Yesterday we looked at the reported periodontal outcomes from a multicenter trial that compared the outcomes for two different treatment options for the shortened dental arch. Today we are considering the report of the oral health quality of life outcomes (OHRQoL).
As outlined previously patients were randomised into two groups; a partial removable dental prosthesis (PRDP) group to replace missing molars and a shortened dental arch (SDA) group with no molar replacement. OHIP-49 was used to measure OHRQoL with data being collected before treatment (pretreatment); 6 weeks (baseline), 6 months, and 12 months (1 year) after the study intervention; and thereafter annually until 5 years.
- 81 patients received RPDPs and 71 patients received SDA treatment (age 34 to 86 years).
- OHIP data was available for 60 patients in the RPDP group and 57 in the SDA group at 5 years.
- No difference in total OHIP score or its subscales between the study groups at any time (p>0.05).
- The median OHIP total scores for pretreatment, baseline, 1 year, and 5 years follow-up show significant reductions of impact.
- In both groups, significant reductions of impact occurred from pretreatment to baseline, with a further improvement in OHRQoL in the RPDP group until the 1-year follow-up (p=0.0002).
- In all subscales, there was a significant reduction of impact from pretreatment to baseline (p<0.0001). In the RPDP group, there is a further significant change from baseline to 1 year in the subscales physical pain, psychological discomfort, physical disability, psychological disability, and handicap (p≤0.05). These were not present in the SDA group (p>0.05).
- From the 1-year follow-up there were no further changes in OHRQoL
The authors concluded
Both treatments show a significant improvement in OHRQoL, which continued in the RPDP group until the 1-year follow-up. No significant differences were seen between groups.
We have highlighted other findings from this interesting study previously (Dental Elf 12th May 2014 & 5th July 2012) and with increased interest in patient reported outcomes it is good to see these published. The authors raise the issue of the sample size as the original power sample suggested at 80 patients per group were required. The authors also highlight the heterogeneity of the dental treatments require both in terms of extend and complexity.
Wolfart S, Müller F, Gerß J, Heyedcke G, Marré B, Böning K, Wöstmann B, Kern M, Mundt T, Hannak W, Brückner J, Passia N, Jahn F, Hartmann S, Stark H, Richter EJ, Gernet W, Luthardt RG, Walter MH. The randomized shortened dental arch study: oral health-related quality of life. Clin Oral Investig. 2014 Mar;18(2):525-33. doi: 10.1007/s00784-013-0991-6. Epub 2013 May 17. PubMed PMID: 23680969.
Dental Elf 12th May 2014 – Trial found minor deterioration of periodontal status in patients with a partial removable dental prosthesis
Dental Elf – 5th July 2012 – Restoring the shortened dental arch with partial removable dental prosthesis
Enjoy following this study. I need to go back to the original protocol but were the partials in both arches or only one? To me if I could get enough function on a SDA this would seem better than wearing an appliance. The next study should compare SDA with first molar occlusion using an implant. My money is on an implant. While quality of life outcomes are subjective I do think we can learn a lot with this type of qualitative study.
The trail protocol has been published and can be read at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2843681/” title=”The randomized shortened dental arch study (RaSDA)design and protocol” rel=”nofollow”>
from a quick scan it is not clear if they placed partials in both arches. It would be interesting to see clinical and QoL outcomes from other approaches.
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