Occlusion and Temporomandibular Function among Subjects with Mandibular Distal Extension Removable Partial Dentures

Abstract

Objective. To quantify effects on occlusion and temporomandibular function of mandibular distal extension removable partial dentures in shortened dental arches. Methods. Subjects wearing mandibular extension removable partial dentures (n = 25) were compared with subjects with shortened dental arches without extension (n = 74) and with subjects who had worn a mandibular extension removable partial denture in the past (n = 19). Subjects with complete dentitions (n = 72) were controls. Data were collected at baseline and at 3-, 6-, and 9-year observations. Results. Occlusal activity in terms of reported awareness of bruxism and occlusal tooth wear of lower anterior teeth did not differ significantly between the groups. In contrast, occlusal tooth wear of premolars in shortened dental arches with or without extension dentures was significantly higher than in the controls. Differences amongst groups with respect to signs and symptoms related to temporomandibular disorders were not found. Occlusal support of the dentures did not influence anterior spatial relationship. Occlusal contacts of the denture teeth decreased from 70% for second premolars via 50% for first molars, to 30% for second molars. Conclusions. Mandibular distal extension removable partial dentures in moderate shortened dental arches had no effects on occlusion and temporomandibular function.

The shortened dental arch revisited: from evidence to recommendations by the use of the GRADE approach

“…Most evidence, however, was derived from crosssectional studies and was scored as very low by the authors. Moreover, BES results are in agreement with the results of the studies included (23,26) in the systematic review, which also revealed that occlusion changes were self-limiting and became stable with time. This body of evidence might therefore support the conducting of a well-designed and robust RCT including the non-therapy approach, with the objective of confirming, or not, previous findings on SDA.…”

“…One (20) reported SD only. One (23) reported SD and SE. Two studies did not report any measure of imprecision (21,22).…”

“…Four studies were RCT (19)(20)(21)(22), and five studies were CT (23)(24)(25)(26)(27). More than 10 different endpoints were used to assess the effectiveness of therapy and ⁄ or other approaches for SDA.…”

Effects of removable dental prostheses on masticatory performance of subjects with shortened dental arches: A systematic review

“…[4][5][6][7][8] Arguments for not extending SDA with distal-extension RDP are potential risk for deterioration of abutment teeth, not contributing to long-term stable occlusion, and perceived limited 'added value' resulting in not wearing the RDP. [9][10][11][12] It has been estimated for the United Kingdom, that some 30 to 50% of patients never or only occasionally wear their RDP. 12 Regarding masticatory ability, only approximately 10% of subjects with moderate SDA reported complaints on chewing function, mainly for chewing hard foods.…”

Prosthetic Rehabilitation of Short Dental Arch: Systematic Review.

“…5(12), 88-100 89 of the molar teeth 16 . Contrary, several studies and reviews have indicated that twenty occluding teeth provide sufficient oral functional ability and the need to replace all missing posterior teeth has been questioned 1,7,11,14,[16][17][18][19][20] When dentists extend or reconstitute reduced, shortened or discontinuous dental arches and replace missing teeth in either anterior or posterior regions to create a complete dental arch (CDA), the following interventions are usually recommended: removable partial denture prosthesis (RPDP) or cantilever fixed denture prosthesis (CFDP), including resin-bonded bridges and implant-retained fixed partial dentures (IFPDs) 18,21,22 .…”