ABSTRACT
PURPOSE: This study aimed to compare the long-term outcomes of two different nonimplant treatments in the bilateral shortened dental arch (SDA). MATERIALS AND METHODS: In a multicenter randomized controlled clinical trial, patients with complete molar loss in one arch were assigned to one of two different nonimplant treatments. In the partial removable dental prosthesis (PRDP) group, patients were provided with a distal-extension prosthesis retained with precision attachments. In the SDA group, patients were treated according to the SDA concept by preserving or restoring a premolar occlusion. RESULTS: Of the 152 treated patients, 82 reached the 10-year examination independent of their dental or prosthetic status. In the intention-to-treat analysis, the survival rates for tooth loss at 10 years were 0.44 (95% confidence interval [CI]: 0.30 to 0.56) in the PRDP group and 0.52 (95% CI: 0.37 to 0.65) in the SDA group. For tooth loss in the study arch, the survival rates were 0.67 (95% CI: 0.52 to 0.78) in the PRDP group and 0.60 (95% CI: 0.45 to 0.73) in the SDA group. The number of teeth lost was higher than expected. In a multivariate analysis using a multiple Cox regression model, the covariates age (unit: 1 year, Hazard Ratio [HR]: 1.033, P = .03) and DMFT value (unit: 1 tooth, HR: 1.121, P = .03) were significant for time to first tooth loss in the study arch. CONCLUSION: The results suggest an overestimation of the influence of the prosthetic management of the bilateral SDA. In treatment decisions, patient preferences should be considered with appropriate weight.
Subject(s)
Dental Arch/pathology , Denture, Partial, Removable , Jaw, Edentulous, Partially/rehabilitation , Tooth Loss , Crowns , DMF Index , Dental Abutments , Dental Occlusion , Denture Precision Attachment , Female , Humans , Male , Molar , Risk FactorsABSTRACT
The aim of this study was to evaluate the role of occlusal factors to determine the extent of their role in temporomandibular disorders (TMD). Two groups were selected: a patient group (I) of 100 patients with TMD problems (pain and clicking) and a control group (II) of 100. Each individual had to have 28 permanent teeth. A clinical evaluation was conducted and the models were evaluated according to the criteria of the Angle Classes and the Reinhardt Index, with the number of permanent teeth (A), the number of the correctly (R) and the number of incorrectly (F) related antagonist pairs of teeth. The individuals had to observe the preference of their chewing side. The results of this investigation revealed: the number of F can be used as an occlusal indicator for possible functional disorders (p=0.041). Individuals with one chewing side have more signs and symptoms of TMD (p<6.22x10(-9)).
