Removable Partial Denture Wearing Research Articles

Effects of acrylic removable partial dentures on periodontal health of abutment teeth.

Objective: To assess the outcomes in patients wearing particularly designed acrylic removable partial dentures at different time intervals. Study Design: Descriptive Case Series Study. Setting: Department of Prosthodontics, FMH College of Dentistry, Lahore. Period: October 2017 to April, 2018. Material & Methods: Sixty five (65) abutments of acrylic removable partial denture wearers were included in the study for assessment of Mean Clinical Attachment Level (CAL), Tooth Mobility (TM) and Mean Gingival Index (GI). These periodontal parameters were clinically assessed at the day of insertion, 30th day and 60th day of insertion. Mean Clinical Attachment Level (CAL) was measured by William’s Probe. Tooth Mobility (TM) was assessed using Miller’s Classification. Gingival health was evaluated using the Gingival Index (GI) of Loe and Silness. Mean and standard deviation were calculated for patient’s age and all the periodontal scores of abutment teeth. Data was stratified for age and gender to identify the effect modifiers. Pearson chi-square test was used for Mean Gingival Index, and Mean Tooth Mobility. Post-stratification student t-test for Mean Clinical Attachment Level was used to compare the results with p ≤ 0.05 considered as significant. Results: Sstatistically insignificant results for all the periodontal parameters, i.e. the Mean Gingival Index (GI), Tooth Mobility (TM) and Mean Clinical Attachment Loss (CAL) were observed, age being not influencing the periodontal health of abutments. The only statistically significant (p= 0.01) result was observed for the Tooth Mobility (TM) in gender categories at the day of insertion and the 30th day of insertion. Conclusion: All the periodontal parameters, except tooth mobility (TM) assessed in the study, were not affected by the acrylic removable partial denture wearing.

Influence of mandibular free-end partial edentulism on the force exerted on maxillary anterior teeth

PurposeThe purpose of this study was to determine the influence of mandibular free-end partial edentulism and the wearing of removable partial dentures in the partially edentulous area on the force exerted on maxillary anterior teeth. MethodsA commercially available jaw model with exchangeable teeth was used. Seven experimental conditions of mandibular free-end edentulism were set up and a distal extension removable partial denture to replace missing posterior teeth was fabricated. Strain gauges were attached to the root surface of the maxillary left central incisor, canine, first premolar and first molar, and the force exerted on them was calculated based on the calibration coefficient. An occlusal load of 49 N was applied and the forces were compared with the Kruskal–Wallis test (P < 0.05). ResultsThe force exerted on the maxillary anterior teeth increased significantly as the number of remaining teeth decreased. The force exerted on the maxillary anterior teeth decreased significantly with use of a removable partial denture. ConclusionsWhen the number of remaining teeth decreases in mandibular free-end partial edentulism, the burden on the maxillary anterior teeth increases. Our findings suggest that for patients with mandibular free-end partial edentulism, wearing a removable partial denture is effective in preserving the remaining teeth by reducing excessive stress.

Mini Dental Implant-Retained Removable Partial Dentures: Treatment Effect Size and 6-Months Follow-up.

ObjectiveThe aim was to compare esthetic outcomes, masticatory performance and a comfort of removable partial denture (RPD) wearing after receiving: clasp-retained RPD (C-RPD) or mini dental implant-retained RPD (MDI-RPD) in the mandible.Materials and MethodsA sample of 88 patients (Kennedy Class I) with all posterior teeth missing and a linear support for a RPD participated. A total of 52 patients (36 females, 16 males; 56 to 84 years old) participated in the C-RPD group and 36 patients (26 females, 10 males; 43 to 81 years old) in the MDI-RPD group. All MDIs were placed adjacent to the last remaining mandibular anterior tooth or one tooth length posteriorly. The new RPDs had Co-Cr frameworks with lingual plate major connectors; the MDI-RPDs were retained by O-ball matrices and the C-RPDs with clasps. Patients answered questions at pre-treatment and post-treatment stages and after 6-months follow-up: how satisfied they had been with esthetic appearance, how confident they were while chewing hard food, how satisfied they were with food comminution and they also evaluated a comfort of RPD wearing. The 0-10 visual-analogue scale was used. Statistics included descriptive methods, t-tests and the standardized effect-size calculation.ResultsThe MDI-RPD wearers were more satisfied with their post-treatment esthetics, food comminution, a comfort with RPDs and had better confidence while chewing than the C-RPD wearers. The MDI-RPD wearers reported larger positive effect of the treatment. The results were consistent throughout the first 6-months period.ConclusionThe MDI-RPD patients showed superior outcomes than the C-RPD patients after the treatment and over the 6-month period.

Partial denture metal framework may harbor potentially pathogenic bacteria.

PURPOSEThe aim of this study was to characterize and compare bacterial diversity on the removable partial denture (RPD) framework over time.MATERIALS AND METHODSThis descriptive pilot study included five women who were rehabilitated with free-end mandibular RPD. The biofilm on T-bar clasps were collected 1 week (t1) and 4 months (t2) after the RPD was inserted (t0). Bacterial 16S rDNA was extracted and PCR amplified. Amplicons were cloned; clones were submitted to cycle sequencing, and sequences were compared with GenBank (98% similarity).RESULTSA total of 180 sequences with more than 499 bp were obtained. Two phylogenetic trees with 84 (t1) and 96 (t2) clones represented the bacteria biofilm at the RPD. About 93% of the obtained phylotypes fell into 25 known species for t1 and 17 for t2, which were grouped in 5 phyla: Firmicutes (t1=82%; t2=60%), Actinobacteria (t1=5%; t2=10%), Bacteroidetes (t1=2%; t2=6%), Proteobacteria (t1=10%; t2=15%) and Fusobacteria (t1=1%; t2=8%). The libraries also include 3 novel phylotypes for t1 and 11 for t2. Library t2 differs from t1 (P=.004); t1 is a subset of the t2 (P=.052). Periodontal pathogens, such as F. nucleatum, were more prevalent in t2.CONCLUSIONThe biofilm composition of the RPD metal clasps changed along time after RPD wearing. The RPD framework may act as a reservoir for potentially pathogenic bacteria and the RPD wearers may benefit from regular follow-up visits and strategies on prosthesis-related oral health instructions.

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.

The Effect of Removable Partial Dentures on Alveolar Bone Resorption: A Retrospective Study with Cone‐Beam Computed Tomography

The aim of this study was to compare vertical and horizontal mandibular alveolar bone resorption by measuring bone morphological variation in Kennedy Class II removable partial denture (RPD) wearers and non-wearers using cone-beam computed tomography (CBCT). In total, 124 sites in the CBCT scans of 62 (29 RPD non-wearers, 33 RPD wearers) Kennedy Class II patients were analyzed retrospectively. Three-dimensional representations of the mandible with superimposed cross-sectional slices were developed with the CBCT scans to evaluate the mandibular alveolar height and width by measuring distances between the mandibular canal, mylohyoid ridge, alveolar crest, and lower border of the mandible in four regions (eight sites) of Kennedy Class II non-wearers and wearers of RPDs. Mandibular alveolar bone height and width were significantly lower in edentulous sites when compared with dentate sites in both Kennedy Class II non-wearers and wearers of RPDs (p < 0.05). Additionally, mean vertical and horizontal mandibular bone resorption was significantly higher in RPD wearers than in non-wearers (p < 0.05). Vertical and horizontal alveolar bone resorption was found to be higher in the RPD wearing patients when comparing the dentate and edentulous sites.

A clinical follow-up study of the periodontal conditions of RPD abutment and non-abutment teeth

The purpose of this study was to evaluate the periodontal conditions of removable partial denture (RPD) wearers, comparing direct and indirect abutment teeth, and the teeth not involved in the denture design before denture placement and 1 year later. Fifty patients (32 women and 18 men), average age 45, were assessed by the same examiner at the moment of denture insertion and 3, 6, 9 and 12 months later. The following items were verified in each assessment: probing depth (PD), plaque index (PI) and gingival index (GI). PD and PI data were evaluated by anova test for linear trend followed by Tukey-Kramer post-test, while GI data were analysed by Friedman's test. Results showed that the teeth not involved in the denture design were the least affected for all variables studied. It was also verified that PD and GI mean values increased from the initial assessment to 1 year of RPD wearing in every group, but that only PI showed a significant increase. This study indicated that direct and indirect retainer elements tend to undergo more damaging periodontal effects associated with RPD wearing when compared with non-abutment elements. Plaque index values were significantly higher after 1 year of denture use.

Pulpal blood flow changes in abutment teeth of removable partial dentures

The purpose of this study was to investigate the effect of tooth supported (TSD) and tooth-tissue supported (TTSD) removable partial denture wearing on pulpal blood flow (PBF) of the abutment teeth by using Laser Doppler Flowmeter (LDF). Measurements were carried out on 60 teeth of 28 patients (28 teeth and 12 patients of TTSD group, 32 teeth and 16 patients of TSD group) who had not worn any type of removable partial dentures before, had no systemic problems and were non smokers. PBF values were recorded by LDF before insertion (day 0) and after insertion of dentures at day 1, day 7 and day 30. Statistical analysis was performed by student t test and covariance analyses of repeated measurements. In the group TTSD, the mean values of PBF decreased statistically significantly at day 1 after insertion when compared with PBF values before insertion (p<0,01). There was no statistically significant difference among PBF mean values on 1st, 7th and 30th day. However, in the group TSD, there was no statistically significant difference among PBF mean values before insertion and on 1st, 7th and 30th day. In other words, PBF mean values in group TSD continued without changing statistically significant on 1st, 7th and 30th day.TTSD wearing may show negative effect on the abutment teeth due to decreasing basal PBF.

Partial dentures as an independent indicator of root caries risk in a group of older adults.

To estimate the independent association between the wearing of removable partial dentures (RPD) and the presence of root caries in a population of older adults. Multivariate logistic regression modeling of root caries prevalence using different measures of root caries as dependent variables. The model included measures of disease history as indicators of historical risk. Data collected in the field from three areas of England. Random sample of adults aged 60 years and over, drawn from lists of patients registered with general medical practitioners. Field measurements of a range of oral health variables including oral disease, disease history, oral status and various social and demographic measures. The presence of root caries, unsound and sound root restorations. Of the five different models of root caries prevalence which were used, RPDs featured as an independent risk indicator for root surface caries in the three which were related to the presence of untreated disease. The odds ratios for the contribution made by RPDs were all over 1.6, and when considered alone was in excess of 2 in one model. These models were generally well fitting. RPDs did not feature as a risk indicator in the two models which related only to the presence of root surface restorations. In this study, where RPDs were present, the odds of untreated disease being present increased substantially.

Periodontal status of teeth in contact with denture in removable partial denture wearers.

The aims of the study were to determine the periodontal status of the teeth in contact with removable partial dentures (RPDs) and to compare them with other teeth in the opposing arch not related to any prosthesis. The periodontal status was also assessed in relation to the age of the dentures. Four hundred and twenty-seven patients treated with RPDs from 1981 to 1986 were recalled for examination. Prior to prosthetic treatment they were given periodontal treatment and fillings when required. Initially all were given oral hygiene instructions and motivation. They were reviewed regularly only on a short-term basis. Eighteen patients were suitable for the present study comprising of eight males and 10 females whose mean age was 41 years. The RPDs were in use from 1.5 to 8 years (mean 4.6 years). The following parameters were assessed: Plaque index (P1I), Gingival index (GI), loss of attachment (LA) and tooth mobility. The wearing of RPDs resulted in higher P1I, GI and LA compared to the controls and these differences were statistically significant. There was an increased frequency of higher P1I, GI and LA with the increase in denture age. Minor changes in tooth mobility were observed. It was concluded that the wearing of RPDs was detrimental to periodontal health in patients whose oral hygiene was less than adequate.

Wearing of removable partial dentures in relation to periodontal pockets.

Using a representative sample of 5028 dentulous Finnish adults the occurrence of periodontal pockets was studied separately for the maxillae and the mandibles among removable partial denture (RPD) wearers and non-wearers. RPD(s) were worn in 11.2% of the 3444 maxillae with at least four natural teeth remaining, and in 7.7% of the 4706 corresponding mandibles (P less than 0.001). Periodontal pockets were more frequently observed in maxillae than mandibles. Wearing of RPDs highly significantly (P less than 0.0001) increased the odds of having periodontal pockets in general (4 mm or more) as well as the odds of having deeper periodontal pockets (exceeding 6 mm). This phenomenon was observed both in the maxillae and in the mandibles. These results suggest that wearing of RPD is a threat to periodontal tissues and that dentists should take care to frequently recall their patients fitted with RPD(s). During the recall visits more attention should be paid to the periodontal conditions of patients wearing RPD(s).

Wearing of removable partial dentures in relation to dental caries.

Using a representative sample of 5028 dentulous Finnish adults the occurrence of dental caries was studied among removable partial denture (RPD) wearers and non-wearers. Of the subjects wearing no RPD(s) 61.4% had one or more carious teeth, among those wearing a single RPD the figure was 60.5% and among those wearing RPDs in both jaws 62.7%, respectively. When sociodemographic background, other oral status measures than caries and oral health care habits were simultaneously controlled, subjects wearing RPDs in both jaws had slightly increased (P less than 0.05) probability of having one or more carious teeth compared to those with no RPD(s). Subjects with a single RPD did not have a statistically significantly increased probability of having carious teeth. Among those 3075 subjects who had one or more carious teeth the wearing of one or two RPDs did not significantly increase the number of carious teeth. Because the subjects wearing RPDs in both jaws were seen to have a slightly increased risk of having caries, this confirms the view that dentists should emphasize good oral hygiene habits and regular dental attendance among RPD wearers.