Sunteți pe pagina 1din 3

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


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


the frequency and degree of oral functional problems
1 Inukai M, Baba K, John MT, and Igarashi Y. Impact of Denture
under the domain of functional limitation. The study Quality on OHRQoL. J Dent Res 2008; 87: 736-39.
population was homogenous in relation to gender and 2 Hassel JA, Grossman CA, Ohlmann B, Rammelsberg P. Corre-
age, as the same groups were analyzed before and after lation between self rating of deture function and OHRQoL in
different age groups. Int J Prosthodont 2007; 20: 242-44.
the treatment. This is in agreement with Zaltaric et al9.
3 Szentpetery A, John M, Slade GD, Setz GM. Problems reported
In the present study , the majority of the patients by patients before and after prosthodontic treatment. Int J
Prosthodont 2005; 18: 124-31.
(96%) showed problem in pronouncing words before
4 Ozahayat EB, Stoltze K, Elverdam B, Owall B. A method for
removable partial denture therapy. This suggests that
assessment of QOL in relation to prosthodontics. Partial
patients encountered speech problems due to missing edentulism and removable partial denture. J Oral Rehabil
teeth and after removable partial denture therapy, 2007; 34: 336-44.
this problem was solved. This is in agreement with 5 Cosme CD, Baldisserorrto MS, Fernande EL. Functional evalu-
ation of oral rehabilitation with removable partial denture after
studies of Kuboki et al15 and John et al.16 In the present
five years. J Appl Oral Sci 2006; 14: 111-16.
study the significant increase in oral health impact
6 Yamazaki M, Inukai M, Baba K, John MT . Japanese version of
profile scores in half of population (56%) suggested the Oral Health Impact Profile (OHIP-J). J Oral Rehabil 2007;
increase in speech problems after removable partial 34: 159-68.
denture therapy. Similar results have been reported in 7 Walter MH, Woronul JI, Tan KH, Lenz U, Koch R, Boening WK,
a study by Szentpetry et al3 , who found that greater Pinchbeck JY.Oral health related quality of life and its associa-
tion with sociodemographic andclinical findings in 3 northern
percentage of patients (60%) reported speech prob- outreach clinics. JCDA 2007; 73(2): 153-153e.
lems at an interval of one month. But in a study by
8 Priscila C, Baelum V, Pannuti MC, Pustiglioni NA, Romito AG,
John et al,16 21% of the population showed difficulty in Pustiglioni EF .Tooth loss prevalence and risk indicators in an
pronouncing words after removable partial denture isolated population of Brazil. Acta Odontologica 2009; 67:
297-303.
therapy. Speech is a complex skill requiring prolong
adaptation to polish surface and shape of prosthesis, 9 Zaltaric KD, Celebic A, Valentic Peruzovic M, Celic R. A survey
of treatment outcomes with removable partial dentures. J Oral
thus lack of improvement in present study may be Rehabil 2006; 30: 847-54.
attributed due to shorter review period.17 10 Grossmann Y, Nissan J, Levin L. Clinical effectiveness of
implant supported removable partial dentures. A review of
The small sample size of one hundred and ten literature and retrospective case evaluation. J Oral Maxillofac
subjects was the limitation of this study. This sample Surg 2009; 67: 1941-46.
size did not allow detailed analyses of results accord- 11 Uludag B, Celik G: Fabrication of a maxillary implant-sup-
ported removable partial denture: A clinical report. J Prosthet
ing to the different Kennedys classes of partially den-
Dent 2006; 19: 95-97.
tate subjects. It has been reported that patients are
12 Allen P.F. Factors influencing the provision of removable par-
least satisfied with distal extension bases.15 Future tial dentures by dentists in irelend. J of the Irish Dental Associa-
studies should use more distinct patient groups e.g. tion 2010; 56: 224-29.
patients with different Kennedys classes and different 13 Scott BJ, Forgie AH, Davis DM. A study to compare the OHRQoL
denture design. and satisfaction before and after having replacement complete
dentures constructed by either copy or conventional technique.
Gerodontology 2006; 23: 79-86.
In the present study, there was an increase in
problem of altered taste sensation after removable 14 Panab S, Awadac M, Thomosonad MJ, Kobayashiae T, Kimutoaf
S. Sex differences in denture satisfaction. J Dent 2008; 36:
partial denture therapy . Szentpetry et al5 and John et 301-08.
al16 also showed the similar results after treatment but 15 Kuboki T, Okamoto S, Suzuki H, Kanyama M, Arakawa H.
the affected study population was small i.e. 20% and Quality of life assesement of bone anchored fixed partial den-
30% respectively. The increase in taste problem with ture patients with unilateral mandibular distal extension
edentulism. J Prosthet Dent 1999; 82: 182-87.
removable partial denture in the present study popu-
16 John MT, Hujoel PP, Miglioretti DL, Leresche L, Koepsell TD,
lation could be due to lack of education and awareness Michaelis W. Dimensions of oral health related quality of life. J
which was responsible for the negative attitude of Dent Res 2004; 83: 956-60.
these patients towards removable partial denture 17 Ahmed B, Hussain M, Yazdanie N. Oral stereogonostic ability:
therapy. Therefore more efforts should be made in a test of oral perception. J Coll Physician Surg Pak 2006; 16 :
794-98.
order to educate denture wearers.

Pakistan Oral & Dental Journal Vol 32, No. 3 (December 2012) 563