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      FUNCTIONAL EVALUATION OF ORAL REHABILITATION WITH REMOVABLE PARTIAL DENTURES AFTER FIVE YEARS Translated title: AVALIAÇÃO FUNCIONAL DA REABILITAÇÃO ORAL COM PRÓTESE PARCIAL REMOVÍVEL APÓS CINCO ANOS

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          Abstract

          Most removable partial denture (RPD) wearers are satisfied with their prostheses, but the factors that influence satisfaction and acceptance are still not determined.

          Objective:

          This study explored technical, biological, and satisfaction variables for the functioning of RPDs after five years, and compared the evaluation by the patient and by the clinician.

          Materials and Methods:

          Fifty adults (39 females, 11 males) were reexamined after five years of RPD service. Data were collected through clinical examination and a structured questionnaire to record the conditions of supporting soft tissues, prosthesis acceptance and technical characteristics, mastication, esthetics, comfort, hygiene, and need for professional intervention. Data were analyzed by descriptive statistics and Spearman correlation.

          Results:

          More than 50% of patients classified their RPDs as excellent regarding retention, mastication, esthetics, comfort, and hygiene. In the professional evaluation, retention and stability were considered excellent in more than 66% of cases, and hygiene of teeth and prostheses was considered good in 52% and 46%, respectively. The metallic framework and acrylic base were considered adapted in 92% of cases. Prosthesis acceptance was associated with retention, mastication, esthetics, hygiene, and comfort evaluated by the patient, and with retention, stability, and condition of the framework evaluated by the clinician. Retention and mastication/comfort evaluated by the patient had moderate positive correlation with retention and stability measured by the clinician. There was no association of hygiene evaluation by the patient and by the clinician.

          Conclusions:

          After five years, the oral rehabilitation with RPDs was satisfactory for most cases. There was correspondence between retention/retention and mastication-comfort/stability variables evaluated by the patient and by the clinician. Oral and prosthesis hygiene were not related.

          Translated abstract

          A maioria dos usuários de PPR mostra-se satisfeita com suas próteses, porém os fatores que influenciam a satisfação e aceitação não estão determinados.

          Objetivo:

          Este estudo explorou variáveis técnicas, biológicas e de satisfação no funcionamento de próteses parciais removíveis (PPRs) após cinco anos de uso, comparando a avaliação do paciente e do cirurgião-dentista.

          Materiais e Métodos:

          Cinqüenta adultos (39 mulheres, 11 homens) foram reexaminados após cinco anos da instalação de PPR. Através de exame clínico e questionário estruturado, foram coletados os dados relativos às condições dos tecidos de suporte, aceitação e características técnicas da PPR, mastigação, estética, conforto, higiene e necessidade de intervenção profissional. Os dados foram analisados por estatística descritiva e por correlação de Spearman.

          Resultados:

          Mais de 50% dos pacientes classificaram suas próteses como excelente quanto à retenção, mastigação, estética, conforto e higiene. Na avaliação do profissional, retenção e estabilidade foram consideradas excelentes em mais de 66% dos pacientes, e a higiene dos dentes e da prótese foi considerada boa em 52% e 46% dos casos, respectivamente. As armações metálicas e bases acrílicas foram consideradas adaptadas em 92% dos casos. Aceitação da prótese foi associada com retenção, mastigação, estética, higiene e conforto avaliados pelo paciente, e com retenção, estabilidade e condição da armação metálica avaliadas pelo profissional. Retenção e mastigação/conforto, avaliados pelo paciente, mostraram correlação positiva moderada com retenção e estabilidade medidas pelo profissional. Não houve associação entre avaliação de higiene pelo paciente e pelo profissional.

          Conclusões:

          Após cinco anos, a reabilitação oral com PPR estava satisfatória na maioria dos casos. Houve correspondência entre as variáveis retenção/retenção e mastigação-conforto/estabilidade. Higiene oral e da prótese não mostraram associação.

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          Most cited references54

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          The effect of removable partial dentures on periodontal health of abutment and non-abutment teeth.

          A removable partial denture (RPD) is a common treatment available for restoration of partially edentulous ridges. Longitudinal studies indicate that RPDs have been associated with increased gingivitis, periodontitis, and abutment mobility. A total of 205 patients with RPDs participated in this study. There were 80 males and 125 females aged 38 to 89, with 123 maxillary and 138 mandibular RPDs. Patients were wearing existing RPDs for different periods ranging from 1 to 10 years. A two-part questionnaire was devised for this study. In the first part, patients answered questions on gender; age; smoking habits; denture age; denture wearing habits; mouth odor; and problems with food accumulating under the denture base, on the outside surface of the denture, and on the outside surface of remaining teeth after eating. The Kennedy classification, material, denture support, denture base shape, and number of teeth in contact, number of existing clasps, and occlusal rests were categorized. The quality of denture construction was also evaluated. In the second part of the questionnaire, baseline recordings of plaque (PI), gingival (GI), and calculus (CI) indexes were made, and Tarbet index (TI), as well as probing depth (PD), gingival recession (GR), and tooth mobility (TM) were measured, both on abutment and non-abutment teeth. Significant differences (P <0.01) were noted for PI, Cl, GI, PD, TM, and GR between abutment and non-abutment teeth, with abutment teeth showing more disease. RPD design plays an important role in the state of the periodontium. Appropriate design and good oral hygiene may decrease the appearance of periodontal disease.
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            Caries, periodontal and prosthetic findings in patients with removable partial dentures: a ten-year longitudinal study.

            A 10-year longitudinal study was carried out on 27 patients treated with RPDs. Before the prosthetic treatment all patients were given oral hygiene motivation and instruction as well as periodontal therapy where indicated. The aim was a high level of cooperation. The RPDs, most of which were lower bilateral distal-extension dentures, were carefully planned and designed. During the follow-up period the patients were examined at yearly intervals, at which time remotivation and reinstruction regarding oral hygiene was given, and scaling, operative restorations, and prosthetic and other treatment procedures were preformed as required. Patient cooperation was excellent, and no significant deterioration of the periodontal status of the remaining teeth was found. In addition, there was a low increase in the frequency of decayed and filled tooth surfaces during the decade. The dentures showed damage and several changes during the follow-up period, conditions that necessitated various corrective prosthetic procedures.
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              A comparison of patient's satisfaction between complete and partial removable denture wearers.

              The aim of this study was to compare satisfaction between complete denture (CD) and Kennedy Class I removable partial denture (RPD) wearers. A total of 156 CD and 112 RPD wearers took a part in this study. From the primary group of the examined patients, only those whose RPDs and CDs were assessed as excellent or very good by the dentist, took a part in this study. Patients graded satisfaction of their dentures by using an analogue scale from 1 to 5 (1=unsatisfactory; 5=excellent). Both CD and RPD wearers were mostly satisfied with their dentures (the distribution of the scores of the patients' assessments was skewed towards the highest scores; more than half of the patients scored all the examined variables to the best score category). Complete Denture wearers were significantly more satisfied with chewing, speech and retention of maxillary denture than RPD wearers (P 0.05; N.S.). A majority of CD and RPD wearers were satisfied with the dentures. CD wearers were more satisfied with speech, chewing and retention of maxillary denture, while RPD wearers were more satisfied with the retention and the comfort of wearing mandibular denture. Different groups of denture wearers have to make significant, but different adjustments to wear their dentures successfully.
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                Author and article information

                Journal
                J Appl Oral Sci
                J Appl Oral Sci
                Journal of Applied Oral Science
                Faculdade de Odontologia de Bauru da Universidade de São Paulo (Bauru )
                1678-7757
                1678-7765
                April 2006
                April 2006
                : 14
                : 2
                : 111-116
                Affiliations
                [1 ]DDS, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
                [2 ]DDS, MSc, Associate Professor, Department of Prosthodontics, Lutheran University of Brazil (ULBRA/RS), Canoas, Brazil
                [3 ]DDS, MSc, PhD, Associate Professor, Department of Prosthodontics, Lutheran University of Brazil (ULBRA/RS), Canoas, Brazil
                [4 ]DDS, MSc, PhD, Associate Professor, Department of Restorative Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
                [5 ]DDS, MSc, PhD, Associate Professor, Department of Prosthodontics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
                Author notes
                Corresponding address: Dúcia Caldas Cosme - Av. José Aluísio Filho 889, casa 97 - Humaitá - Porto Alegre/RS- Cep.: 90250-180 Fone: 51- 33747326- e-mail: duciacaldas@ 123456terra.com.br
                Article
                S1678-77572006000200009
                10.1590/S1678-77572006000200009
                4327452
                19089041
                6020ee80-b50e-4d0a-8ce8-0839f0bb9c9c

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 May 2005
                : 30 August 2005
                : 13 December 2005
                Page count
                Figures: 0, Tables: 5, Equations: 0, References: 28, Pages: 6
                Categories
                Original Article

                removable partial denture,dental prosthesis retention,hygiene

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