Journal article

Publication year: 2021

Journal: Journal of Evidence-Based Dental Practice

Volume number: 21

Issue number: 4

ISSN: 1532-3382

eISSN: 1532-3390

DOI Link: https://doi.org/10.1016/j.jebdp.2021.101622

Publisher: Elsevier

Abstract: 

Background

A shortened dental arch (SDA) is an established treatment concept for patients with missing molars. However, little is known regarding long-term course of oral health-related quality of life (OHRQoL) in patients with SDA and the benefits from replacement of missing molars.

Objective

Purpose of this multi-center randomized clinical trial was to assess OHRQoL over a period of 15 years in patients with molar replacement by a removable partial denture (RPD) compared to patients with a restored SDA without molar replacement.

Methods

Patients at least 35 years of age with all molars missing in 1 jaw and at least the canine and one premolar present on each side were included. Patients received either a precision attachment-retained, RPD for replacement of missing molars ( n = 79), or the dental arch ended with the second premolar (SDA) that had to be present or replaced by a cantilever fixed dental prosthesis ( n = 71). Follow-up examinations continued for 15 years. OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). OHIP summary and dimension scores were longitudinally modeled in the statistical analyses to assess course of OHRQoL over time applying an intention-to-treat approach. In addition, scores for the OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were analyzed.

Results

After an initial improvement in OHRQoL indicated by a mean decrease of 20.0 OHIP points with an effect size of 0.61 in the entire study population, OHRQoL stayed relatively constant over the entire follow-up period. Assuming a constant time and treatment effects over the study period, OHRQoL did not differ statistically significant between the 2 treatments (0.4 OHIP points; 95%-CI: 7.1 -6.2). OHRQoL after treatment did not change notably over 15 years and was statistically nonsignificant as well ( P = .872). Similar findings were observed in all 4 OHRQoL dimensions.

Conclusions

In patients, missing all molars in one jaw OHRQoL improved providing RPD or restoring SDA to a clinically relevant degree. Treatment-related improvement remained mostly stable over a period of at least 15 years. Therefore, patients can be informed that both treatment concepts are equivalent concerning long-term OHRQoL. Accordingly, patients' preferences regarding treatment options should be granted priority in treatment decision making with the SDA treatment option being the default.

Harvard Citation style: Schierz, O., Reissmann, D., Rauch, A., John, M., Marre, B., Luthardt, R., et al. (2021) IMPACT OF SHORTENED DENTAL ARCH ON ORAL HEALTH-RELATED QUALITY OF LIFE, Journal of Evidence-Based Dental Practice, 21(4), Article 101622. https://doi.org/10.1016/j.jebdp.2021.101622

APA Citation style: Schierz, O., Reissmann, D., Rauch, A., John, M., Marre, B., Luthardt, R., Mundt, T., Hannak, W., Kohal, R., Kern, M., Nothdurft, F., Hartmann, S., Boening, K., Boldt, J., Stark, H., Edelhoff, D., Woestmann, B., Wolfart, S., Jahn, F., ...Walter, M. (2021). IMPACT OF SHORTENED DENTAL ARCH ON ORAL HEALTH-RELATED QUALITY OF LIFE. Journal of Evidence-Based Dental Practice. 21(4), Article 101622. https://doi.org/10.1016/j.jebdp.2021.101622