Longevity of removable prosthodontics

Tooth loss can occur at any stage of life and replacement of missing teeth can be replace using a removable dental prosthesis (RDP), bridges or implants. The aim of this review from the Canadian Agency for Drugs and Technologies in Health (CADTH) was to determine the longevity of removable dental prostheses with a focus on complete dentures and partial plastic or metal dentures. Three questions were to be addressed:-

What is the clinical evidence on the longevity of complete dentures?
What is the clinical evidence on the longevity of plastic partial dentures?
What is the clinical evidence on the longevity of metal partial dentures?

Methods

Searches were conducted in PubMed, The Cochrane Library, University of York Centre for Reviews and Dissemination (CRD) databases, Canadian and major international health technology agencies and restricted to the English language A single review selected studies. The AMSTAR checklist was used to assess systematic reviews with non-randomised studies being assessed using the Downs & Black checklist. A narrative summary of the findings was presented.

Results

8 studies (5 systematic reviews, 1 RCT and 2 non-randomised studies) were included.
3 studies were from Germany, with one each from Brazil Canada, Greece, Switzerland, and USA.
The included systematic reviews were considered to be of limited quality.
Only 1 study was included for both complete dentures and metal partial dentures .
6 studies were included on plastic partial dentures.

Conclusions

The authors concluded:

The investigations included in this report for complete and partial plastic removable dental prostheses demonstrate a wide range of survival at various time points. After 5 years survival times ranged from 83.6% for plastic RPDs to 100% for complete dentures. This suggests that the overall endurance of these prostheses at this time point may be acceptable. In many situations the complications that were encountered were easily repaired though the variability in these results makes analysis of this difficult.

Comments

There was limited evidence available to address the three questions posed and the numbers of patients involved in the studies was also small. The authors also highlighted a lack of a standardised definition for success and failure, which makes study comparisons difficult. These issues mean that the findings form this review must be interpreted with caution.