An observational cohort study on shortened dental arches—clinical course during a period of 27–35 years
Tóm tắt
The objective of this study was to investigate the clinical course of shortened dental arches (‘SDA group’) compared to SDAs plus removable denture prosthesis (‘SDA plus RDP group’) and complete dental arches (‘CDA group’, controls). Data (numbers of direct and indirect restorations, endodontic treatments, tooth loss and tooth replacements) were extracted from patient records of subjects attending the Nijmegen Dental School who previously participated in a cohort study on shortened dental arches with three to four posterior occluding pairs (POPs). Records of 35 % of the original cohort were retrievable. At the end of the follow-up (27.4 ± 7.1 years), 20 out of 23 SDA subjects still had SDA with 3–4 POPs compared to 6 out of 13 for SDA plus RDP subjects (follow-up 32.6 ± 7.3 years). Sixteen out of 23 CDA subjects still had CDA; none of them lost more than one POP (follow-up 35.0 ± 5.6 years). SDA group lost 67 teeth: 16 were not replaced, 16 were replaced by FDP and 35 teeth (lost in three subjects) replaced by RDP. Mean number of treatments per year in SDA subjects differed not significantly compared to CDA subjects except for indirect restorations in the upper jaw. Shortened dental arches can last for 27 years and over. Clinical course in SDA plus RDP is unfavourable, especially when RDP-related interventions are taken into account. The shortened dental arch concept seems to be a relevant approach from a cost-effective point of view. Replacement of absent posterior teeth by free-end RDP cannot be recommended.
Tài liệu tham khảo
Kanno T, Carlsson GE (2006) A review of the shortened dental arch concept focusing on the work by the Käyser/Nijmegen group. J Oral Rehabil 33(11):850–862
Aras K, Hasanreisoglu U, Shinogaya T (2009) Masticatory performance, maximum occlusal force, and occlusal contact area in patients with bilaterally missing molars and distal extension removable partial dentures. Int J Prosthodont 22(2):204–209
Gerritsen AE, Sarita P, Witter DJ, Kreulen CM, Mulder J, Creugers NH (2008) Esthetic perception of missing teeth among a group of Tanzanian adults. Int J Prosthodont 21(2):169–173
Gotfredsen K, Walls AW (2007) What dentition assures oral function? Clin Oral Impl Res 18(Suppl 3):34–45. doi:10.1111/j.1600-0501.2007.01436.x
Witter DJ, Van Elteren P, Käyser AF, Van Rossum GM (1990) Oral comfort in shortened dental arches. J Oral Rehabil 17(2):137–143
Armellini DB, Heydecke G, Witter DJ, Creugers NH (2008) Effect of removable partial dentures on oral health-related quality of life in subjects with shortened dental arches: a 2-center cross-sectional study. Int J Prosthodont 21(6):524–530
Baba K, Igarashi Y, Nishiyama A, John MT, Akagawa Y, Ikebe K, Ishigami T, Kobayashi H, Yamashita S (2008) The relationship between missing occlusal units and oral health-related quality of life in patients with shortened dental arches. Int J Prosthodont 21(1):72–74
Montero J, Bravo M, Hernandez LA, Dib A (2009) Effect of arch length on the functional well-being of dentate adults. J Oral Rehabil 36(5):338–345
Budtz-Jørgensen E, Isidor F (1990) A 5-year longitudinal study of cantilevered fixed partial dentures compared with removable partial dentures in a geriatric population. J Prosthet Dent 64(1):42–47
Thomason JM, Moynihan PJ, Steen N, Jepson NJ (2007) Time to survival for the restoration of the shortened lower dental arch. J Dent Res 86(7):646–650
Walter MH, Weber A, Marré B, Gitt I, Gerss J, Hannak W, Hartmann S, Heydecke G, Huppertz J, Jahn F, Ludwig A, Mundt T, Kern M, Klein V, Pospiech P, Stumbaum M, Wolfart S, Wöstmann B, Busche E, Böning K, Luthardt RG (2010) The randomized shortened dental arch study: tooth loss. J Dent Res 89(8):818–822
Kuboki T, Okamoto S, Suzuki H, Kanyama M, Arakawa H, Sonoyama W, Yamashita A (1999) Quality of life assessment of bone-anchored fixed partial denture patients with unilateral mandibular distal-extension edentulism. J Prosthet Dent 82(2):182–187
Witter DJ, Creugers NH, Kreulen CM, de Haan AF (2001) Occlusal stability in shortened dental arches. J Dent Res 80(2):432–436
Witter DJ, Kreulen CM, Mulder J, Creugers NH (2007) Signs and symptoms related to temporomandibular disorders—follow-up of subjects with shortened and complete dental arches. J Dent 35(6):521–527. doi:10.1016/j.jdent.2007.02.003
Creugers NH, Witter DJ, Van’t Spijker A, Gerritsen AE, Kreulen CM (2010) Occlusion and temporomandibular function among subjects with mandibular distal extension removable partial dentures. Int J Dent. doi:10.1155/2010/807850, 2010:807850
Deligeorgi V, Mjör IA, Wilson NH (2001) An overview of reasons for the placement and replacement of restorations. Prim Dent Care 8(1):5–11
Haugejorden O, Klock KS, Trovik TA (2003) Incidence and predictors of self-reported tooth loss in a representative sample of Norwegian adults. Community Dent Oral Epidemiol 31(4):261–268
Müller F, Naharro M, Carlsson GE (2007) What are the prevalence and incidence of tooth loss in the adult and elderly population in Europe? Clin Oral Impl Res 18(Suppl 3):2–14. doi:10.1111/j.1600-0501.2007.01459.x
Fure S, Zickert I (1997) Incidence of tooth loss and dental caries in 60-, 70- and 80-year-old Swedish individuals. Community Dent Oral Epidemiol 25(2):137–142
McKenna G, Allen PF, Flynn A, O'Mahony D, Damata C, Cronin M, Woods N (2011) Impact of tooth replacement strategies on the nutritional status of partially-dentate elders. Gerodontology. doi:10.1111/j.1741-2358.2011.00579.x
do Amaral BA, Barreto AO, Gomes Seabra E, Roncalli AG, da Fonte Porto Carreiro A, de Almeida EO (2010) A clinical follow-up study of the periodontal conditions of RPD abutment and non-abutment teeth. J Oral Rehabil 37(7):545–552
Jepson NJ, Moynihan PJ, Kelly PJ, Watson GW, Thomason JM (2001) Caries incidence following restoration of shortened lower dental arches in a randomized controlled trial. Br Dent J 191(3):140–144
Jepson N, Allen F, Moynihan P, Kelly P, Thomason M (2003) Patient satisfaction following restoration of shortened mandibular dental arches in a randomized controlled trial. Int J Prosthodont 16(4):409–414
Faggion CM Jr (2011) The shortened dental arch revisited: from evidence to recommendations by the use of the GRADE approach. J Oral Rehabil 38(12):940–949. doi:10.1111/j.1365-2842.2011.02230.x