SELF-PERCEIVED ESTHETICS, CHEWING FUNCTION AND ORAL HEALTH-RELATED QUALITY OF LIFE IN PATIENTS TREATED WITH NEW REMOVABLE DENTURES
Figure 3. Mean differences between the baseline and the after-treatment scores of the OES, OHIP14 and CF questionnaires in the CD and the CD-RPD group of patients
However, with the mean after-treatment OES summary score as the dependent variable, the effect of the factor type of treatment was statistically significant( F = 5.60, p < 0.01), while gender( F = 0.02; p = 0.9) and age( F = 0.8; p = 0.37) showed no significant effects. Patients with CDs in both jaws rated their aesthetics significantly better( higher scores) than the CD-RPD group.
4. Discussion
The treatment of complete or partially edentulous patients has long been a major challenge in prosthodontics. Many studies had confirmed significant benefit of an implant-prosthodontic therapy. 20-22 Removable dentures receiving support from dental implants have been improving patients’ OHRQoL and / or chewing function better than. the conventional removable denture therapy
20-22
However, the conventional complete and removable partial dentures have still been the most common treatment in the world, mostly due to medical and / or economic factors. 23-25 Therefore we decided to analyze treatment results obtained by conventional removable dentures. The success of conventional treatment with removable dentures often depends mostly on the patients’ adaptive capacity to overcome reduced retention and stability of dentures. 26 Patient-based outcome measures using psychometrically verified questionnaires have been recognized as important measures necessary to understand problems regarding orofacial issues. The results of such specific measures help dentists in planning and decision making. 27-29 We measured OES, CF and OHRQoL by standardized questionnaires to get better insight into the most common types of conventional removable denture therapy. The most frequent type of removable denture patients have been either completely edentulous patients in both jaws, or those who have been completely edentulous in
the maxilla and Kennedy Class I( with only incisors and incisors and canines left) in the mandible. Therefore we have chosen such groups of patients. As expected, both treatment options elicited significant treatment results and all after-treatment summary scores showed improvement of the issue measured( OHRQoL, CF, OES), compared to the baseline scores. The CD-RPD treatment showed slightly higher treatment effects than the CD treatment( although not significantly), which may be attributed to the fact that all CD patients had a previous pair of dentures, while some of the CD-RPD patients had no previous dentures in the mandible and therefore had worse baseline scores. Significantly lower after-treatment ratings of orofacial esthetics in the CD-RPD group than in the CD group may be attributed to the visibility of denture clasps in the mandible. Slightly better after treatment chewing function assessment in the CD- RPD group than in the CD group was attributed to the better retention of RPDs due to denture clasps as compared to complete mandibular dentures. However, slightly lower OHIP14 after-treatment scores registered in the CD group( better OHRQoL) may be attributed to clasp visibility. Some studies reported that besides the type of treatment, gender and age may also influence
23, 30
clinical outcomes by new removable dentures. To test the premise, the 2 way analysis of variance( ANCOVA) was performed with the OHIP14, the OES and the CFQ after treatment summary scores as dependent variables; gender and the type of treatment as independent variables, and the age as a covariate. The results revealed that gender and age yielded no significant effects( p > 0.05), either for a chewing function, or for the OHRQoL or orofacial aesthetics. However, limitations of the study have to be mentioned, such as various pre-treatment summary scores, as well as variability in a number
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