Rehabilitation of shortened dental arches: A fifteen-year randomised trial.
dental arch
dental prostheses
dental restauration failure
prosthesis survival
tooth loss
treatment outcome
Journal
Journal of oral rehabilitation
ISSN: 1365-2842
Titre abrégé: J Oral Rehabil
Pays: England
ID NLM: 0433604
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
11
02
2021
accepted:
04
03
2021
pubmed:
14
3
2021
medline:
15
5
2021
entrez:
13
3
2021
Statut:
ppublish
Résumé
Few long-term studies on treatments in the shortened dental arch (SDA) are available. The objective of this trial was to analyse the long-term success of two different treatment concepts. Patients over 35 years of age with missing molars in one jaw and at least the canine and one premolar present on both sides were eligible. In the partial removable dental prosthesis (PRDP) group (N = 81), molars and missing second premolars were replaced by a precision attachment retained prosthesis. In the SDA group (N = 71), the dental arch ended with the second premolar that had to be present or replaced by a cantilever fixed dental prosthesis. Follow-up examinations were carried out over 15 years. A comprehensive outcome variable comprised four failure categories for which Kaplan-Meier survival (success) analyses were conducted. Half of the patients exhibited a continuous preservation of the per protocol prosthetic status that remained totally unaffected by complications for more than 10 years. The event-free success rates for moderate or worse failure implied a loss of the per protocol prosthetic status. The respective survival rates fell below 50% at 14.2 years in the PRDP group and 14.3 years in the SDA group. In none of the analyses, a significant group difference was found. In patients with an SDA condition, changes in the prosthetic status have to be expected. The affected proportion increases almost linearly from shortly after treatment and comprises the majority after 15 years. The influence of the examined treatments on success appears to be low.
Sections du résumé
BACKGROUND
BACKGROUND
Few long-term studies on treatments in the shortened dental arch (SDA) are available.
OBJECTIVE
OBJECTIVE
The objective of this trial was to analyse the long-term success of two different treatment concepts.
METHODS
METHODS
Patients over 35 years of age with missing molars in one jaw and at least the canine and one premolar present on both sides were eligible. In the partial removable dental prosthesis (PRDP) group (N = 81), molars and missing second premolars were replaced by a precision attachment retained prosthesis. In the SDA group (N = 71), the dental arch ended with the second premolar that had to be present or replaced by a cantilever fixed dental prosthesis. Follow-up examinations were carried out over 15 years.
RESULTS
RESULTS
A comprehensive outcome variable comprised four failure categories for which Kaplan-Meier survival (success) analyses were conducted. Half of the patients exhibited a continuous preservation of the per protocol prosthetic status that remained totally unaffected by complications for more than 10 years. The event-free success rates for moderate or worse failure implied a loss of the per protocol prosthetic status. The respective survival rates fell below 50% at 14.2 years in the PRDP group and 14.3 years in the SDA group. In none of the analyses, a significant group difference was found.
CONCLUSIONS
CONCLUSIONS
In patients with an SDA condition, changes in the prosthetic status have to be expected. The affected proportion increases almost linearly from shortly after treatment and comprises the majority after 15 years. The influence of the examined treatments on success appears to be low.
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
738-744Subventions
Organisme : Deutsche Forschungsgemeinschaft (German Research Association)
ID : DFG WA 831/2-1 to 2-6
Organisme : Deutsche Forschungsgemeinschaft (German Research Association)
ID : DFG WO 677/2-1.1 to 2-2.1
Organisme : Deutsche Forschungsgemeinschaft (German Research Association)
ID : WA 831/3-1
Organisme : Deutsche Forschungsgemeinschaft (German Research Association)
ID : LU 723/8-1
Organisme : Cendres & Metaux SA
ID : 0442-11
Organisme : Deutsche Gesellschaft für Prothetische Zahnmedizin und Biomaterialien e.V.
Organisme : Deutsche Gesellschaft für Zahn- Mund- und Kieferheilkunde
Informations de copyright
© 2021 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.
Références
McLister C, Donnelly M, Cardwell CR, et al. Effectiveness of prosthodontic interventions and survival of remaining teeth in adult patients with shortened dental arches-a systematic review. J Dent. 2018;78(11):31-39.
Fueki K, Baba K. Shortened dental arch and prosthetic effect on oral health-related quality of life: a systematic review and meta-analysis. J Oral Rehabil. 2017;44(7):563-572.
Käyser AF. Shortened dental arches and oral function. J Oral Rehabil. 1981;8(5):457-462.
Khan SB, Chikte UM, Omar R. An overview of systematic reviews related to aspects of the shortened dental arch and its variants in adults. Int J Prosthodont. 2017;30(4):357-366.
McKenna G, Allen PF, O'Mahony D, et al. The impact of rehabilitation using removable partial dentures and functionally orientated treatment on oral health-related quality of life: a randomised controlled clinical trial. J Dent. 2015;43(1):66-71.
Thomason JM, Moynihan PJ, Steen N, Jepson NJA. Time to survival for the restoration of the shortened lower dental arch. J Dent Res. 2007;86(7):646-650.
Khan S, Chikte UM, Omar R. Outcomes with a posterior reduced dental arch: a randomised controlled trial. J Oral Rehabil. 2017;44(11):870-878.
Luthardt RG, Marre B, Heinecke A, et al. The randomized shortened dental arch study (RaSDA): design and protocol. Trials. 2010;11:1-9.
Reissmann DR, Wolfart S, John MT, et al. Impact of shortened dental arch on oral health-related quality of life over a period of 10 years - a randomized controlled trial. J Dent. 2019;80(1):55-62.
Walter MH, Dreyhaupt J, Mundt T, et al. Periodontal health in shortened dental arches: a 10-year RCT. J Prosthodont Res. 2020;64(4):498-505.
Walter MH, Dreyhaupt J, Hannak W, et al. The randomized shortened dental arch study: tooth loss over 10 years. Int J Prosthodont. 2018;31(1):77-84.
Preshaw PM, Walls AWG, Jakubovics NS, et al. Association of removable partial denture use with oral and systemic health. J Dent. 2011;39(11):711-719.
Tada S, Ikebe K, Matsuda K-I, Maeda Y. Multifactorial risk assessment for survival of abutments of removable partial dentures based on practice-based longitudinal study. J Dent. 2013;41(12):1175-1180.
Moldovan O, Rudolph H, Luthardt RG. Clinical performance of removable dental prostheses in the moderately reduced dentition: a systematic literature review. Clin Oral Investig. 2016;20(7):1435-1447.
Mizuno Y, Bryant R, Gonda T. Predictors of tooth loss in patients wearing a partial removable dental prosthesis. Int J Prosthodont. 2016;29(4):399-402.