Kennedy Class Research Articles

Does a mandibular RDP and new maxillary CD improve masticatory efficiency and quality of life in patients with a mandibular Kennedy class I arch?

To evaluate the change in masticatory efficiency and quality of life of patients treated with mandibular Kennedy class I removable partial dentures (RPDs) and maxillary complete dentures at the Department of Dentistry of the Federal University of Rio Grande do Norte. A total of 33 Kennedy class I patients were rehabilitated with maxillary complete dentures, and mandibular RPDs were selected for this non-randomized prospective intervention study. The patients had a mean age of 59.1years. Masticatory efficiency was evaluated by colorimetric assay using fuchsin capsules. The measurements were conducted at baseline and 2 and 6months after prosthesis insertion. Quality of life was evaluated using the Oral Health Impact Profile (OHIP-14) at baseline and 6months after denture insertion. The Kolmogorov-Smirnov normality test was applied. Masticatory efficiency was evaluated by repeated measures ANOVA. Oral health-related quality of life was compared using the paired t test. There was no statistically significant difference in masticatory efficiency after denture insertion (p = 0.101). Significant differences were found (p = 0.010) for oral health-related quality of life. A significant improvement in psychological discomfort (p < 0.01) and psychological disability (p < 0.01) was observed. Mean difference value (95% confidence interval) was 6.8 (3.8 to 9.7) points, reflecting a low impact of oral health on quality of life, considering the 0-56 range of variation of the OHIP-14 and a Cohen's d of 1.13. According to the results of the present study, rehabilitation with Kennedy class I RPDs and complete dentures did not influence masticatory efficiency but improved oral health-related quality of life. The association between the patient's quality of life and the masticatory efficiency is important for treatment predictability.

The Use of Digital Impressions to Fabricate Tooth-Supported Partial Removable Dental Prostheses: A Clinical Report.

Impression making is a critical step in the fabrication of a partial removable dental prosthesis (RDP). A technique is described for making final impressions to fabricate partial RDPs for Kennedy class III patients using a computer-aided design and computer-assisted manufacturing digital impression system.

Pattern, incidence and causes of partial edentulism in a group of patients attending dental school of Sulaimani university

Objectives: The aim of this study was to determine the pattern of partial edentulism and its relationship with age, gender and etiological factors in group of patients attending prosthodontic department, School of dentistry, University of Sulaimani-Iraq.&#x0D; Materials and Methods: The study sample consisted of 274 patients attending prosthodontic department, the partial edentulism was recorded by visual examination using Kennedy’s Classification. The source of data was patient’s case sheets and the patients were informed that the recorded informations were required for a research purpose and their consent and agreements were taken verbally. Data was analyzed using SPSS version 16 and presented as a simple frequency table and figures.&#x0D; Results: The study results showed that 170 of the patients were female (62.1%) and 104 of the patient were male (37.9%). The most frequently occurred Kennedy class was Kennedy Class I (39.2%) followed by Kennedy Class III and II (31.9%), (27.6%) respectively and the least frequent was Kennedy Class IV (1.3%). The highest percentage of Kennedy class I arch was seen in the mandible (49.4%), while the most frequently seen Kennedy class in the maxilla was class III arch (40.9%), with an increase in age, there is an increase in class I and class II dental arches and a decrease in class III arch both in maxilla and in mandible. Finally, the results revealed that the most frequent reason of exodontias stand out to be caries in both male and female (81.7%), (85.2%) respectively.&#x0D; Conclusions: It was concluded that the most common pattern of partial edentulism in examined sample was found to be class I in mandible then class III in maxilla and class IV being the least common in both jaws. The mandibular arches are more partially edentulous than maxillary arches and female patients more demanding Prosthodontic treatments than male patients. With an increase in age there is a transition of bounded saddle to free end saddles and the principle cause of tooth loss was dental caries.

A survey to assess the validity of Kennedy's classification system in the present era

The present classification system for removable of partial dentures has been proposed by Dr. Edward Kennedy 87 years ago. With the decrease in prevalence of edentulousness, this system of classification is questionable in this modern technologically and scientifically advanced era. This survey is the first of its kind in assessing the validity of Kennedy's classification system. Based on the results obtained from the survey, a new system of classification has been proposed.

Implant-connected versus tooth-connected implant-supported partial dentures: 2-year clinical and radiographic comparative evaluation.

The purpose of this study was to clinically and radiographically compare implant-connected and tooth-connected implant-supported fixed-detachable mandibular partial dentures. Twenty partially edentulous patients (age range: 25 to 50 years) with mandibular Kennedy Class II configurations were equally divided into two groups receiving a three-unit, fixed-detachable, screw-retained partial denture. Group 1 comprised patients with unilateral missing mandibular molars and premolars. Two implants were placed at the mandibular first premolar and first molar areas. Group 2 comprised patients with missing mandibular molars and second premolars. An implant was placed at the mandibular first molar area, the first premolar was prepared, and a coping was cemented to the tooth with permanent cement. Each case was evaluated clinically and radiographically at baseline (partial denture insertion) and after 6, 12, and 24 months. Data were collected and statistically analyzed using repeated-measures one-way and two-way analysis of variance tests. There was no statistically significant difference between the two groups (P > .05). The implant-tooth-supported prosthesis provided an equally predictable treatment option compared to the totally implant-supported prosthesis in terms of implant survival and loss of marginal bone.

Fit accuracy of metal partial removable dental prosthesis frameworks fabricated by traditional or light curing modeling material technique: An in vitro study

ObjectiveThe aim of this study was to compare the fit accuracies of metal partial removable dental prosthesis (PRDP) frameworks fabricated by the traditional technique (TT) or the light-curing modeling material technique (LCMT).Materials and methodsA metal model of a Kennedy class III modification 1 mandibular dental arch with two edentulous spaces of different spans, short and long, was used for the study. Thirty identical working casts were used to produce 15 PRDP frameworks each by TT and by LCMT. Every framework was transferred to a metal master cast to measure the gap between the metal base of the framework and the crest of the alveolar ridge of the cast. Gaps were measured at three points on each side by a USB digital intraoral camera at ×16.5 magnification. Images were transferred to a graphics editing program. A single examiner performed all measurements. The two-tailed t-test was performed at the 5% significance level.ResultsThe mean gap value was significantly smaller in the LCMT group compared to the TT group. The mean value of the short edentulous span was significantly smaller than that of the long edentulous span in the LCMT group, whereas the opposite result was obtained in the TT group.ConclusionWithin the limitations of this study, it can be concluded that the fit of the LCMT-fabricated frameworks was better than the fit of the TT-fabricated frameworks. The framework fit can differ according to the span of the edentate ridge and the fabrication technique for the metal framework.

Clinical evaluation of removable partial dentures on the periodontal health of abutment teeth: a retrospective study.

The aim of this retrospective study was to evaluate the effect of removable partial dentures in periodontal abutment teeth in relation to the type of denture support and design of RPD in a five-year worn period. Methods : A total of 64 patients with removable partial dentures (RPDs), participated in this study. It were examined ninety-one RPDs. There were seventy-five RPDs with clasp-retained and sixteenth were RPDs with attachments. There were 28 females and 36 males, aged between 40-64 years, 41 maxillary and 50 mandible RPDs. For each subjects the following data were collected: denture design, denture support, and Kennedy classification. Abutment teeth were assessed for plaque index (PI), calculus index (CI), blending on probing (BOP), probing depth (PD), gingival recession (GR), tooth mobility (TM). Level of significance was set at p<0.05. Results : According to denture support of RPD, BOP, PD, PI, GR, CI and TM-index showed no statistically significant difference. Based on the denture design of RPD’s, BOP, PD, PI, CI, and TM-index proved no statistically significant difference. Except GR-index according to denture design confirmed statistically significant difference in RPD with clasp p<0.01. The higher values of all periodontal parameter as BOP, PD, PI, CI and TM were in patients with RPD’s with claps comparing with RPD’s with attachment. Conclusion : RPD’s with clasp increased level of gingival inflammation in regions covered by the dentures and below the clasp arms in abutment teeth.

Accuracy of surgical guides made from conventional and a combination of digital scanning and rapid prototyping techniques

Statement of problemSurgical guides aid in accurately placing dental implants to achieve a predictable restorative outcome. Which surgical guide fabrication technique results in the most accurately fitting surgical guide is unknown. PurposeThe purpose of this investigation was to determine the internal fit of dental implant surgical guides on dentate and edentulous ridges by using implant surgical guides fabricated from conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) techniques. Material and methodsEighty surgical guides were fabricated from conventional and CAD/CAM techniques; half were designed from Kennedy Class 2 (K2) casts, and half were designed from Kennedy Class 3 (K3) casts. Conventional surgical guides were fabricated from acrylic resin. The CAD/CAM surgical guides were scanned by using cone beam computed tomography (CBCT) or an optical scan (OS). The guides were printed with stereolithography (SL) or 3-dimensional digital printing (3DP). All surgical guides were cemented to their respective design casts, sectioned, and measured at standardized locations. A 2-way ANOVA and the post hoc Fisher least square difference t test was performed (α=.05). ResultsThe 2-way ANOVA indicated that the difference between surgical guide groups and Kennedy class was statistically significant (P<.05) and the interaction between groups and Kennedy class was statistically significant (P<.05). The OS/3DP CAD/CAM guide was the best-fitting cast for the K2 cast group, and the conventional guide was the best-fitting guide for the K3 group. ConclusionsConventionally fabricated and OS surgical guides have greater accuracy of fit than CBCT scanned surgical guides.

Prevalence and Clinical Effects of Certain Therapy Concepts among Partially Edentulous Serbian Elderly.

This study was conducted to identify the prevalence of partially edentulous individuals in Serbia and to identify prosthodontic treatment used for their rehabilitation as well as to compare prosthodontic treatment concepts among Serbian elderly participants who answered closed-format questionnaires. The study was conducted at the Clinic for Dental Prosthetics, University of Belgrade, Military Medical Academy and the Department of Prosthodontics of Home Centre Belgrade; the study consisted of 120 participants. A questionnaire with closed-format questions regarding the influence of applied therapy concepts for participants with Kennedy Class I partial edentulism was created. Statistical software SPSS 11.5 was used for data analysis. Chi-square tests were performed, and p-values were calculated for each parameter. A total of 1081 people were examined; 730 participants were partially edentulous in at least one jaw. Five hundred forty-one participants wore Kennedy Class I maxillary or mandibular removable partial dentures (RPDs). Ninety percent of the patients were restored with RPDs; 60% of participants were unrestored, had shortened dental arches, and requested alternative therapeutic solutions. Significantly lower needs for new treatments were identified in participants with fixed dental prostheses (7.5%). Kennedy Class I was the most common type of partial edentulism among Serbian elderly, usually treated with RPDs. Elderly participants with the applied shortened dental arch and RPD therapy concepts requested alternative therapeutic solutions more often than those rehabilitated with fixed partial dentures.

Prevalence of partial edentulousness among the patients reporting to the Department of Prosthodontics Sri Ramachandra University Chennai, India: An epidemiological study.

Aims and Objectives:To determine the occurrence of various missing teeth pattern among the partial edentulous patients residing in Chennai who are undergoing treatment for the replacement of missing teeth in the Department of Prosthodontics, Sri Ramachandra University Chennai, India.Settings and Design:Study was undertaken from January 2014 to October 2014, and the design was a descriptive cross-sectional study.Materials and Methods:Five hundred and sixty-one persons aged between 13 and 87 years (267 males and 294 females) were selected, intraoral examination was done visually and results were recorded on specially designed clinical examination forms.Statistical Analysis:Data were analyzed using statistics SPSS 19.0 version (IBM India Private Limited Bangalore) to investigate the relationship between quantitative variables.Results:The results showed the patients with Kennedy's Class III were found to be the most prevalent among all the groups (55%). The most common modification in all the groups was Class III modification I (26%). It was also found that Kennedy's Class III was founded more in the age group of 31–40 with 54.4% in the maxillary arch and 47.2% in the mandibular arch.Conclusion:The findings of this study show that the Kennedy's Class III was the most commonly occurring and were found to be more predominant in the younger group of population.

Functionally generated pathways to develop occlusal scheme for removable partial denture

The functionally generated pathway (FGP) technique consists of registering the occlusal pathways of the posterior teeth in the functional wax and has been classically described as the three-dimensional static expression of dynamic tooth movement. This clinical report describes the treatment of a partially edentulous patient, with a cast removable partial denture, in which occlusion was developed using the FGP procedure. The FGP technique utilizes the patient's masticatory system to develop occlusion and has the advantages of being simple, accurate, and reliable. If the FGP technique is properly accomplished, only minor intraoral occlusal adjustments are necessary. This article described a technique of developing the FGP occlusion for a patient with cast partial denture with Kennedy's Class III edentulous mandibular arch. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY The FGP is highly versatile technique of developing the occlusion-pattern in the removable and fixed dental prostheses including implant restorations. It can be employed with equal efficacy in fabrication of relatively simple restorations such as a single crown, or more complex full mouth reconstructions.

Long-span fixed dental prostheses not meeting Ante's law: a retrospective analysis.

The aim of this retrospective study was to evaluate the long-term outcomes of long-span fixed dental prostheses (LSFDPs) not meeting Ante's law. This study is based on the data of 36 patients who received 41 LSFDPs. The mean survival time of the LSFDPs was calculated using the Kaplan-Meier technique. The influence of the factors (gender, localization, number of abutments, Kennedy Class, dentition of the opposing jaw) were analyzed (log-rank test and Cox regression; P < .05). During the observation period, 22.0% (n = 9) of the LSFDPs ceased to function. The calculated outcome probability after 3 years was 88.3%, and 57.4% after 5 years. The only significant difference in the mean survival time could be found in LSFDPs with two abutment teeth in comparison with LSFDPs with three and more abutment teeth. Although all of the patients were invited to an oral health and maintenance program regularly, only 13.8% attended. The results, taken together with data from the literature, indicate that the patient's compliance is a crucial factor in the successful implementation of a LSFDP, whereas other factors are of minor importance.

Patient satisfaction and complication rates after delivery of removable partial dentures: A 4-year retrospective study

Background: Patients' satisfaction and complication rates of removable partial dentures (RPDs) can affect patient acceptance and compliance in using RPDs. This study aims to determine complication and satisfaction rates in patients wearing RPDs. Materials and Methods: Patients that were treated with RPDs at the Prosthodontic Department in the last 4 years (2010-2014) were invited for a clinical examination. Demographic information and RPD characteristics (Kennedy classification; edentulous jaw: Upper versus lower; clinician: General dental students or prosthodontic residents; denture type: Cobalt-chromium or full acrylic) were recorded. The patients' satisfaction was measured on the basis of four criteria: Mastication, esthetic appearance, speech, and comfort components by a visual analog scale. Data were analyzed by SPSS version 18 using Kruskal-Wallis and Mann-Whitney tests (P 0.05). Conclusion: The findings of this study revealed that RPD complications were not uncommon. The clinicians' experience can influence postinsertion patient satisfaction and complication rates.

Effect of storage time and framework design on the accuracy of maxillary cobalt-chromium cast removable partial dentures.

Statement of Problem:Inaccuracies in the fit of palatal major connectors may be related to distortion of the wax pattern due to prolonged storage time and faulty major connector design.Purpose:This in vitro study was carried out to find out the effect of storage time and major connector design on the accuracy of cobalt-chromium cast removable partial dentures (RPDs).Materials and Methods:A brass metal die with a Kennedy Class III, modification 1, the partially edentulous arch was used as a master die. Thirty-six refractory casts were fabricated from the master die. The refractory casts were divided into three groups (Group I: Anterior-posterior palatal bar, Group II: Palatal strap and Group III: Palatal plate) based on the design of maxillary major connector and subdivided into four groups (sub Group A: 01 h, sub Group B: 03 h, Sub Group C: 06 h, and sub Group D: 24 h) based on the storage time. For each group, 12 frameworks were fabricated. The influence of wax pattern storage time and the accuracy of the fit palatal major connector designs on the master die were compared. Casting defects (nodules/incompleteness) of the frameworks were also evaluated before finishing and polishing. Repeated measures analysis of variance was used to analyze the data.Results:The gap discrepancy was least in sub Group A (01 h) followed by sub Group B (03 h) and C (06 h) and most in sub Group D (24 h). Statistically significant differences (P < 0.05 in all locations L1–L5) in the fit of the framework were related to the design of the major connector. The gap discrepancy was least in Group I (anterior-posterior palatal bar) followed by Group II (palatal strap) and most in Group II (palatal plate).Conclusions:It is recommended that the wax patterns for RPD to be invested immediately on completion of the wax procedure. The selection of a major connector design is crucial for an accurate fit of RPD.

The Detection of BANA Hydrolysis Activity in Abutment Teeth in Patients with Removable Partial Denture

ABSTRACT Purpose The aim of this study was to detect the presence of N-benzyl-Dl-arginase-2-naphthalamide (BANA) micro- organisms in chronic periodontitis of abutment teeth in subjects wearing removable partial dentures (RPDs) by measuring the red complex using BANA-ZymeTM test. Materials and methods Twenty-five subjects (mean age: 59.3 years) with Kennedy class II partially edentulous arch participated in this study. The microbiological record of red complex was done by BANA-Zyme kit and clinical parameters, such as plaque index (PI), gingival index (GI) and probing depth were recorded at abutment teeth in contact with the direct retainer of unilaterally designed RPDs and the corresponding nonabutment teeth on the opposite side. Results Mean scores of BANA for the red complex, PI and GI of the abutment teeth were significantly greater than those of the nonabutment teeth (p &lt; 0.01). No significant mean difference in pocket depth (PD) was found between the abutment and nonabutment teeth. Logistic regression analysis revealed that abutment teeth, high scores of PI and a maintenance interval longer than 6 months were significant predictors for positive red complex scores (p &lt; 0.05). Conclusion These results suggest that the microbiological risk for periodontitis of abutment teeth is greater than that for nonabutment teeth in RPD wearers. How to cite this article Kalaria JP, Patel BG, Patel V, Agrawal C. The Detection of BANA Hydrolysis Activity in Abutment Teeth in Patients with Removable Partial Denture. Int J Prosthodont Restor Dent 2015;5(2):31-37

Stress analysis induced by casted and flexible designs used in Kennedy class II modification 2 with pierabutment.

Stress analysis induced by casted and flexible designs used in Kennedy class II modification 2 with pierabutment.

In Vitro Comparative Study of Retention of Maxillary Kennedy Class I Removable Partial Denture Retained with Four Different Designs of Esthetic Clasps

To study the effect of clasp, design, material, and amount of retentive undercut of esthetic clasp on retention of removable partial dentures restoring maxillary Kennedy class I removable partial denture.

Signs of Combination Syndrome and removable partial denture wearing

Introduction: Combination Syndrome (CS) is a pathological condition observed in maxillary complete denture (CD) and mandibular removable partial denture (RPD) wearers. Purpose: The aim of this study was to observe and measure the prevalence of CS signs in treatment-seeking wearers of maxillary CD associated or not with RPD (mandibular Kennedy Class I). The association between RPD wearing and the number of CS clinical signs was also evaluated. Material and method: The sample included 62 patients seen at the Department of Dentistry, Federal University of Rio Grande do Norte (UFRN). A clinical oral examination was conducted to assess the presence of specific clinical signs of CS as described by Kelly (1972): bone resorption in the maxillary anterior region, tuberosity overgrowth, palatal papillary hyperplasia, extrusion of mandibular anterior teeth and bone resorption in the mandibular posterior region. The chi-square test at the 95% level of significance was used to test the association between dependent and independent variables. Result: Mandibular resorption was the most frequent complication (93.5%). There was a statistically significant difference between RPD wearers and non-wearers with regard to extrusion of mandibular anterior teeth (p = 0.045). Conclusion: Within the limitations of the present study, a high prevalence of CS clinical signs was observed, but no association between RPD wearing and syndrome characteristics was found.

Fuerza máxima de mordida en pacientes adultos mayores de origen mapuche y no mapuche portadores de prótesis parciales removibles clase I Kennedy

ObjectiveTo compare the maximum bite force (FMM), in two different measurement periods, of mapuche and non-mapuche elderly patients with both maxillary and mandibular Kennedy class I removable partial dentures. Patients and methodsA total of 40 subjects with ages ranging between 60 and 80 years were divided into 2 groups according to their ethnic origins to measure FMM in the molar region using a hydraulic device. The subjects were instructed to perform three bites with each side as hard as possible, and the highest value was considered as the maximum force. Data were analyzed by Student's t- test and Levene test. ResultsMale gender showed higher FMM values (p<0.05). The group of mapuche individuals showed the highest values of FMM (p<0.05). Finally, considerably higher FMM values were identified at one-month period subsequent to the insertion of the new prosthesis (p<0.05). ConclusionsThe highest FMM values were observed in patients of mapuche ethnic origin, in male patients, and at one-month period after both prostheses were inserted.

Partially Edentulous Arches: A 5-Year Survey of Patients Treated at the Fluminense Federal University Removable Prosthodontics Clinics in Brazil.

This study investigated the number and Kennedy Classification of the edentulous arches in patients treated at the Removable Partial Denture (RPD) Clinics of the Fluminense Federal University School of Dentistry (FO-UFF) in Rio de Janeiro, Brazil, from 2005 to 2010. A cross-sectional retrospective survey was conducted on patient record charts to identify gender, age, number, and location of the edentulous arches, and Kennedy Class type. One hundred and forty-six patients were analyzed for this study (96 [65.8%] women and 50 [34.2%] men). Two hundred and ninety-two arches were analyzed: 74 arches (25%) were found with intact dentitions, 18 (6.1%) were edentulous arches, and 200 (68.8%) were partially edentulous arches. Ninety-one patients (62.3%) needed oral rehabilitation with RPDs on one arch and 55 (37.7%) in both arches. One hundred and eight (53.2%) partially edentulous mandibles and 92 (46.8%) partially edentulous maxillae were found. Kennedy Class I was more frequent in the mandibular arch (58 patients; 29%) whereas Kennedy Class III was more frequent in the maxillary arch (40 patients; 20%). Patients aged between 51 and 60 years presented the highest percentage of partially edentulous arches (33.6%). Mandibular Kennedy Class I and maxillary Kennedy Class III presented the highest frequency in patients treated at the FO-UFF. These results are in agreement with previous studies that evaluated the different Kennedy classes in partially edentulous arches.