Periodontal health in shortened dental arches: A 10-year RCT

Michael H Walter; Jens Dreyhaupt; Torsten Mundt; Ralf Kohal; Matthias Kern; Angelika Rauch; Frank Nothdurft; Sinsa Hartmann; Klaus Böning; Julian Boldt; Helmut Stark; Daniel Edelhoff; Bernd Wöstmann; Ralph Gunnar Luthardt; Wolfgang Hannak; Stefan Wolfart; Guido Heydecke; Florentine Jahn; Peter Pospiech; Birgit Marré

doi:10.1016/j.jpor.2020.01.005

Periodontal health in shortened dental arches: A 10-year RCT

J Prosthodont Res. 2020 Oct;64(4):498-505. doi: 10.1016/j.jpor.2020.01.005. Epub 2020 Feb 13.

Authors

Michael H Walter¹, Jens Dreyhaupt², Torsten Mundt³, Ralf Kohal⁴, Matthias Kern⁵, Angelika Rauch⁶, Frank Nothdurft⁷, Sinsa Hartmann⁸, Klaus Böning⁹, Julian Boldt¹⁰, Helmut Stark¹¹, Daniel Edelhoff¹², Bernd Wöstmann¹³, Ralph Gunnar Luthardt¹⁴, Wolfgang Hannak¹⁵, Stefan Wolfart¹⁶, Guido Heydecke¹⁷, Florentine Jahn¹⁸, Peter Pospiech¹⁹, Birgit Marré⁹

Affiliations

¹ Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany. Electronic address: michael.walter@uniklinikum-dresden.de.
² Institute of Epidemiology and Medical Biometry, Ulm University, Schwabstraße 13, Ulm 89075, Germany.
³ Department of Prosthodontics, Gerodontology and Biomaterials, Dental School, University of Greifswald, Rotgerberstr. 8, Greifswald 17487, Germany.
⁴ Department of Prosthetic Dentistry, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, Freiburg im Breisgau 79106, Germany.
⁵ Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Christian-Albrechts-Platz 4, Kiel 24118, Germany.
⁶ Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstr. 18, Leipzig 04103, Germany.
⁷ Department of Prosthetic Dentistry and Dental Materials Science, Medical Center, Dental School and Clinics, Saarland University, Campus Homburg, Kirrberger Str. 100, Homburg/Saar 66421, Germany.
⁸ Department of Prosthetic Dentistry, Johannes-Gutenberg University of Mainz, Langenbeckstr. 1, Mainz 55131, Germany.
⁹ Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany.
¹⁰ Department of Prosthetic Dentistry, Julius-Maximilians University of Würzburg, Pleicherwall 2, Würzburg 97070, Germany.
¹¹ Department of Prosthodontics, Preclinical Education and dental Materials Science, University of Bonn, Welschnonnenstr.17, Bonn 53111, Germany.
¹² Department of Prosthetic Dentistry, University Hospital, LMU Ludwig-Maximilians-University, Goethestraße 70, Munich 80336, Germany.
¹³ Department of Prosthetic Dentistry, Justus-Liebig University of Gießen, Rudolf-Buchheim-Str. 8, Gießen 35392, Germany.
¹⁴ Department of Prosthetic Dentistry, Center of Dentistry, Universitätsklinikum Ulm, Albert-Einstein-Allee 11, Ulm 89081, Germany.
¹⁵ Charité - Universitätsmedizin Berlin, CC3 - Charité, Center for Dental and Craniofacial Sciences, Department of Prosthodontics, Geriatic Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin, Aßmannshauser Straße 4-6, Berlin 14197, Germany.
¹⁶ Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, Aachen 52074, Germany.
¹⁷ Department of Prosthodontics, University Medical Center Eppendorf, Zahnärztliche Prothetik, Martinistr. 52, Hamburg 20246, Germany.
¹⁸ Department of Prosthetic Dentistry and Dental Material Science, Friedrich-Schiller University of Jena, Poliklinik für Zahnärztliche Prothetik und Werkstoffkunde, An der Alten Post 4, Jena 07743, Germany.
¹⁹ Vogelweidestr. 5, 97230 Estenfeld, Germany.

PMID: 32063531
DOI: 10.1016/j.jpor.2020.01.005

Abstract

Purpose: This analysis focused on periodontal health in shortened dental arches (SDAs).

Methods: In a randomized controlled clinical trial, patients with missing molars in one jaw and at least one premolar and canine on both sides were eligible for participation. In the partial removable dental prosthesis (PRDP) group (n = 79), molars were replaced with a precision attachment retained PRDP. In the SDA group (n == 71), the SDA up to the second premolars was either left as is or restored with fixed dental prostheses. Outcome variables were vertical clinical attachment loss (CAL-V), pocket probing depth (PPD), bleeding on probing (BOP) and plaque index (PLI). For CAL-V and PPD, the changes at six measuring points per tooth were analyzed. For BOP and PLI, patient related rates were calculated for each point in time. Statistical methods included linear regression analyses.

Results: In the intention-to-treat (ITT) analysis for CAL-V in the study jaw, the 10 year patient related mean changes were 0.66 mm in the PRDP group and -0.13 mm in the SDA group. The resulting mean patient related group difference of 0.79 mm (95% CI: 0.20 mm-1.38 mm) was significant (p = 0.01). There were no significant differences in the ITT analyses for PPD. For BOP and PLI, significant group differences with more favorable results for the SDA group were found.

Conclusions: In view of lacking substantial differences for CAL-V and PPD, the overall differences were considered of minor clinical relevance. The results add confirmatory evidence to the shortened dental arch concept and its clinical viability (controlled-trials.com ISRCTN97265367).

Keywords: Attachment loss; Bleeding on probing; Periodontal health; Plaque index; Pocket probing depth; Shortened dental arch.

Publication types

Randomized Controlled Trial

MeSH terms

Bicuspid
Dental Arch
Denture, Partial, Removable*
Humans
Molar
Tooth Loss*