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The randomized shortened dental arch study: tooth loss over five years
1Department of Prosthetic Dentistry, University Hospital Carl Gustav Carus, Dental School, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany, michael.walter@uniklinikum-dresden.de
Clinical Oral Investigations
|June 27, 2012
Summary
This study found no significant difference in tooth loss between partial removable dental prosthesis and shortened dental arch treatments over five years. Neither approach reliably achieved sustainable oral rehabilitation or prevented further tooth loss.
Area of Science:
- Dental prosthetics
- Oral rehabilitation
- Clinical outcomes research
Background:
- The shortened dental arch (SDA) concept aims to preserve premolar occlusion after molar loss.
- Treatment options for missing molars include partial removable dental prostheses (PRDPs) and adhering to the SDA concept.
- Clinical outcome data comparing these treatments are crucial for patient management.
Purpose of the Study:
- To provide clinical outcome data for two treatments of the shortened dental arch (SDA).
- To compare tooth loss rates between PRDP and SDA treatments over a 5-year period.
Main Methods:
- A multicenter randomized controlled clinical trial was conducted.
- Patients with complete molar loss in one jaw received either PRDP with precision attachments or SDA treatment.
- The primary outcome measured was tooth loss, with no implants used.
Main Results:
- After 5 years, 132 of 152 patients were examined; 38 experienced tooth loss.
- Kaplan-Meier survival rates for tooth loss at 5 years were similar between PRDP (0.74) and SDA (0.74) groups.
- No significant differences in tooth loss were observed between the treatment groups, and no suitable Cox regression models were found.
Conclusions:
- Neither PRDP nor SDA treatments reliably achieved sustainable oral rehabilitation or prevented further tooth loss.
- The impact of prosthetic treatment type on tooth loss may have been overestimated.
- Patient preferences are increasingly important in clinical decisions regarding removable versus fixed restorations in SDAs.
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