Abstract
ObjectivesThe objective of this study was to investigate the clinical course of shortened dental arches (‘SDA group’) compared to SDAs plus removable denture prosthesis (‘SDA plus RDP group’) and complete dental arches (‘CDA group’, controls).Materials and methodsData (numbers of direct and indirect restorations, endodontic treatments, tooth loss and tooth replacements) were extracted from patient records of subjects attending the Nijmegen Dental School who previously participated in a cohort study on shortened dental arches with three to four posterior occluding pairs (POPs).ResultsRecords of 35 % of the original cohort were retrievable. At the end of the follow-up (27.4 ± 7.1 years), 20 out of 23 SDA subjects still had SDA with 3–4 POPs compared to 6 out of 13 for SDA plus RDP subjects (follow-up 32.6 ± 7.3 years). Sixteen out of 23 CDA subjects still had CDA; none of them lost more than one POP (follow-up 35.0 ± 5.6 years). SDA group lost 67 teeth: 16 were not replaced, 16 were replaced by FDP and 35 teeth (lost in three subjects) replaced by RDP. Mean number of treatments per year in SDA subjects differed not significantly compared to CDA subjects except for indirect restorations in the upper jaw.ConclusionShortened dental arches can last for 27 years and over. Clinical course in SDA plus RDP is unfavourable, especially when RDP-related interventions are taken into account.Clinical relevanceThe shortened dental arch concept seems to be a relevant approach from a cost-effective point of view. Replacement of absent posterior teeth by free-end RDP cannot be recommended.
Highlights
The shortened dental arch concept is a potentially costeffective approach in the management of reduced dentitions
The outcomes are rather controversial: on the one hand, shortened dental arches are found to be related to oral healthrelated quality of life (OHRQoL) impairment [6], especially when first molar contacts were absent [7] and on the other hand, subjects with a shortened dental arch reported to be satisfied with their oral status [8]
The initial cohort, a convenient sample, comprised subjects with shortened dental arches in at least one jaw with three to four posterior occluding pairs (POPs) and intact anterior areas without distal extension removable dental prosthesis (RDP) (‘SDA group’, n074), subjects with a shortened dental arch extended by RDP (‘SDA plus RDP group’, n025), and subjects with complete dental arches (CDA) (‘CDA group’, n072, control group)
Summary
The shortened dental arch concept is a potentially costeffective approach in the management of reduced dentitions. This concept is globally accepted, but not widely practiced [1]. A body of mainly circumstantial evidence shows that shortened dental arches, comprising all anterior teeth and three to five occluding units, provide a stable and functional dentition with respect to chewing ability, aesthetics and oral comfort [2,3,4,5]. The functionality of shortened dental arches has been reflected in outcomes of studies on oral healthrelated quality of life (OHRQoL). Oral health care aims at the retention of at least a functional and natural dentition throughout life.
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