ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title When Maintenance of Two Remaining Contralateral Mandibular Teeth Is Possible, Patients Report High Satisfaction with Tooth-Supported Direct Abutment Overdentures and Moderate Satisfaction with Removable Partial Dentures
Clinical Question In patients with two remaining contralateral mandibular teeth, is higher satisfaction reported by patients with an overdenture or a removable partial denture (RPD)?
Clinical Bottom Line Separate studies show that patients with tooth-supported direct abutment overdentures have a high level of satisfaction, while patients with a mandibular RPD report moderate satisfaction. A direct comparison study does not exist. Both prostheses should be an option for a patient with two remaining contralateral mandibular teeth.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23741602Gargari/201243 patients needing total prosthetic rehabilitationCohort Study
Key resultsThe article reports that there was no statistically significant difference in satisfaction between implant-supported and tooth-supported overdentures. There was a high level of satisfaction in masticatory function, aesthetics, and phonetics for tooth-supported overdentures. They also report that patients had a slightly higher level of satisfaction aesthetically with the tooth-supported overdenture. However, no p-values were reported to confirm.
#2) 9656176Frank/1998410 patients who received a mandibular RPD within the last 5 yearsCase Control Study
Key resultsThe majority of patients were overall moderately or completely satisfied with their mandibular RPD. 26% of patients reported overall dissatisfaction or only slight satisfaction. Younger age (less than age 60), poorer health, and no prior experience lead to most reports of dissatisfaction. These indirectly related factors are not associated to the RPD itself.
Evidence Search ((("overdenture") AND "root supported") AND (("tooth supported overdenture" OR "tooth supported overdentures"))) AND "satisfaction" and (("removable partial denture") AND "mandibular") AND satisfaction
Comments on
The Evidence
Validity: Different satisfaction questionnaires were used in each study. Gargari’s study was prospective while Frank‘s was retrospective. Gargari never mentioned how patients were selected for each group, which might suggest some bias. Frank’s questionnaire was more extensive and provided numbers that were the result of statistical analysis. The information collected was also not exclusive to specific remaining teeth in the mandible. No competing interests were reported in either study.
Applicability No studies exist comparing the satisfaction of patients with two remaining contralateral teeth being used as tooth supported direct overdenture abutments for a mandibular complete denture vs being used as sole abutment teeth for a mandibular RPD. However, these satisfaction surveys give some guidance about what outcomes might be expected when presenting mandibular removable prosthetic treatment plans for the patient with two contralateral mandibular teeth.
Specialty/Discipline (General Dentistry) (Prosthodontics)
Keywords Tooth-supported overdentures, removable partial denture, satisfaction
ID# 3047
Date of submission: 04/13/2016spacer
E-mail HolbeinA@livemail.uthscsa.edu
Author Arden Holbein
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Tam T. Van, DDS
Faculty mentor/Co-author e-mail Van@uthscsa.edu
Basic Science Rationale
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