Periodontal health in shortened dental arches: A 10-year RCT

Abstract

Purpose: This analysis focused on periodontal health in shortened dental arches (SDAs).
Methods: In a randomized controlled clinical trial, patients with missing molars in one jaw and at least one premo-lar and canine on both sides were eligible for participation. In the partial removable dental prosthesis (PRDP) group ( n = 79), molars were replaced with a precision attachment retained PRDP. In the SDA group ( n == 71), the SDA up to the second premolars was either left as is or restored with fixed den- tal prostheses. Outcome variables were vertical clinical attachment loss (CAL-V), pocket probing depth (PPD), bleeding on probing (BOP) and plaque index (PLI). For CAL-V and PPD, the changes at six mea- suring points per tooth were analyzed. For BOP and PLI, patient related rates were calculated for each point in time. Statistical methods included linear regression analyses.
Results: In the intention-to-treat (ITT) analysis for CAL-V in the study jaw, the 10 year patient related mean changes were 0.66 mm in the PRDP group and −0.13 mm in the SDA group. The resulting mean patient related group difference of 0.79 mm (95% CI: 0.20 mm–1.38 mm) was significant ( p = 0.01). There were no significant differences in the ITT analyses for PPD. For BOP and PLI, significant group differences with more favorable results for the SDA group were found.
Conclusions: In view of lacking substantial differences for CAL-V and PPD, the overall differences were considered of minor clinical relevance. The results add confirmatory evidence to the shortened dental arch concept and its clinical viability (controlled-trials.com ISRCTN97265367).