of SDA, 67.8% agreed it could have a useful place in treatment planning within Jordan. Cost reduction for patients was the main reason for this answer, as reported by 51% of those who agreed. 26.4% did not apply SDA for any of their patients, while 50.6% applied it for <10% of their patients. Conclusion The majority of the dentists was aware of the SDA concept and had a positive attitude towards it; however, few of them applied it in their practice.
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Rüdiger SG, Dahlén G, Emilson C. The furcation tunnel preparation—A prospective 5‐year follow‐up study. J Clin Periodontol 2019; 46:659-668. [DOI: 10.1111/jcpe.13120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/17/2019] [Accepted: 04/23/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Stefan G. Rüdiger
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Specialist Dental Care Centre Public Dental Service Malmö Sweden
| | - Gunnar Dahlén
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Claes‐Göran Emilson
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
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The Impact of Subject Age, Gender, and Arch Length on Attitudes of Syrian Dentists towards Shortened Dental Arches. Int J Dent 2015; 2015:643176. [PMID: 26265916 PMCID: PMC4523669 DOI: 10.1155/2015/643176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 06/12/2015] [Accepted: 07/05/2015] [Indexed: 11/18/2022] Open
Abstract
Objective. This study aimed to investigate the impact of subject age, gender, and arch length on dentists' attitudes towards unrestored shortened dental arches. Materials and Methods. 93 Syrian dentists were interviewed and presented with 24 scenarios for male and female subjects of different ages and shortened dental arches of varying length. Participants were asked to indicate on a standardized visual analogue scale how they would value the health of the mouth if the posterior space was left unrestored. Results. A value of 0.0 represented the worst possible health state for a mouth and 1.0 represented the best. The highest mean value (0.73) was assigned to a shortened dental arch with missing second molar teeth in the mouth of a 70-year-old subject. A 35-year-old female subject with an extremely shortened dental arch (all molar and premolar teeth are missing) attracted the lowest mean value (0.26). The statistical analysis indicated a significant decrease in the value placed on unrestored shortened dental arches as the number of remaining teeth decreased (p < 0.008). While subject gender had almost no impact on dentists' attitudes towards shortened dental arches, the scenarios for the older shortened dental arch subjects attracted significantly higher values compared to the scenarios for the younger subjects (p < 0.017). Conclusion. Subject age and arch length affect dentists' attitudes towards shortened dental arches, but subject gender does not.
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Murai S, Matsuda K, Ikebe K, Enoki K, Hatta K, Fujiwara K, Maeda Y. A field survey of the partially edentate elderly: Investigation of factors related to the usage rate of removable partial dentures. J Oral Rehabil 2015; 42:828-32. [PMID: 26059645 DOI: 10.1111/joor.12318] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2015] [Indexed: 11/30/2022]
Abstract
Although the shortened dental arch (SDA) concept has been known to all over the world, acceptance of the SDA concept as an oral health standard can be questionable from the patients' point of view, even if it is biologically reasonable. Furthermore, because the health insurance system covers removable partial dentures (RPDs) for all citizens in Japan, SDA patients seem to prefer to receive prosthetic treatment to replace the missing teeth. However, there were few field surveys to investigate the usage rate of RPDs in Japan. The purpose of this study was to determine the usage rate of RPDs in older Japanese subjects and to investigate the factors related to the usage of RPDs. Partially edentate participants (n = 390) were included in this study. Oral examinations were conducted to record several indices. The Cochran-Armitage trend test was used to evaluate the relationship between the number of missing teeth and the usage rate of RPDs. Chi-squared tests and logistic regression analysis were conducted to evaluate the factors related to the usage rate of RPDs. Usage of RPDs had a significantly positive association with the number of missing distal extension teeth and bilaterally missing teeth. The usage rate of RPDs increased as the number of missing distal extension teeth increased (P for trend < 0·001). The conclusion of this study was that participants with missing distal extension teeth had higher usage rates of RPDs than other participants, and the usage rate increased as the number of missing distal extension teeth increased.
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Affiliation(s)
- S Murai
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan
| | - K Matsuda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan
| | - K Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan
| | - K Enoki
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan
| | - K Hatta
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan
| | - K Fujiwara
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Y Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan
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Nassani MZ, Ibraheem S, Al-Hallak KR, El Khalifa MOA, Baroudi K. A study of dentists' preferences for the restoration of shortened dental arches with partial dentures. Eur J Dent 2015; 9:183-188. [PMID: 26038647 PMCID: PMC4439843 DOI: 10.4103/1305-7456.156802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This study aimed to use a utility method in order to assess dentists' preferences for the restoration of shortened dental arches (SDAs) with partial dentures. Also, the impact of patient age and length of the SDA on dentists' preferences for the partial dentures was investigated. MATERIALS AND METHODS Totally, 104 subjects holding a basic degree in dentistry and working as staff members in a private dental college in Saudi Arabia were interviewed and presented with 12 scenarios for patients of different ages and mandibular SDAs of varying length. Participants were asked to indicate on a standardized visual analog scale how they would value the health of the patient's mouth if the mandibular SDAs were restored with cobalt-chromium removable partial dentures (RPDs). RESULTS With a utility value of 0.0 representing the worst possible health state for a mouth and 1.0 representing the best, dentists' average utility value of the RPD for the SDAs was 0.49 (sd= 0.15). Mean utility scores of the RPDs across the 12 SDA scenarios ranged between 0.35 and 0.61. RPDs that restored the extremely SDAs attracted the highest utility values and dentists' utility of the RPD significantly increased with the increase in the number of missing posterior teeth. No significant differences in dentists' mean utility values for the RPD were identified among SDA scenarios for patients of different ages. CONCLUSION Restoration of the mandibular SDAs by RPDs is not a highly preferred treatment option among the surveyed group of dentists. Length of the SDA affects dentists' preferences for the RPD, but patient age does not.
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Affiliation(s)
| | - Shukran Ibraheem
- Department of Restorative Dental Sciences, Al-Farabi Colleges, Riyadh, Saudi Arabia
| | | | | | - Kusai Baroudi
- Department of Restorative Dental Sciences, Al-Farabi Colleges, Riyadh, Saudi Arabia
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Nassani MZ, Tarakji B, Baroudi K, Sakka S. Reappraisal of the removable partial denture as a treatment option for the shortened dental arch. Eur J Dent 2013; 7:251-256. [PMID: 24883037 PMCID: PMC4023187 DOI: 10.4103/1305-7456.110199] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
For patients with shortened dental arches, many treatment options are available. The existing situation can be maintained by stabilizing the present dentition and improving the occlusion without extending the arch. Alternatively, the shortened dental arch can be extended by either a free-end saddle removable partial denture, cantilevered fixed bridge, or by an implant-supported prosthesis. The free-end saddle removable partial denture can be considered a simple, non-invasive, and relatively cheap treatment option for the shortened dental arch. It was believed that such prosthodontic rehabilitation would be beneficial for the patients in terms of improving oral functions. However, the existing literature indicates that the prognosis of free-end saddle removable partial denture is not predictable, it is problematic, and its contribution to oral functions in patients with shortened dental arches is considered to be dubious. This paper reviews and summarizes the current literature about the outcome of extending the shortened dental arch by a free-end saddle removable partial denture. It also outlines factors that may affect the prognosis of this prosthetic treatment.
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Affiliation(s)
| | - Bassel Tarakji
- Department of Oral and Maxillofacial Sciences, Al-Farabi Dental College, Riyadh, Saudi Arabia
| | - Kusai Baroudi
- Department of Restorative Dental Sciences, Al-Farabi Dental College, Riyadh, Saudi Arabia
| | - Salah Sakka
- Department of Oral and Maxillofacial Sciences, Al-Farabi Dental College, Riyadh, Saudi Arabia
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