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The randomized shortened dental arch study: tooth loss over five years
Authors:M. H. Walter  W. Hannak  M. Kern  T. Mundt  W. Gernet  A. Weber  B. Wöstmann  H. Stark  D. Werner  S. Hartmann  U. Range  F. Jahn  N. Passia  P. Pospiech  G. Mitov  J. Brückner  S. Wolfart  E. Busche  R. G. Luthardt  G. Heydecke  B. Marré
Affiliation:1. Department of Prosthetic Dentistry, University Hospital Carl Gustav Carus, Dental School, Technische Universit?t Dresden, Fetscherstra?e 74, 01307, Dresden, Germany
2. Department of Prosthodontics, Geriatic Dentistry and Craniomandibular Disorders, CC3, Center for Dental and Craniofacial Sciences, Campus Benjamin Franklin, Charité Universit?tsmedizin Berlin, A?mannshauser Str. 4-6, 14197, Berlin, Germany
3. Department of Prosthetic Dentistry, Christan-Albrechts University at Kiel, Arnold-Heller-Str. 16, 24105, Kiel, Germany
4. Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Rotgerberstr. 8, 17487, Greifswald, Germany
5. Department of Prosthetic Dentistry, Ludwig-Maximilians University, Goethestr. 70, 80336, Munich, Germany
6. Department of Prosthetic Dentistry, Justus-Liebig University of Giessen, Schlangenzahl 14, 35392, Gie?en, Germany
7. Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Welschnonnenstr.17, 53111, Bonn, Germany
8. Department of Prosthetic Dentistry, Julius-Maximilians University of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
9. Department of Prosthetic Dentistry, Johannes Gutenberg University of Mainz, Augustusplatz 2, 55131, Mainz, Germany
10. Institute for Medical Informatics and Biometry, Medical Faculty Carl Gustav Carus, Technische Universit?t Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
11. Department of Prosthetic Dentistry and Dental Material Science, Friedrich-Schiller University of Jena, An der alten Post 4, 07740, Jena, Germany
12. Department of Prosthetic Dentistry, Albert-Ludwigs University of Freiburg, Hugstetter Str.55, 79106, Freiburg, Germany
13. Danube Privat University Krems, Dr-Karl-Dorrek-Str 23, 3500, Krems, Austria
14. Department of Prosthetic Dentistry and Dental Material Science, University of Leipzig, Nürnberger Str.57, 04103, Leipzig, Germany
15. Department of Prosthodontics and Dental Materials, RWTH Aachen University, Pauwelsstra?e 30, 52074, Aachen, Germany
16. Department of Prosthetic Dentistry, Witten–Herdecke University, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany
17. Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
18. Department of Prosthodontics, University Medical Center Eppendorf, Martinistra?e 52, 20246, Hamburg, Germany
Abstract:

Objectives

The study was designed to provide clinical outcome data for two treatments of the shortened dental arch (SDA).

Material and Methods

In a multicenter randomized controlled clinical trial, patients with complete molar loss in one jaw were provided with either a partial removable dental prosthesis (PRDP) retained with precision attachments or treated according to the SDA concept preserving or restoring a premolar occlusion. No implants were placed. The primary outcome was tooth loss.

Results

Of 152 treated patients, 132 patients reached the 5-year examination. Over 5 years, 38 patients experienced tooth loss. For the primary outcome tooth loss, the Kaplan–Meier survival rates at 5 years were 0.74 (95 % CI 0.64, 0.84) in the PRDP group and 0.74 (95 % CI 0.63, 0.85) in the SDA group. For tooth loss in the study jaw, the survival rates at 5 years were 0.88 (95 % CI 0.80, 0.95) in the PRDP group and 0.84 (95 % CI 0.74, 0.93) in the SDA group. The differences were not significant. No Cox regression models of appropriate fit explaining tooth loss on the patient level could be found.

Conclusions

The overall treatment goals of a sustainable oral rehabilitation and the avoidance of further tooth loss over longer periods were not reliably achievable. The influence of the type of prosthetic treatment on tooth loss might have been overestimated.

Clinical Relevance

Regarding our results, the patient’s view will gain even more importance in the clinical decision between removable and fixed restorations in SDAs.
Keywords:
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