Partial Removable Dental Prosthesis Research Articles

Dental prosthesis plaque index of Augsburger and Elahi: Expansion and standardisation in community-dwelling frail older people.

Inadequate daily oral hygiene care of dental prostheses could worsen general health of frail older people. The index of Augsburger and Elahi is often recommended to assess maxillary dental prosthesis plaque (DPP). To assess the reliability of an expanded and standardised DPP index of Augsburger and Elahi in trained and untrained examiners, and to determine the applicability of the index in community-dwelling frail older people. Ten community-dwelling frail older persons with complete and partial removable dental prostheses (RDPs) (mean ± SD age = 87.9 ± 8.4 years) participated. Seven persons were revisited after 3 months. The index was expanded with mandibular RDPs. Standardisation was achieved with a specially designed reference sheet. The RDPs were photographed after plaque colouring. Two trained examiners scored the photographs; thereafter, two untrained examiners. One trained examiner scored the photographs again after 3 weeks. Changes in DPP over the 3-month period were assessed with Wilcoxon signed-rank test. Inter- and intra-examiner reliability was assessed with intraclass correlation coefficients (ICCs). The DPP scores did not change significantly over time (Z = -0.594, p = 0.553). Inter-examiner reliability was excellent in the trained examiners (ICC = 0.859-0.947), and fair-to-good in the untrained examiners (ICC = 0.671-0.703). Intra-examiner reliability was excellent (ICC = 0.941-0.962). The proposed expansion and standardisation of the DPP index has an excellent inter- and intra-examiner reliability when performed by trained examiners, and a fair-to-good inter-examiner reliability by untrained examiners. Therefore, the index could be recommended for application in dental prostheses-wearing older persons and could be useful for awareness and education of professional and informal caregivers and the older persons themselves. The Netherlands Trail Register NTR6159.

A Comparative Evaluation of Removable Partial Denture Prostheses and Dental Caries Status among Diabetic and Nondiabetic Patients

Abstract Introduction Oral health is an integral part of general health. Systemic diseases such as diabetic condition and local factors have an impact on oral health of individuals. Dental caries is one of the most common oral health conditions affecting 60 to 90% of the population. Acrylic removable partial denture (RPD) is one of the most widely accepted means of tooth replacement. Its insertion in the mouth leads to altering the oral environment and increases plaque formation, particularly on tooth surface of those in contact with the acrylic partial denture facilitating the initiation of caries. Aim The aim of the study was to evaluate the effect of acrylic RPDs on caries prevalence in diabetic and nondiabetic patients. Methodology This comparative study was performed on 400 patients of age between 20 and 64 years visiting JSS Dental College and Hospital in Mysuru. Patients participating in this study were explained regarding the survey analysis and informed consent was taken. It was a questionnaire-based clinical study. Inclusion and exclusion criteria were considered for the selection of the study sample and categorize the patients into one of the following groups, with prostheses (Group A) and without prostheses (Group B) and subgroups diabetic patients with prostheses (Group A1) and nondiabetic patients with prostheses (Group A2). Diabetic patients without prostheses (Group B1) and nondiabetic patients without prostheses (Group B2). Sociodemographic information of each patient was recorded, and clinical examination was performed for decayed, missing, and filled teeth (DMFT) using DMFT index. Results A statistically significant high prevalence of dental caries was observed among nondiabetic patients with acrylic RPD (Group A2). Conclusion Acrylic RPD and diabetes had least role in caries prevalence.

Oral health-related quality of life and reasons for discontinuing partial removable dental prosthesis usage: a cross-sectional study with one to seven years of follow-up

BackgroundIn partial edentulous individuals, a partial removable dental prosthesis (PRDP) is a common dental replacement option to improve oral function and quality of life. However, some patients discontinue using their denture over time. The aim of this study was to determine the prevalence and characteristics of partial edentulous patients who no longer wear their dentures, explore their reasons, and assess their oral health-related quality of life (OHRQoL).MethodologyThis cross-sectional study, conducted at Chulalongkorn University Dental School from 2013 to 2019, involved patients who received PRDP treatment. They were contacted via phone calls and asked about their denture usage. Eligible participants were patients who had stopped or rarely used their PRDPs. Data on oral status, health insurance, and PRDP variables were collected from hospital records. Telephone interviews were conducted to collect the initial reasons for seeking PRDP treatment, reasons for discontinuation, desire for a new PRDP, and OHRQoL. The Oral Impacts on Daily Performances index was used to assess the OHRQoL. The score was dichotomized into the absence or presence of oral impacts. Chi-square tests and multivariable binary logistic regression were employed to determine the associations between oral impacts and various factors in the participants who discontinued PRDP usage.ResultsAmong the 975 contacted participants, 175 (17.9%) discontinued using their PRDPs. Most of these individuals had at least 20 remaining natural teeth and/or 4 posterior occluding pairs. The primary initial reason for seeking PRDP treatment was often based on a dentist’s suggestion. Although many participants reported no impact on OHRQoL and did not express the need for new PRDPs, those experiencing oral impacts were more likely to seek replacements.ConclusionsWith up to 7 years follow-up duration, individuals with partial edentulism and sufficient remaining functional dentition without oral impacts were more inclined to discontinue PRDP usage. Those with maxillary anterior teeth loss were less likely to discontinue using their PRDP. The primary initial reason for seeking PRDP treatment was often a dentists’ suggestion. However, the individuals reporting oral impacts expressed their needs for new denture replacements. This highlights the significance of incorporating patient needs and preferences in prosthodontic decision-making.

Clinical Measurements of Force Exerted on Anterior Teeth in Partial Edentulous Distal Extension.

To determine the influence of partial edentulous distal extension and the use of removable partial dental prostheses in partially edentulous areas on the force exerted on the anterior teeth. A total of 83 volunteer patients participated in this study. The occlusal force was measured using an occlusal force measuring sheet in the patient's mouth. The occlusal forces and ratios were compared using the Wilcoxon signed-rank test (P < .05). The force exerted on the anterior teeth increased significantly as the number of remaining teeth decreased in an edentulous distal extension. The force exerted on the anterior teeth decreased significantly with the use of a removable partial dental prosthesis. In a clinical setting, when the number of remaining teeth in a partial edentulous distal extension decreases, the burden on the anterior teeth increases. Our findings suggest that, for patients with partial edentulous distal extension, using a removable partial dental prosthesis is effective in preserving the residual anterior teeth by reducing excessive force.

Evaluation the Effect of Diazonium Salt and Aluminum Oxide on the Shear Bond Strength of Heat Cure Acrylic Resin at Co/Cr and Titanium Alloys Interface

Bonding between metal components and denture base resin plays an important role in the success of removable partial denture. Removable partial denture prostheses often present a mechanical failure. The bonding between metal framework and acrylic resin is usually a mechanical interlock, since they do not chemical bond spontaneously. The aim of this study was to evaluate the effect of different surface treatments (diazonium salt and aluminum oxide) on the shear bond strength of PMMA at the Co/Cr and titanium alloys interface. Sixty-disc shape specimens were prepared and divided into 2 main groups according to the type of material, 30 specimens for Co/Cr alloy and 30 specimens for titanium alloy, then subdivided into 3 groups each one consist of 10 specimens, according to type of surface treatments. Each group had control group, aluminum oxide group (110 μm), and diazonium salt group. The specimens were thermocycled (3000 cycles) after applications of PMMA. Shear bond strength test conducted with crosshead speed 0.5mm/min. Data analyzed via One-way ANOVA and GHD test. Co/Cr alloy revealed that diazonium salt surface treatment had highest mean value of shear bond strength followed by aluminum oxide surface treatment at p&lt;0.01. For titanium alloy, the results showed the diazonium salt surface treatment had highest mean value of shear bond strength followed by aluminum oxide surface treatment group at p&lt;0.01. Aluminum oxide treatment slightly increased shear bond strength for both Co/Cr and titanium, while diazonium salt treatment statistically increased shear bond strength for Co/Cr and titanium alloy.

Evaluation of physico-mechanical properties of dental plaster modified with pulverized acrylic waste

Background: Dental plaster is most widely used to make temporary casts and as an investment medium during the fabrication of removable complete and partial denture prostheses. Dental plasters exhibit poor mechanical properties. Aim: This study aimed to evaluate the physico-mechanical properties of dental plaster modified with various concentrations of pulverized acrylic waste. Materials and Methods: A total of 120 specimens were fabricated using dental plaster and were divided into four groups of 30specimens each to evaluate setting time, one-hour compressive strength, 24-hour compressive strength, and surface reproducibility. Each group was subdivided into five groups of six specimens (n=6), each with the incorporation of various concentrations of pulverized acrylic powder. The specimens incorporated with various concentrations of pulverized acrylic powder (0.5 wt%, 1.0 wt%, 5.0 wt% and 10.0 wt%) were considered as modified groups and the dental plaster with no additives was considered as a control group. The initial and final setting times were measured using a Gillmore needle apparatus, the compressive strength was measured using a universal testing machine, and the surface reproducibility was analyzed using a stereo microscope. The obtained data were subjected to statistical analysis using one-way ANOVA and post hoc analysis. Results: The incorporation of 0.5 wt% resulted in more final and initial setting times. The one-hour and 24-hour compressive strengths of the dental plaster increased with increasing concentration of acrylic waste. Poor surface details were observed with an increase in the concentration of acrylic waste. Conclusions:The addition of acrylic waste resulted in an increase in the one-hour and 24-hour compressive strengths, decreased initial and final setting times, and poor surface reproducibility.

Effect of silver nanoparticles incorporation on impact strength of Heat-cure denture base resins

Background:Poly (Methyl methacrylic acid) based materials are widely used for the fabrication of removable complete and partial denture prostheses. these materials are prone to fractures when subjected to impact forces. While recent studies have explored the antimicrobial potential of denture base materials incorporating silver nanoparticles, their impact on the mechanical properties crucial for the prosthesis's durability has not been adequately established.Aim:To evaluate the impact strength of the heat-cure denture base materials incorporated with various concentrations of silver nanoparticles. Materials and Methods:Silver nanoparticles were incorporated at various concentrations (0.5, 1.0, 2.0 and 5.0 wt%) into three different heat-cure denture base materials. A total of 150 rectangular-shaped specimens (50 x 6 x 4), which comprises 50 samples from each of the three heat-cure acrylic resins were made using the compression molding technique. Ten specimens (n=10) were allocated for each concentration such as control, 0.5wt%, 1.0wt%, 2.0wt% and 5.0wt% concentrations of silver nanoparticles. A “V” notch was made exactly at the centre of each specimen to prevent the ductile fracture. The impact strength was evaluated using the Izod impact tester. The data were subjected to One-way ANOVA and Post hoctests for statistical analyses.Results: A decrease in the impact strength was observed in the modified groups compared to the control groups. One-way ANOVA showed significant differences (p=0.000) among the different concentrations of all three denture base materials.Conclusion:Silver nanoparticles incorporation reduced the impact strength of the denture base materials.

Polyetherether-Ketone (PEEK) Kennedy Class III Removable Partial Dentures: A case report

Modified poly-ether-ether-ketone (PEEK) is a new material that can be used for patients allergic to metals, or who dislike the metallic taste, the weight, and for patients with aesthetic concerns related to the visibility of the metallic clasps. This polymer would allow increased biocompatibility, durability, and elasticity, as well as more esthetically pleasing results. It has been used for years in orthopedics and medical field. The clinical use of PEEK removable partial denture prosthesis frameworks is presented as an alternative for the conventional metallic prosthesis.

Narrow-Diameter Implants for Partial Fixed and Removable Prostheses: A Systematic Review and Meta-Analysis.

To answer the following focus question: Are narrow-diameter implants feasible to support fixed dental prostheses (FDPs) and partial removable dental prostheses (PRDPs)? This review followed the PRISMA statement and was registered in the PROSPERO database (CRD42020153729). Six databases and the gray literature were searched through October 2021 without language, publication time, or follow-up restrictions. The main outcomes were survival, success, and marginal bone loss (MBL). Risk of bias was assessed for each study design, and random-effects meta-analyses were performed (α = .05). Seventeen studies were included in the qualitative analysis, and 3 were included in the meta-analyses. In total, 1,624 NDIs and 339 standard-diameter implants (SDIs) were placed in 1,060 patients. Follow-up varied from 1 to 10 years, and 17 failures (implant loss) were recorded. No differences in survival rate for FDPs supported by NDIs vs SDIs were found (odds ratio [OR] = 0.59, 95% CI: 0.18 to 1.92, P = .38). However, Kaplan-Meier analysis evaluating only NDI performance revealed a higher survival rate of NDIs ≥ 3.3-mm diameter (P = .002), placed with delayed loading (P = .024), and placed in the maxilla (P = .014). FDPs supported by NDIs vs SDIs presented similar success rates (OR = 1.48, 95% CI: 0.41 to 5.34, P = .55); however, MBL was lower in the NDI group (mean difference = -0.23 mm, 95% CI: -0.41 to -0.06, P = .01). Insufficient data regarding PRDPs were available. Despite the limited studies available, FDPs supported by NDIs presented survival and success rates comparable to those supported by SDIs, with slightly lower MBL. For PRDPs, strong conclusions were not possible.

Force exerted on maxillary anterior teeth in mandibular unilateral and bilateral distal extension partial edentulous situation.

The purpose of this study was to determine the influence of mandibular unilateral and bilateral distal extension partial edentulous situation and the use of removable partial dental prostheses on the force exerted on maxillary anterior teeth. A commercially available jaw model with exchangeable teeth was used. Seven experimental conditions of mandibular distal extension edentulous situation were prepared and a distal extension removable partial dental prosthesis to replace missing posterior teeth was fabricated. The occlusal force was measured by inserting an occlusal force measuring film between the maxillary and mandibular teeth of the model. An occlusal load was applied and the forces and ratios were compared using the Kruskal-Wallis test and the Mann-Whitney U test (p < 0.05). As a result, the force exerted on the maxillary anterior teeth increased significantly as the number of remaining teeth decreased in unilateral and bilateral edentulous situation. The force exerted on the maxillary anterior teeth decreased significantly with use of a removable partial dental prosthesis. It is concluded that when the number of remaining teeth decreases in mandibular unilateral and bilateral distal extension partial edentulous situation, the burden on the maxillary anterior teeth increases. Our findings suggest that for patients with mandibular distal extension partial edentulous situation, using a removable partial dental prosthesis is effective in preserving the remaining teeth by reducing excessive force.

Uso e necessidade de próteses dentárias em idosos domiciliados: um estudo transversal de base populacional

Abstract Background By the use of complete or partial dental prosthesis, function, esthetics, and phonetics are reestablished. Few population-based studies are available in the literature using an older adult population. Objective Evaluate the use of and need for dental prostheses and their associated factors. Method This study included a random sample of 287 elderly, in the city of Cruz Alta, Brazil. Use of and need for dental prostheses were the main outcomes, and two analytical models were constructed. Subgroup analyses were performed for individuals using fixed partial denture (FPD) and removable (partial and/or complete) dental prosthesis (RDP). Results Use of and need for dental prosthesis were identified in 83.6% (n=240) and 42.5% (n=122) of the elderly, respectively. Women presented a significantly higher prevalence ratio (PR) for use of dental prostheses (PR=1.15; 95%IC:1.02–1.28) and lower need (PR=0.70; 95%IC:0.54–0.91). No statistically significant difference was demonstrated for the use of FPD regarding the sex. Higher education level was associated with lower use of prostheses (PR=0.73; 95%IC:0.58–0.91) when compared to lower level of education. Medium level of education showed a significantly lower need for dental prostheses (PR=0.61 – 95%IC:0.39–0.94). Those that did not consume alcohol presented with a significantly lower use of FPD and RDP (PR=0.46; 95%IC:0.23–0.93 and 0.90;0.81–0.99, respectively). Conclusion The use of and need for dental prostheses were associated with sex, level of education, and behavioral factors.

Evaluation of Perceived Possible Outcomes in Patients Treated with Mandibular Distal Extension Partial Removable Dental Prostheses

Objectives: This study evaluated the perceived positive and negative general and oral health outcomes of patients after using mandibular distal extension partial removable dental prostheses (PRDPs) and assessed the effect of recall procedures on the treatment outcomes. Methods: A questionnaire comprising 20 items, pertaining to perceived positive and negative outcomes related to the patients’ perception scores after using mandibular distal extension PRDPs, was designed. The patients were recalled 1 week and 3 months after the insertion of the mandibular distal extension PRDPs. The perception scores were obtained, and the mean values calculated at 1 week and 3 months were compared using the paired t-test. Results: A significant difference in the mean scores was observed for the perceived positive outcomes (p = 0.018) but not for the perceived negative outcomes at 1 week and 3 months. Most patients agreed or strongly agreed with the statements concerning the perceived positive outcomes and disagreed or strongly disagreed with those concerning the perceived negative outcomes after 3 months. Conclusion: Most patients were satisfied with their mandibular distal extension PRDPs in terms of the perceived positive outcomes and disagreed with the statements concerning the perceived negative outcomes. The questionnaire was deemed appropriate for measuring the patients’ perceptions about the possible outcomes of using mandibular distal extension PRDPs

Comparison of digital and conventional methods of fit evaluation of partial removable dental prosthesis frameworks fabricated by selective laser melting

Statement of problemThree-dimensional (3D) printing technology may improve the fit of partial removable dental prosthesis frameworks made by selective laser melting. Conventionally, the gaps between definitive casts and prostheses are evaluated by using clinical replicas, but digital evaluations may provide a better alternative. PurposeThe purpose of this in vitro study was to compare digital and conventional methods for evaluating the fit of partial removable dental prosthesis frameworks made by selective laser melting. Material and methodsA printed resin definitive cast representing a Kennedy class II modification 2 design with 5 reference markers was made from a dentiform cast. Twelve cobalt-chromium partial removable dental prosthesis frameworks were fabricated by selective laser melting on this definitive cast with a digital design software program. The gaps between the frameworks and the cast were assessed by using the clinical replica method with a silicone impression material and measuring the thickness at each marker with calipers. Digital casts of each framework and the definitive cast were scanned and then registered with the CloudCompare software program to measure 3D gaps at the 5 reference markers and 3 occlusal rests. The results were analyzed individually for each technique by 1-way analysis of variance (ANOVA) with post hoc Bonferroni tests (α=.05). ResultsFor clinical registration, the mean gap between the frameworks and definitive cast was 13.9 ±7.6 μm. For digital registration, the root mean square gap was 70.7 ±24.2 μm. Statistically significant differences among the gaps for different markers were found for both approaches (P<.05). There were no significant differences among the gaps between the different frameworks. In both situations, the gap measurements were below the 300-μm clinically acceptable standard. ConclusionsBoth registration methods determined whether the fit of a framework fabricated by selective laser melting was within a clinically acceptable standard. The differences in the values produced most likely arose from the different registration methods.

Effect of Acrylic Removable Partial Denture in Caries Prevalence Among Diabetic and Non-Diabetic Patients.

Background:Dental caries is the most prevalent dental disease affecting human race. The etiology and pathogenesis of dental caries are known to be multifactorial. Studies have shown that removable partial dentures in the oral cavity increases the biofilm formation and consequently an increase in the occurrence of caries and periodontal diseases. There is a complex relationship between diabetes mellitus and dental caries. Patients with diabetes are more susceptible to oral sensory, periodontal, and salivary disorders which could increase the risk of developing new and recurrent dental caries. Therefore, the aim of the study was to assess the prevalence of dental caries among diabetic and non-diabetic acrylic removable partial denture wearers.Materials and Methods:Individuals participating in the study were partially edentulous and aged between 18 and 64 years. Patients were screened at Out patient department (OPD) in the Department of Prosthodontics JSSDCH, among which 60 patients were diabetic based on the random blood sugar level more than 160 mg/dl—30 patients were wearing RPD and 30 were without RPD. And 60 non-diabetic patients were selected among which 30 were wearing RPD and 30 without RPD. A total 120 patients were screened. Dental caries prevalence was assessed using Decayed, Missing, Filled (DMFT) index.Results:Diabetic group unrehabilitated with removable partial prosthesis showed significant difference in the number of missing teeth when compared to non-diabetic patients without removable prosthesis (P < 0.05).Conclusion:Removable partial denture prosthesis had less impact on prevalence of dental caries with good oral hygiene, following post insertion RPD instructions and regular dental visits irrespective of diabetes.

Dental status and prosthetic treatment needs among adult refugees in Germany.

Due to the current global situation of refugees, Europe has experienced increased migration from African, Middle Eastern, and Eastern European countries. The objective of this study was to explore oral health, especially prosthetic status and treatment needs, in adult refugees, and to compare these findings with German cohorts. This representative, multicenter, cross-sectional survey on oral health and treatment needs among refugees was carried out in 10 registration centers for asylum seekers aged 18 to 75 years across Germany in 2016 to 2017. The clinical examination included past caries experience (DMFT) and both existing and necessary prosthetic measures. These measures were registered according to the National German Health Survey 2016 and compared to the German resident population. A high untreated caries experience (DT 3.9 ± 4.6) was found among refugees (n = 288, age 37 ± 12), in addition to the expected increase of caries experience with getting older (DMFT 7.4 ± 5.7 to 14.9 ± 7.7). In contrast to the German resident population, extractions were the preferred past caries treatment, resulting in a considerable number of missing teeth (MT 7.6 ± 7.3, FT 3.6 ± 4.3, 45- to 64-year-olds). Existing prosthetic treatments such as partial and full removable dental prostheses were very rare among refugees (2% to 4%). Fixed dental prostheses were mostly required in the mandible of young adults (25%, 18- to 44-year-olds), while elderly refugees required more often removable dental prostheses (45 to 64 years, 39.7% maxilla, 38.4% mandible). Newly arrived refugees in Germany exhibit higher dental treatment needs in general and prosthetic treatment needs in particular due to former extractions, which were performed as a main caries treatment.

Prosthetic rehabilitation status, dental prosthesis functionality and masticatory function in nursing home residents.

To evaluate the association of masticatory function with prosthetic rehabilitation status and dental prosthesis functionality in nursing home residents. Prosthetic rehabilitation status and dental prosthesis functionality may adversely affect mastication of older people, and this relationship is underestimated in nursing home residents. This cross-sectional study included 179 nursing home residents who used dental prostheses [mean (SD) age: 78.9 (9.0) years]. Masticatory function data were determined by assessing (a) masticatory performance using two-colour chewing gum, and (b) swallowing thresholds by counting the number of peanut chewing cycles. Older adults were categorised as: (1) using dental prostheses in both jaws (n=100) and (2) partially dentate using removable partial dental prostheses (RPDPs) or complete dentures (CDs) in only one jaw (n=41), or (3) edentulous using CD in only one jaw (n=38). Stability, retention, occlusion, vertical dimension and defects were considered in assessing dental prosthesis functionality. Greater variance of hue (VOH) of the chewing gum and lower swallowing thresholds (worse masticatory function) was associated with edentulous using CD in only one jaw. Older adults wearing dental prostheses with poor occlusion and vertical dimensions presented worse masticatory function. Dental prosthesis stability was associated with lower VOH values. Higher number of chewing cycles while eating peanuts was associated with non-broken dental prosthesis use. Edentulous participants using CD in only one jaw and non-functional dental prosthesis use negatively affect the masticatory function of nursing home residents.

Effect of Staining Solutions on Color Stability, Gloss and Surface Roughness of Removable Partial Dental Prosthetic Polymers.

To assess the effect of commonly used solutions on color stability, gloss, and surface roughness of removable partial dental prostheses polymers. Discs (n = 112) were made of a poly(etheretherketone) (PEEK) polymer, a polyamide, an acetal resin and a heat-cured poly(methylmethacrylate) PMMA acrylic resin polished according to manufacturers' instructions. Seven specimens of each material were immersed in coffee, red wine, coca cola and distilled water for 30 days at 37ο C. Changes of color (ΔΕ*) and color coordinates L*α*b* after immersion were calculated with a colorimeter. Changes in the values of gloss and surface roughness parameters (Sa, Sz, Str, Sdr, Sci, Svi) were also measured. Two-way ANOVA and pairwise comparisons were used to evaluate the effect of material and staining solution on parameter value alterations (α = 0.05). The two-way ANOVA revealed that the interaction between material and staining solution significantly affected color changes after immersion [F(9,96) = 44.67, p < 0.001]. PEEK presented the lowest color change (ΔΕ* = 3.83 ± 2) while polyamide had the highest color change overall (ΔΕ* = 14.59 ± 8.65) (p < 0.001). Coffee caused the highest color (ΔΕ* = 13.08 ± 6.98) and gloss changes (ΔG = -6.36 ± 19.2 GU) among different solutions (p < 0.001). PEEK showed the highest alteration of gloss (ΔG = -11.31 ± 15.49 GU), with significant difference with the other three materials (p < 0.001). Insignificant interaction of material and immersing solution was found for surface roughness parameters (p > 0.05). Among the materials tested, PEEK seemed to be the most stable material when subjected to common, everyday staining solutions. Therefore, PEEK could be a viable solution for an RPDP framework fabrication, expanding the material list of prosthetic options. Further research and clinical trials are required to confirm the above statement.

Rehabilitation of shortened dental arches: A fifteen‐year randomised trial

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 35years 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 15years. 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 10years. 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 14.2years in the PRDP group and 14.3years 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 15years. The influence of the examined treatments on success appears to be low.

Influence of mandibular distal extension implant-supported removable partial dentures on the force exerted on maxillary anterior teeth.

Purpose This study aimed to determine the influence of mandibular free-end partial edentulism and use of conventional or implant-supported removable dental prostheses in the partially edentulous area on the load exerted on the maxillary anterior teeth.Methods A jaw model with mandibular free-end missing teeth was used, and a distal extension, removable partial dental prosthesis was fabricated to replace the missing posterior teeth. Four experimental conditions were set up: 1) without prosthesis, 2) with a conventional removable partial dental prosthesis, 3) with an implant-supported removable partial dental prosthesis, and 4) with a complete dental arch. Strain gauges were attached to the root surface of the maxillary left central incisor, canine, first premolar, and first molar. The load exerted on them was calculated based on the calibration coefficient. An occlusal load of 49 N was applied, and the forces were compared using a Kruskal-Wallis test (P < 0.05). Results The load exerted on the maxillary anterior teeth increased significantly with no prosthesis, decreased significantly with a conventional removable partial dental prosthesis, and decreased even more significantly with an implant-supported removable partial dental prosthesis. Conclusions The burden on the maxillary anterior teeth decreased with the use of a removable partial dental prosthesis and decreased even further with the use of an implant-supported dental prosthesis. The use of an implant to support a distal extension removable partial dental prosthesis is potentially effective in preserving the remaining teeth and tissues by reducing excessive stress in patients with mandibular free-end partial edentulism.

JUVENILE TRABECULAR OSSIFYINGFIBROMA: A CASE REPORT

Juvenile ossifying fibromas are aggressive benign fibro-osseous neoplasms that present 2 distinctive histologic variants, trabecular and psammomatoid. The trabecular variant occurs most commonly in the maxilla and affects younger patients, children and adolescents, with a mean age of 8.5 to 12 years. A 9-year-old girl presented with an asymptomatic swelling in the left maxilla. Computed tomography showed a well-circumscribed, expansive, unilocular, mixed hypodense/hyperdense lesion in the left maxilla and nasal cavity. The incisional biopsy confirmed the diagnosis of juvenile trabecular ossifying fibroma. After surgical excision with peripheral ostectomy under general anesthesia, prosthetic rehabilitation with removable partial dental prosthesis was performed. One year and 3 months later, computed tomography images were suggestive of recurrence. The recurrent lesion was treated by surgical excision with peripheral ostectomy followed by another prosthetic rehabilitation. At the moment, no sign of recurrence was noted in 5 years’ of follow- up after the second surgery.