Overtreatment with removable partial dentures in shortened dental arches

Abstract

In our cultural pattern shortened dental arches are frequently seen, as molars are often seriously afflicted by caries and periodontal disease. The necessary restorative treatment is often omitted because of lack of motivation andlor financial limitations.Clinical investigations among subjects with shortened dental arches show that there is sufficient adaptive capacity to maintain adequate oral function when at least four occlusal units are left, preferably in a symmetrical position.Treatment by providing free-end removable partial dentures introduces unfavourable conditions for the remaining dentition. Overtreatment with these appliances is caused by traditional mechanically and morphologically oriented occlusal concepts, disregard of the adaptive capacity in biologic systems, and quantity promoting fee schedules. Problem solving approaches in occlusal therapy should be stimulated to prevent overtreatment.

Resin-bonded Cantilever Partial Dentures are Effective in Terms of Patient Satisfaction in the Restoration of the Mandibular Shortened Dental Arch

“…Kanno and Carlsson 2 carried out a comprehensive review of clinical and epidemiologic studies on this issue. Their review supports credible work by a Dutch research group [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] demonstrating that people can adapt to shortened dental arches in which 3 to 5 occlusal units remain. However, extreme cases with only 0 to 2 remaining units (1 unit = a pair of occluding premolars; 2 units = a pair of occluding molars) should be individually assessed based on a patient's needs and demands as well as oral characteristics, such as periodontal health, type of occlusion, parafunctional habits, and temporomandibular disorders.…”

A systematic review of prosthetic restoration in patients with shortened dental arches

“…Furthermore, treatment with RPDs has a high 'biological cost' with high caries incidence and periodontal breakdown of abutment teeth [4][5][6]. Thus, fixed restorations using CFPDs or IFPDs are recommended as alternative options for replacement of distal extension edentulous space especially in patients who have high risk for caries occurrence and periodontal disease [7][8][9][10]. Japanese Dental Science Review (2011) 47, 167-174 KEYWORDS Prosthetic restoration; Shortened dental arch; Removable partial denture; Cantilever fixed partial denture; Implant-supported fixed partial denture Summary The literature regarding the effect of prosthetic restoration in patients having distal extension edentulous space in posterior area (shortened dental arch: SDA) is reviewed in the following article.…”

A survey of dentists practice in the restoration of the shortened dental arch

“…Also, some patients may be reluctant to leave their SDAs unrestored. Furthermore, there are still situations where extending the SDA should be considered, where loss of posterior teeth creates, for example, aesthetic problems, occlusal instability or chewing difficulties (3,4).…”