Removable Partial Denture Treatment Research Articles

No difference in the 5-year survival rates between the resin-bonded cantilever bridge and the removable partial denture for the restoration of the shortened dental arch

This was a randomised controlled trial (RCT) in a dental hospital. Resin-bonded fixed partial dentures (RBFPD) or removable partial dentures (RPD) were compared. The RBFPD restored 1 occlusal unit, up to but not beyond the second premolar, by means of single pontics cantilevered from single abutments whenever possible. Bilateral lower free-end saddle RPD were constructed on cast metal frameworks that incorporated rests, retainers and a rigid connector. The trial's participants were reviewed 3 months and 1 year after insertion of the new lower prosthesis, and thereafter at yearly intervals. Additional review and maintenance appointments were scheduled as clinically required. Survival of the prosthesis was assessed at each review according to specified criteria. Survival analysis was performed using a Cox proportional hazard regression ratio. Eleven fixed partial dentures and 15 RPD failed. Debonding was the most common cause of failure in the RBFPD group, with non-use and loss of teeth most common in the RPD group. Although the RPD group required rather more maintenance visits, the difference in prosthesis survival rates was not statistically significant [hazard ratio (HR), 0.59; 95% confidence intervals (CI), 0.27-1.29]. The absence of a significant difference in 5-year survival, the reported advantages of fixed partial dentures, and the greater maintenance need for those in the RPD treatment group support the use of RBFPD.

はたして歯周病患者にはどのような補綴方法が有効か？―Ｐａｒｔ ２：歯周病患者に対するＲＰＤ・ＦＰＤ治療の文献Ｒｅｖｉｅｗと臨床的示唆（ＲＰＤ ｖｓ．ＦＰＤ ｖｓ．Ｉｍｐｌａｎｔ）―

To review the clinical literature on fixed partial denture (FPD) and removable partial denture (RPD)treatment for periodontally compromised patients with partial dentate. In addition, prosthodontic management in periodontitis-susceptible subjects was evaluated from the results of Part 1 and Part 2. Clinical studies that documented survival rates of FPD in periodontally compromised patients were selected and reviewed. There was no RPD study that fulfilled the criteria of this review paper. On the other hand, 8 reports that were reviewed in this study showed good survival rate of FPD in long-term clinical results. Since the number of reports on RPD is very few, it was difficult to evaluate the RPD treatment for periodontally compromised patients. From the results of some long-term follow-up retrospective studies, however, it was suggested that FPD of high-risk design showed excellent results. Regarding management in periodontits- susceptible subjects, it should be discussed whether positive prosthodontic treatment is necessary. Strict plaque control by both doctors and patients before/after treatment is indispensable for prosthodontic management in periodontally compromised patients.

Fabrication of a maxillary implant-supported removable partial denture: A clinical report

Implant-supported removable partial denture treatment provides an esthetic and functional result that allows proper access for hygiene and maintenance. This article describes the treatment of a patient with a maxillary removable partial denture supported by 3 implants. The use of alignment-correction abutments enabled restoration of misaligned implants.

Avaliação das disfunções craniomandibulares em pacientes parcialmente edentados unilaterais: um estudo longitudinal sobre o efeito da utilização de Prótese Parcial Removível (PPR)

O objetivo deste estudo foi comparar a severidade dos sinais e sintomas das desordens craniomandibulares em 29 pacientes edentados parciais unilaterais, submetidos a tratamento protético corretivo, acompanhados e avaliados longitudinalmente, por meio de investigação clínica, dois anos após a instalação da prótese parcial removível. Em cada um dos casos, a comparação das diferenças clínicas, antes e após os procedimentos de reconstrução protética, baseou-se na mensuração e registro das variáveis por meio da utilização de uma metodologia de testes de escores. As observações clínicas objetivas e subjetivas consistiram no exame da sensibilidade dolorosa muscular e da ATM, na auscultação dos ruídos articulares e no registro dos movimentos mandibulares (MM). Vinte e nove outros pacientes, totalmente dentados, atuaram como grupo controle. Após análise estatística não-paramétrica, conclui-se que os pacientes apresentavam uma prevalência significativamente maior na severidade das desordens craniomandibulares antes do tratamento protético e que o tratamento corretivo por meio da instalação de prótese parcial removível (PPR) bem indicada e planejada, atuou positivamente na diminuição da severidade destes distúrbios nesses pacientes.

Deflection fatigue of cobalt-chromium, titanium, and gold alloy cast alloy cast denture clasp: Vallittu, P.K. and Kokkonen, K. J. Prosthet. Dent. (1995) 74 (4), 412–419

The number of partially dentate adults is increasing, and many patients will require replacement of missing teeth. Although current treatment options also include fixed partial dentures and implants, removable partial dentures (RPDs) can have advantages and are widely used in clinical practice. However, a significant need exists to advance materials and fabrication technologies because of the unwanted health consequences associated with current RPDs.The purpose of this review was to assess the current state of and future need for prosthetics such as RPDs for patients with partial edentulism, highlight areas of weakness, and outline possible solutions to issues that affect patient satisfaction and the use of RPDs.The data on treatment for partial edentulism were reviewed and summarized with a focus on currently available and future RPD designs, materials, means of production, and impact on oral health. Data on patient satisfaction and compliance with RPD treatment were also reviewed to assess patient-centered care.Design, materials, ease of repair, patient education, and follow-up for RPD treatment all had a significant impact on treatment success. Almost 40% of patients no longer use their RPD within 5 years because of factors such as sociodemographics, pain, and esthetics. Research on RPD-based treatment for partial edentulism for both disease-oriented and patient-centered outcomes is lacking.Future trials should evaluate new RPD materials and design technologies and include both long-term follow-up and health-related and patient-reported outcomes. Advances in materials and digital design/production along with patient education promise to further the application of RPDs and improve the quality of life for patients requiring RPDs.

Social and functional impact of reduced posterior dental units in older adults.

The number of teeth needed to maintain adequate dental function in older adults is unknown. The purpose of this study was to examine the relationship between oral function and the number of opposing pairs of posterior teeth. We identified 338 subjects with complete anterior dentitions from an interview and examination survey of Ontario adults aged 50 and over; 261 had no partial denture and 77 had removable partial dentures (RPD). Oral function was measured using questions assessing chewing ability, mandibular function and socio-psychological impact. Subjects with no partial dentures were further allocated to five groups, based on their dental status: complete dental arch (n = 69); 5-7 functional units-pairs of opposing posterior teeth (n = 109); 3 or 4 functional units (n = 48) and 0-2 functional units (n = 35). Oral function problems increased with decreasing functional units being markedly more prevalent among the groups with 0-2 functional units. 34% of subjects in the 0-2 group reported one or more problems with chewing ability compared to 6-17% in the other groups (chi 2 P = 0.001 d.f. = 3). The 77 subjects who wore removable partial dentures, reported social and dental function at levels comparable to those with no dentures. From these results, there appears to be little socio-functional need to replace lost posterior teeth with a partial denture unit the person has fewer than, 3 posterior functional units. The low number of partial denture wearers limited our ability to detect a lasting benefit from RPD treatment.

Veterans administration cooperative dental implant study—comparisons between fixed partial dentures supported by blade-vent implants and removable partial dentures. Part IV: Comparisons of patient satisfaction between two treatment modalities

This study compares treatment assessments made by two groups of patients with Kennedy class I or class II mandibular edentulous conditions, who received either a removable partial denture (RPD) (N = 115) or one or two fixed partial dentures (FPDs), each supported distally by a blade implant (N = 113). Two questionnaires were administered, one at 16 weeks after the implant or RPD insertion and at the 6-month interval and the other at 18, 36, and 60 months. Marked functional improvements were perceived by a large majority of patients in both groups after the insertion of prosthesis. At 6 months, a higher percent of patients with RPDs than those with FPDs found it easy to clean their RPDs and experienced chewing discomfort, restriction of food choices, feeling of insecurity with their RPDs, and difficulty with their pronunciation. The exclusion of assessments by 25 RPD patients, whose treatment was judged to be a failure functionally, made the mean differences between the two treatments statistically significant ( p < 0.05) only for ease of cleaning in favor of the RPD and fewer restrictions of food choices in favor of the FPD group. At 60 months, significant differences between the percents of patients with the most favorable responses occurred for perceptions of eating enjoyment, food particles seldom getting under the removable partial denture, and improvement in social life in favor of the FPD treatment and for the ease of cleaning the removable partial denture in favor of the RPD treatment. The results seem to support superiority of the FPD in terms of patient satisfaction, but not enough to favor this type of prosthesis over the RPD without consideration of other pertinent factors.

Removable partial denture survey: clinical practice today.

Abstract A survey was conducted of two dental school classes that graduated 7 years apart: group A in the '70s and group B in the '60s. The questions dealt with type of practice, removable partial denture treatment, and framework design. Results of the survey showed significant differences between the groups in answer to several questions, as well as in general trends in treatment and design. Discussion centered on the need for improvement in performance and the level at which it should occur.

Five-year survey of treatment with removable partial dentures. Part I

A survey involving 137 patients treated with 203 removable partial dentures was conducted in England, the Netherlands, and the United States from samples of 1-year and 5-year posttreatment data. The objectives were to (1) develop a practical clinical and radiologic method to evaluate the results of removable partial denture treatment and (2) establish baseline values and results of removable partial denture treatment for use by all investigators. The results indicated the following: 1. Gingival pocket depth around abutment teeth was reduced at posttreatment examination. 2. There was an increase in posttreatment abutment teeth mobility that was greater in mandibular than maxillary teeth. Mobility increase was less for abutment teeth than for control teeth. 3. There was a slight loss of bone around abutment teeth that was about equal to loss around control teeth. 4. Oral care (plaque index) showed that 62.4% of all tooth surfaces had plaque accumulation at posttreatment examination. 5. Eleven of 616 abutment teeth (1.78%) were extracted.

Swinglock removable partial dentures: Where and when

The where and when of swinglock removable partial denture treatment planning have been presented, including indications, contraindications, and advantages. While the principles asserted in this article do not represent a panacea to partial denture design, the swinglock design concept does provide another treatment alternative for select and difficult biomechanic situations.

Dentist and Laboratory: A "Love-Hate" Relationship

The author's intent has been to promote a close working relationship between the dentist and the technician. Certainly, McCracken was doing that when he said that he hoped they could "work together in proper sequence to develop restorations that are biologically and mechanically sound and to produce removable partial dentures that reflect continuous progress in prosthetic dentistry". That's the secret. The dentist and the technician should work together and in proper sequence. Too often dental education and the dental profession have seemed to espouse the idea that the technician must function as an automaton in the fabrication of removable partial dentures. The practitioner of general dentistry can certainly ask for ideas and suggestions from the technician and still control the ultimate outcome. The dentist can share thoughts with the technician to ameliorate the "love-hate" relationship and still be responsible for the removable partial denture treatment.

Occlusal and prosthodontic trauma

There is a tendency among dentists to approach the problem of the removable partial denture treatment from the mechanic-artisan point of view, rather than from the biologic, health, and professional point of view. The trend is to differentiate these spheres of activity properly in prosthodontics and to place greater responsibility on the health operator—the dentist. Many more items relating to occlusal trauma and “dynamic irritation” are associated with partial prosthodontic treatments than have been discussed in this essay. The hope is that dentists will become increasingly conscious of the need to eliminate these various traumas associated with this branch of prosthodontics and that much less resistance will be offered professionally to the considerable preparations generally needed by the oral components of a broken-down masticatory organ, such as is common to patients wearing removable partial dentures.