Restoration of the partially edentulous mouth — a comparison of overdentures, removable partial dentures, fixed partial dentures and implant treatment

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.