Despite improvements in oral health tooth loss is common and is strongly associated with socio-economic status.  Removable partial dentures (RPD) provide a lower cost option than fixed partial dentures (FPDs) and dental implants for tooth replacement. Although reviews suggest that as many as 30-50% of patients provided with them may not use their RPDs.

The aim of this review was to assess the influence of removable partial denture (RPD) therapy on satisfaction and quality of life (QoL).

Methods

Searches were conducted in the PubMed, Embase and Cochrane Central databases

Randomised controlled trials (RCTs), Controlled clinical trials  (CCTs), cohort studies and retrospective studies  with more than 10 patients reporting on quality of life and or patient satisfaction with RPDs and published in English, Spanish, or German were considered. Two reviewers selected studies. Data was abstracted and study bias was assessed. A qualitative summary was presented.

Results

• 18 studies involving a total of 4002 patients were included.
• 16 reported on treatment satisfaction, 6 reported on oral health- quality of life (OHQoL)
• 5 of the studies were prospective (2 RCTs; 3 cohorts). The remaining studies were retrospective cross-sectional designs.
• improvement in OHQoL or satisfaction following provision of RPDs was not consistently reported.
• little evidence supporting any association between patient-reported QoL or satisfaction with technical or biological parameters of therapy.

Conclusions

The authors concluded: –

A paucity of detailed investigations concerning outcomes of RPD therapy was noted. Improvement in OHQoL or satisfaction following provision of RPDs was not consistently reported. There is little evidence supporting any association between patient-reported QoL or satisfaction with technical or biological parameters of therapy. Therapeutic success of tooth replacement using RPDs should be carefully considered and compared with alternatives.

Comments

A broad database search was conducted for this review but few prospective studies were identified. As the authors note it is surprising that given the large number of patients with missing teeth there is a paucity of research on outcomes related to RPDs in general and patients related outcomes in particular.  The lack of prospective studies means that the available data is at high risk of bias. The author also note that research suggests that recognised design or fabrication standards of RPDs relate to patient satisfaction.

Links

Primary paper

De Kok IJ, Cooper LF, Guckes AD, McGraw K, Wright RF, Barrero CJ, Bak SY, Stoner LO. Factors Influencing Removable Partial Denture Patient-Reported Outcomes of Quality of Life and Satisfaction: A Systematic Review. J Prosthodont. 2017 Jan;26(1):5-18. doi: 10.1111/jopr.12526. Epub 2016 Sep 6. Review. PubMed PMID: 27598416.

Other references

Dental Elf – 16^th Jun 2017

 Shortened dental arch: impact on oral health-related quality of life