Background
The prosthodontics considerations for the treatment of edentulism can be divided as removable and fixed appliances. The conventional mucosa and tooth-supported dentures are the most widely used form of removable appliances for both maxillary and mandibular edentulous regions. The aim of this doctoral study, which was split as retrospective epidemiological and prospective clinical parts, was to analyse trends of prosthodontic treatment on Kosovo and to assess the influence of removal partial dentures on oral health indicators among residents in the Kosovo.
Participants and Methods
For the epidemiological study, the data on ARPDs delivery and CDs delivery were obtained from the archives of primary health centres of three Kosovo regions (Prizren, Peje, Ferizaj) from 2002 to 2013. The data were analysed concerning year of treatment, type of dentures, jaw, age, gender and urban or rural origin of the patients. The prospective clinical study was performed on 40 patients of which 20 received ARPDs (9 maxilla and 11 mandible) and 20 received MRPDs (9 maxilla and 11 mandible). The patients were aged between 45-65 years with 24 females and 16 males. To monitor oral health, the various parameters were analysed: biological complications like caries, tooth fractures, tooth loss, clinical and biochemical indicators of periodontal complications, with additional biochemical measurement of serum C-reactive protein (Hs-CRP), and alkaline phosphatase (ALP) and three-dimensional changes in the bone and soft tissues under denture free-end saddles. Technical complications of denture dental and gingival components were detected. The influence of RPDs on the patients’ quality of life were analysed with Oral Health Impact Profile (OHIP-14) questionnaire.
Results
The significant results of the epidemiological study showed that there was an increase in the absolute numbers of CDs when taken into consideration the relative numbers of ARPDs. However, the average number of ARPD’s increases more rapidly compared with the average number of CD’s and the potential for this denture type to be used in younger patients was significantly higher.
In the prospective study: i) no distinct differences between MRPDs and ARPDs in new carious lesions; ii) abutment teeth with higher plaque scores in MRPD’s wearers when compared to ARPD’s wearers, whereas ARPD users had significantly higher mean BOP values than MRPD users; iii) no significant differences between MRPDs and ARPDs in mobility of abutment teeth; iv) no significant differences between MRPDs and ARPDs regarding biochemical measures CRP and ALP; v) no significant differences between MRPDs and ARPDs regarding bone and soft tissue changes in mandibular jaws based in qualitative scoring classification as well as based on quantitative bone and mucosa volume changes; vi) at T1 interval both compared denture groups had higher OHIP-ALB14 scores and the average scores significantly decreased in T2 and T3, but with no significant differences between MRPD and ARPD.
Conclusion
The trend in the frequency of new CD and ARPD treatment increased linearly from 2002 to 2013 in the Primary Health Centres in three regions of Kosovo. The need for CD treatment in absolute numbers is more than twice as high as the need for treatment with ARPD. However, the proportion of ARPDs compared to CDs significantly increased over the years.
Conclusions can be summarized that after 12 months of treatment with removable partial dentures, there are no differences between ARPD and MRPD in terms of the occurrence of technical and biological complications and patients oral health self-assessment.
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