Effect of removable partial dentures on oral health-related quality of life in subjects with shortened dental arches: a 2-center cross-sectional study

Debora B Armellini, Guido Heydecke, Dick J Witter, Nico H J Creugers
International Journal of Prosthodontics 2008, 21 (6): 524-30

PURPOSE: To assess the value of removable partial dentures (RPDs) in subjects with shortened dental arches (SDAs) with regard to quality of life.

MATERIALS AND METHODS: Subjects from 2 university dental centers (82 men, 78 women; mean age: 54 +/- 18 years) were categorized into the following groups: (1) SDA with intact anterior regions (SDA-1, n = 44); (2) SDA and interrupted anterior region (SDA-2, n = 21); (3) SDA (intact anterior region) extended with distal-extension RPD (RPD-1, n = 25); (4) subjects with interrupted SDA and interrupted anterior region treated with RPD (RPD-2, n = 32); or (5) complete dental arches (CDA, n = 38) as a control. All subjects underwent a short clinical examination and completed 2 structured questionnaires: the Oral Health Impact Profile (OHIP-49) and the Short-Form Health Survey (SF-36). Recorded clinical variables included: teeth present (yes/no), replacement by RPD (yes/no), and number of occlusal units. Age-dependent outcomes were adjusted to outcomes for the age of 60 years. Linear regression models were used to assess differences between the groups.

RESULTS: Reliability and validity were good for all subscales. For OHIP, the investigation groups had significantly higher scores (more complaints) than CDA for the subscales "functional limitation," "psychologic discomfort," and "physical disability." Of the 4 investigation groups, SDA-1 subjects had the lowest mean scores. SF-36 scores showed less prominent and less conclusive differences between investigation groups and CDA subjects. SDA-2 subjects showed worse health, with significantly lower scores than RPD-2 subjects for "vitality," "social function," and "mental health." For pure SDA subjects (SDA-1) there was a significant positive effect for "number of occlusal units" in 5 of the OHIP subscales and 2 of the SF-36 subscales.

CONCLUSION: From a quality-of-life perspective, patients with SDAs perceive benefits from RPDs only if anterior teeth replacements are included. In contrast, in subjects with uninterrupted SDAs, where only posterior teeth were replaced by distal-extension RPDs, such benefits could not be demonstrated.

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