Introduction: To formulate an ideal treatment plan for edentulous patients, data collected from various diagnostic aids need to be structured and classified according to their treatment needs. The lack of structured diagnostic findings for edentulous patients has always been a barrier to effective care for patients. To address these issues, the American College of Prosthodontists (ACP) established the Prosthodontic Diagnostic Index (PDI) based on specific criteria. Aim: To screen and allot completely edentulous patients to students using PDI in a dental school, in Jeddah, Saudi Arabia. Materials and Methods: This cross-sectional study was conducted on 122 completely edentulous patients who visited the outpatient clinic of a dental school in Jeddah, Saudi Arabia. The edentulous patients based on PDI were classified into four classes (Class I–IV) according to the diagnostic findings based on the complexities. The parameters studied were: mandibular bone height measured on a panoramic radiograph, residual ridge morphology of the maxillary arch, muscle attachments in the mandibular arch, and maxillomandibular relationship. Statistical analyses were performed using counts and percentages. Results: In the overall classification of PDI maximum 52 (42.6%) patients were classified as Class IV. Among the different criteria of PDI, 48 (39.4%) patients exhibited Class III mandibular bone height of 11-15 mm, whereas 40 (32.8%) patients exhibited Class IV mandibular bone height of 10 mm or less. In the maxillary residual ridge morphology, 62 patients (50.8%) were classified as Class I. A large number of patients 84 (70%) had Type A mandibular muscle attachment criteria and were classified as Class I or II. In the maxillomandibular relationship, the maximum number of patients 74 (60.7%) was of Class I. Conclusion: The majority of patients in the study were categorised as Class IV (severely compromised). Edentulous patients must be classified according to PDI during the initial screening phase so that less complex cases (Class I and II) can be allotted to undergraduate students and more complex cases (Class IV) can be handled by prosthodontists or can be referred to specialist centers so that costly and time-consuming remake of complete dentures can be avoided.
The importance of the first molar in the development of occlusion is well-known. The difficulties when first molar is not there during the eruption of the second molar and the premolar don't have to be explained much. The construction of a space maintainer in the area of missing first molar is difficult when seven and five are not erupted. The article highlights a case where a grossly decayed first molar with repeated endodontic failures was treated by intentional extraction and replantation as a last resort. A follow-up along with indications and considerations are documented.
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