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Patient's denture assessment cutoff values for classifying denture-treatment needs in removable complete denture
Tin Thinzar Linn1, Phichaya Phimonwongsaphor1, Pinpinut Wanichsaithong2
1Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
Purpose:
To determine the patient's denture assessment (PDA) cutoff values for classifying treatment needs in patients wearing conventional complete dentures (CCDs) and implant-retained overdentures (IODs).
Materials And Methods:
Ninety-six edentulous patients wearing mandibular CCDs or IODs (with opposing maxillary CCDs) for ≥3 months were clinically categorized into three treatment-need groups: no treatment required (G1), chairside maintenance required (G2), and laboratory modification required (G3) for the denture. The participants then completed the 19-item PDA using a 100-mm visual analogue scale. Data were analyzed using Spearman's rank correlation for association between PDA scores and treatment needs, Kruskal-Wallis tests for pairwise comparisons, and multinomial logistic regression to evaluate the association between the PDA subscale scores and treatment needs. Receiver operating characteristic curves were used to identify optimal PDA cutoffs on the basis of the highest Youden's index values alongside likelihood ratios (LRs).
Results:
Overall PDA scores correlated significantly with treatment needs (r = 0.606, p < 0.0001). Overall PDA scores differed significantly between G3 and G1 (p ≤ 0.001) and between G3 and G2 (p ≤ 0.02), but did not differ significantly between G1 and G2. For discriminating G3 from G1/G2, the optimal cutoff score was ≤83 mm (area under the curve [AUC]: 0.96, sensitivity: 0.86, specificity: 0.91, positive LR [LR+]: 6.6, negative LR [LR-]: 0.1). To identify any treatment need (G2/G3 vs. G1), the optimal cutoff score was ≤91 mm (AUC: 0.79, sensitivity: 0.81, specificity: 0.70, LR+: 2.7, LR-: 0.3). Lower "upper denture" subscale scores were significantly associated with the need for laboratory modifications (p = 0.03).
Conclusions:
The PDA is an effective clinical screening tool for complete-denture treatment needs, particularly for identifying laboratory-modification requirements. Suggested overall PDA cutoff scores are 84-91 mm for chairside adjustments and ≤83 mm for laboratory modifications.