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      Evaluating the cost-effectiveness of prosthetic rehabilitation for partially edentulous teeth in India: A comparative study of Clasp-Retained RPDs, Thermoplastic Resin RPDs, and Cast Partial Dentures

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          Abstract

          Background

          With rising life expectancy, partial edentulism has increased, particularly in developing nations where economic constraints, limited awareness, and inadequate dental care exacerbate the burden on aging populations. Patients with fewer than 20 teeth often experience a reduction in Oral Health-Related Quality of Life (OHRQoL), emphasizing the need for effective tooth replacement. Removable partial dentures (RPDs) are versatile, cost-effective solutions for partial tooth loss, including metal clasp-retained RPDs (MC-RPDs), thermoplastic resin RPDs (TR-RPDs), and cast partial dentures (CPDs).

          Methods

          This study evaluates the oral health-related quality of life, patient satisfaction, and cost-effectiveness of these three RPD types. A cross-sectional study was conducted with 42 participants, divided into three groups: MC-RPD, TR-RPD, and CPD, each with 14 patients. The Oral Health Impact Profile (OHIP-14) and Satisfaction Questionnaire (SAT) were administered at baseline and three months post-denture delivery. The study adhered to Consolidated Health Economic Evaluation Reporting Standards.

          Results

          Results showed significant differences in OHIP scores between the groups, with CPD offering the highest quality of life, followed by TR-RPD, and MC-RPD. Post-treatment, the mean OHIP scores for MC-RPD, TR-RPD, and CPD were 30.57 ± 4.09, 20.71 ± 4.03, and 22.36 ± 2.92, respectively, with CPD showing the greatest improvement. Patient satisfaction was highest for CPD, followed by TR-RPD, and least for MC-RPD. However, satisfaction differences between the groups were not statistically significant after three months.

          Conclusion

          This study highlights the superior performance of CPDs in enhancing OHRQoL and patient satisfaction, though their higher cost may limit accessibility. These findings provide valuable insights for dental practitioners and patients in selecting the most suitable and cost-effective RPD treatment options.

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          Most cited references27

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          Cost effectiveness in low- and middle-income countries: a review of the debates surrounding decision rules.

          Cost-effectiveness analysis (CEA) is increasingly important in public health decision making, including in low- and middle-income countries. The decision makers' valuation of a unit of health gain, or ceiling ratio (lambda), is important in CEA as the relative value against which acceptability is defined, although values are usually chosen arbitrarily in practice. Reference case estimates for lambda are useful to promote consistency, facilitate new developments in decision analysis, compare estimates against benefit-cost ratios from other economic sectors, and explicitly inform decisions about equity in global health budgets. The aim of this article is to discuss values for lambda used in practice, including derivation based on affordability expectations (such as $US150 per disability-adjusted life-year [DALY]), some multiple of gross national income or gross domestic product, and preference-elicitation methods, and explore the implications associated with each approach. The background to the debate is introduced, the theoretical bases of current values are reviewed, and examples are given of their application in practice. Advantages and disadvantages of each method for defining lambda are outlined, followed by an exploration of methodological and policy implications.
            • Record: found
            • Abstract: found
            • Article: not found

            Removable partial dentures: The clinical need for innovation.

            The number of partially dentate adults is increasing, and many patients will require replacement of missing teeth. Although current treatment options also include fixed partial dentures and implants, removable partial dentures (RPDs) can have advantages and are widely used in clinical practice. However, a significant need exists to advance materials and fabrication technologies because of the unwanted health consequences associated with current RPDs.
              • Record: found
              • Abstract: found
              • Article: not found

              Characteristics of denture thermoplastic resins for non-metal clasp dentures.

              Six thermoplastic resins and conventional acrylic resin were examined to characterize their mechanical and physical properties, water sorption, solubility, flexural strength, modulus of elasticity, tensile strength and color stability. Thermoplastic resins for non-metal clasp dentures exhibiting low water sorption and solubility offer hygienic advantages. Since they have a low modulus of elasticity and are easily manipulated, these materials make it possible for larger undercuts to be used for retention compared to acrylic resin. Not all of the thermoplastic resins tested fractured after the bending test in contrast to the conventional denture base resin, which fractured when tested beyond its proportional limit. It was also found that clinically noticeable staining may occur on the polyamide resins and polyethylene terephtalate resins.

                Author and article information

                Contributors
                Journal
                J Oral Biol Craniofac Res
                J Oral Biol Craniofac Res
                Journal of Oral Biology and Craniofacial Research
                Elsevier
                2212-4268
                2212-4276
                10 February 2025
                Mar-Apr 2025
                10 February 2025
                : 15
                : 2
                : 240-245
                Affiliations
                [a ]Department of Prosthodontics, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, India
                [b ]Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, India
                Author notes
                [* ]Corresponding author. Department of Prosthodontics Amrita School of Dentistry Kochi, Kerala, India. draswini2000@ 123456gmail.com
                Article
                S2212-4268(25)00016-8
                10.1016/j.jobcr.2025.01.014
                11867513
                40018667
                44e8ab26-8f14-4004-ad4b-c2c86821a94c
                © 2025 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 17 October 2024
                : 26 December 2024
                : 11 January 2025
                Categories
                Article

                cost effectiveness,removable partial dentures,oral health related quality of life,prosthetic rehabilitation,case partial dentures

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