Vrieling, Danielle (2021) A retrospective database study on implant-supported removable partial dentures in the mandibular: 5-year results. thesis, Dentistry.
Full text available on request.Abstract
This study aims to determine the success of an implant-supported removable partial denture (ISRPD) after a 5-year evaluation period based on clinical outcomes and patient satisfaction. The study is based on the implants, abutment teeth, the RPD’s and patients’ factors. To provide patients with evidence-based support information to make a more informed choice between one of the two treatments (conventional RPD or ISRPD) for bilateral free-ending saddles in the mandibula. Therefore, this study investigated whether ISRPD’s compared to conventional partial dentures 'removable partial dentures' (RPD) are still successful in terms of patient satisfaction and clinical outcomes of the implants, abutment teeth and frames after a period of 5 years. The study was set up as a retrospective database study, building on a randomized clinical trial in 2016. For this study, data from 27 of 30 Kennedy class I patients who had a conventional bilateral partial denture 'removable partial denture' (RPD) with lack of stability and retention, from the randomized clinical trial was analyzed after a 5-year period. First, the patients received a new RPD without implant support. After that, patients were treated bilaterally with 2 implants in the premolar and 2 implants in the molar region and received an ISRPD in 2016. Patients’ satisfaction through questionnaires was measured with a validated version of the Oral Health Impact Profile questionnaire (OHIP-49) which measures oral health-related quality of life and the Visual Analogue Scale (VAS). The clinical examination consisted of recording probing pocket depth, plaque, bleeding on probing, recession, bone level changes, biological complications and technical complications. Results were analyzed with the repeated measures ANOVA and the Wilcoxon signed rank test. Clinical variables of the implants and pillar elements were assessed at Tconventional and T5years. Patient satisfaction was assessed at Tbaseline, Tconventional and T5years. Retrospectively, an improvement in quality of life was seen in ISRPDs through reduction in total OHIP-NL49 score (15.1 14.8) compared to the old RPD (51.1 35.9) (p = ,000) and the new RPD without implant support (39.7 29.2) (p = ,000). A significantly higher patient satisfaction was seen with the implant supported treatment (88.3 13.5) (p < ,001) compared to the old RPD (42.0 26.2) and the new conventional RPD (60.6 30.6). An implant survival rate of 97.22% was seen in this study. As expected, peri-implant mucositis was seen in 40,7% of the implants and peri-implantitis in 12,96%. Stable peri-implant condition was seen in this study. A statistically significantly higher score (p < ,05) for probing pocket depth, bleeding on probing, recession and marginal bone level was seen around PM and M implants. Admittedly, this falls within the healthy range which is also seen in other studies. Around molar implants plaque is more seen in this study. A statistical significantly lower score for bleeding on probing was seen around the right and left abutment teeth (p < ,05). Minor technical complications occurred in 40,7% of the prostheses, these could be easily remedied. All patients were still wearing their implant-supported partial denture after 5 years. Within the limitations of this retrospective study, it can be concluded that an ISRPD is a viable and successful treatment option in case of a Kennedy Class I situation in the mandible. Nevertheless, regular visits and strict oral hygiene are recommended.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Jensen-Louwerse, Dr. C. |
| Faculty: | Medical Sciences |
| Date Deposited: | 01 May 2023 11:50 |
| Last Modified: | 01 May 2023 11:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3492 |
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