Evaluation of Oral Function after Removable Partial Denture Therapy

ORIGINAL ARTICLE

EVALUATION OF ORAL FUNCTION AFTER REMOVABLE PARTIAL

DENTURE THERAPY
1
AYESHA SADAF, BSC, BDS, FCPS
2
NAZIA YAZDANIE, BDS, MSC, PhD
3
AQEEL IBRAHIM, BDS, FCPS

ABSTRACT

This study aimed to evaluate the oral function after removable partial denture therapy from
patients perspective. It was a descriptive case series. One hundred and ten partially dentate subjects
were studied in the Department of Prosthodontics, de, Montmorency college of dentistry, Lahore. All
the subjects were given oral health impact profile -14 questionnaire before and one month after
provision of removable partial denture. Before and after treatment responses were recorded on 5 point
Lickert scale. The post treatment scores were compared with pretreatment baseline scores and
improvement in oral functional problems were assessed. 96% of study subjects had problems in
pronouncing words, which persisted in 56% of the subjects after using removable partial denture . 94%
of the study group had taste problems before removable partial denture treatment, which improved
in 50% of study population after therapy. This suggested that removable partial dentures had a
positive impact on oral function in almost half of the population. Lack of improvement in remaining
group can be attributed to lack of education and awareness which was responsible for negative attitude
of these patients towards removable partial dentures.

Key Words: Removable partial denture, Lickert scale, Oral health impact profile.

INTRODUCTION In the literature8,9,10 there is a strong support for

Tooth loss results in deterioration of functional,
psychological and social status of an individual.1 Re-
movable partial denture represents one of the major
treatment modalities for the replacement of missing
teeth.2 There are also some practical problems with
removable partial dentures such as food retention,
difficulty in pronouncing words and pressure spots3.
Their success is often judged differently by patients
and dentists.4,5 Dentists consider dentures successful
when they meet certain technical standards, whereas
patient evaluate them from their personal satisfaction
.Therefore, even if they are constructed according to
all accepted criteria, some patients are still
dissatisfied.6,7
the patient based measures than the functional mea-
sures for detecting the differences between the treat-
ment and psychosocial consequences of the oral condi-
tion. Thus the knowledge about patients use of remov-
able partial denture would be helpful to both the
dentist and patient, when making a decision about a
prosthodontic treatment option.
Studies11,12 show that clinicians judgment corre-
lates quite poorly with patients judgment about com-
fort, esthetics and function of removable partial den-
tures. Therefore the aim of present study was to
evaluate the oral functional problems after provision
of removable partial dentures from patients
perspective.

Correspondence:
1
Assistant Professor, Department of Prosthodontics, de,Montmorency College of Dentistry, Ravi Road Lahore. E-mail: drashsad@gmail.com
Cell No: 0321-4149089. Mailing Address: N-14 Cantt view Housing Scheme Bedian Road Lahore.
2
Professor & Dean Fatima Memorial Institute of Dentistry, Shadman Lahore. Email: nazia508@gmail.com. Cell No: 0333-4317508
3
Head Dental Department, CMH, Muzaffarabad

Pakistan Oral & Dental Journal Vol 32, No. 3 (December 2012) 561
 Evaluation of Oral Function after Removable Partial Denture Therapy

METHODOLOGY TABLE 2: GENDER DISTRIBUTION

Gender No. of patients Percentage
It was a descriptive case series. Non-Probability
sampling technique was used. Partially dentate sub- Males 53 48.0
jects with 4-5 teeth missing in either arch with age Females 57 52.0
range of 35-45 years and first time denture wearers Total 110 100
were included in the study. Study sample consisted of
one hundred and ten partially dentate subjects with 4-
5 missing teeth in either arch visiting Department of TABLE 3: NUMBER & PERCENTAGE OF PA-
Prosthodontics, Punjab Dental Hospital Lahore and TIENTS ACCORDING TO DIFFICULTY IN PRO-
requesting removable partial denture for the first NOUNCING WORDS AND PROBLEMS
ASSOCIATED WITH TASTE
time. Informed consent was taken from each subject.
Patients underwent a history and clinical examina- Oral functional Pre-treat- Post-treat-
tion. Patients were asked to answer a questionnaire on problem ment n (%) ment n (%)
socio-demographic factors. In addition a self adminis-
Difficulty in pro- 105 (96%) 61 (56%)
tered questionnaire called Oral health impact profile -
nouncing
1413 was used for patient based assessment of oral
functional problems i.e. problems in speech and sensa- Problems with taste 103 (94%) 55 (50%)
tion of taste. The questionnaire consisted of 14 ques-
tions which covered 7 domains namely functional
limitation, physical pain, psychological discomfort, TABLE 4: DISTRIBUTION OF PATIENTS AC-
physical disability, social disability and handicap. Only CORDING TO RESPONSES ON LICKERT SCALE
one domain i.e. functional limitation was selected for FOR DIFFICULTY IN PRONOUNCING WORDS
the present study. Responses by subjects were made Responses Before fre- After fre- Level of
on 5 point Lickert scale14 and coded as (0 = Never, 1= quency quency signifi-
Hardly ever, 2 = Occasionally, 3= Fairly often, 4= Very cance
often). The Prosthodontic procedures were carried out
by experienced Prosthodontists. All study subjects Never 3 6 P > 0.001
were subjected to answer the oral health impact pro- Hardly ever 16 29 P < 0.001
file-14 before treatment and one month after provision Occasionally 9 54 P < 0.001
of removable partial denture. The post treatment Fairly often 48 11 P < 0.001
scores were compared with pretreatment baseline
Very often 24 0 P < 0.001
scores . Confounding variables i.e. age , number of
missing teeth, experience of denture wearing and
prosthodontic treatment modality were controlled and TABLE 5: DISTRIBUTION OF PATIENTS AC-
being addressed in inclusion criteria. CORDING TO RESPONSES ON LIKERT SCALE
FOR PROBLEMS ASSOCIATED WITH TASTE
SPSS software version 16.0 was used to analyze
the data. The demographic variables (age, gender and Responses Before fre- After fre- Level of
occupation) were analyzed using simple descriptive quency quency signifi-
statistics. Age was presented by calculating Mean +- cance
S.D. Gender and responses of questions were repre- Never 9 11 P > 0.001
sented by calculating percentages and frequencies.
Hardly ever 26 43 P < 0.001
RESULTS Occasionally 18 36 P < 0.001
TABLE 1: DISTRIBUTION OF AGE OF THE Fairly often 34 7 P < 0.001
SUBJECTS Very often 13 3 P < 0.001
Age range (years) No. of patients DISCUSSION
35-40 years 43
Patient perception of oral health status are impor-
40-45 years 67
tant outcomes in Prosthodontics15 .Oral health prob-
Total 110
lems experienced by the patients seeking Prosthodontic
Mean + S.D = 41.1 + 2.91 treatment are important for diagnosis and success of

Pakistan Oral & Dental Journal Vol 32, No. 3 (December 2012) 562
 Evaluation of Oral Function after Removable Partial Denture Therapy
Prosthodontic therapy. The present study has shown
the frequency and degree of oral functional problems
under the domain of functional limitation. The study
population was homogenous in relation to gender and
age, as the same groups were analyzed before and after
the treatment. This is in agreement with Zaltaric et al9.
In the present study , the majority of the patients
(96%) showed problem in pronouncing words before
removable partial denture therapy. This suggests that
patients encountered speech problems due to missing
teeth and after removable partial denture therapy,
this problem was solved. This is in agreement with
studies of Kuboki et al15 and John et al.16 In the present
study the significant increase in oral health impact
profile scores in half of population (56%) suggested
increase in speech problems after removable partial
denture therapy. Similar results have been reported in
a study by Szentpetry et al3 , who found that greater
percentage of patients (60%) reported speech prob-
lems at an interval of one month. But in a study by
John et al,16 21% of the population showed difficulty in
pronouncing words after removable partial denture
therapy. Speech is a complex skill requiring prolong
adaptation to polish surface and shape of prosthesis,
thus lack of improvement in present study may be
attributed due to shorter review period.17
The small sample size of one hundred and ten
subjects was the limitation of this study. This sample
size did not allow detailed analyses of results accord-
ing to the different Kennedys classes of partially den-
tate subjects. It has been reported that patients are
least satisfied with distal extension bases.15 Future
studies should use more distinct patient groups e.g.
patients with different Kennedys classes and different
denture design.
In the present study, there was an increase in
problem of altered taste sensation after removable
partial denture therapy . Szentpetry et al5 and John et
al16 also showed the similar results after treatment but
the affected study population was small i.e. 20% and
30% respectively. The increase in taste problem with
removable partial denture in the present study popu-
lation could be due to lack of education and awareness
which was responsible for the negative attitude of
these patients towards removable partial denture
therapy. Therefore more efforts should be made in
order to educate denture wearers.
Pakistan Oral & Dental Journal Vol 32, No. 3 (December 2012)
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