The Randomized Shortened Dental Arch Study: Tooth Loss Over 10 Years

Area of Science:

• Dental Prosthodontics
• Oral Health Outcomes
• Clinical Trials

Background:

• Bilateral shortened dental arch (SDA) management involves complex prosthetic considerations.
• Nonimplant treatments are crucial for patients with complete molar loss.
• Long-term comparative data on different nonimplant strategies are essential for evidence-based practice.

Purpose of the Study:

• To compare the 10-year outcomes of two nonimplant treatments for bilateral shortened dental arch (SDA).
• To evaluate tooth loss and survival rates between partial removable dental prosthesis (PRDP) and SDA treatments.

Main Methods:

• A multicenter randomized controlled clinical trial involving 152 patients with complete molar loss in one arch.
• Patients were assigned to either PRDP (distal-extension prosthesis with precision attachments) or SDA (preserving/restoring premolar occlusion).
• 10-year follow-up examinations assessed dental and prosthetic status, with survival analysis and Cox regression.

Main Results:

• At 10 years, 82 patients completed the examination.
• Intention-to-treat analysis showed 10-year tooth loss survival rates of 0.44 for PRDP and 0.52 for SDA.
• Tooth loss in the study arch had survival rates of 0.67 for PRDP and 0.60 for SDA; higher than expected.
• Age and DMFT (Decayed, Missing, Filled Teeth) were significant predictors of tooth loss.

Conclusions:

• The prosthetic management's influence in bilateral SDA may have been overestimated.
• Treatment decisions for SDA should incorporate patient preferences.
• Further research into factors influencing long-term tooth retention in SDA patients is warranted.