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Comparison of postinsertion adjustments between conventional and immediate complete dentures and their association
Neena L D'Souza1, Ana Vasconcelos2, Beshr HajHamid3
1Adjunct Professor, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; and Private practice, Mississauga, Ontario, Canada.
Statement Of Problem:
Patient satisfaction with complete dentures has been linked to the number of postinsertion adjustments. However, evidence on the number of postinsertion appointments and adjustments and their link to denture survival is limited.
Purpose:
The purpose of this retrospective clinical study was to compare patient demographics, the number of postinsertion appointments and types of adjustments between conventional and immediate complete dentures and their association with denture survival 5 years after insertion of the prosthesis.
Material And Methods:
The records of patients at a university clinic for whom standard and immediate conventional complete dentures were inserted between 2013 and 2015 and followed up for 5 years were examined. The outcome variables included postinsertion appointments, types of major and minor adjustments, and denture survival. Statistical analyses included descriptive statistics for data summarization and chi-squared and Fisher exact tests for categorical variables. Survival analysis (Kaplan-Meier, Cox regression) and logistic regression (simple, multivariable) assessed denture failure risks, while Poisson regression evaluated numerical outcomes (α=.05).
Results:
The study comprised 246 participants with 195 standard and 113 immediate dentures. There were 135 (54.9%) men, 111 (45.1%) women, with a mean ±standard deviation age of 66.80 ±11.86 years with no significant differences between sexes. Twenty-five dentures failed, representing a failure rate of 8.1%. (Kaplan Meier estimated failure-free time mean=4.39 years with 95% confidence interval 4.16 to 4.61 years). Immediate dentures had a significantly higher failure rate (n=15, 13.3%) compared with standard dentures (n=10, 5.1%), Fisher exact P=.016, and were associated with significantly more postinsertion appointments compared with nonfailed dentures (OR=1.49, 95% CI 1.12 to 1.99, P=.007). The mean number of postinsertion appointments for all dentures was 4.07, median=3; the majority of participants (68.8%) had no major and 68.8% had 4 or fewer minor adjustments. Immediate dentures in general were associated with more postinsertion appointments (Poisson regression, P<.001) with minor (P<.001) and major adjustments, (P<.001) compared with standard dentures. Immediate dentures were separately associated with more minor (multiple Poisson regression), (P<.001) and major adjustments (P=.001) compared with standard dentures. Participants with cardiovascular disorders (mean=0.63) had significantly more major adjustments than those with other medical conditions (mean=0.38), P=.022).
Conclusions:
The 5-year survival rate for complete dentures was 91.9%. Immediate dentures had a higher failure rate and required more appointments and adjustments than standard complete dentures.
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