Professional Documents
Culture Documents
Oral Rehabilitation
Introduction
Removable partial dentures (RPD) are an alternative
treatment for the restoration of edentulous areas; these
dentures are conservative treatments and provide a
rapid solution and accessible cost. However, longitudinal studies have shown that they have been associated
with increased gingivitis, periodontitis and abutment
teeth mobility (1, 2).
Clinical studies (3, 4) have emphasized RPD-related
periodontal tissue reactions, such as inflammation,
increase in probing depth, in dental mobility and in
marginal bone loss. Drake & Beck (4) stated that RPDs
have an unfavourable effect on patients periodontal
conditions. In addition, it appears that abutment teeth
suffer even more damaging effects, besides receiving
2010 Blackwell Publishing Ltd
546
B. A.
DO
A M A R A L et al.
Table 1. Type of teeth (incisor, canine, pre-molar and molar) presented in the study
Maxilla
Direct
Indirect
Control
Total
Mandible
Incisor
Canine
Pre-molar
Molar
Incisor
Canine
Pre-molar
Molar
Total
16
3
39
42
3
2
27
7
9
48
22
19
10
31
44
441
15
6
20
34
2
14
23
1
4
215
75
151
Mandible
Incisor
Canine
Pre-molar
Molar
Incisor
Canine
Pre-molar
Molar
Total
7
8
22
10
27
7
67
2
1
4
219
3
11
17
13
20
0
164
55
C-Clasp
T-bar clasp
Total
Maxilla
Mandible
Total
198
37
97
103
295
140
385
Results
Table 4. Sample size (n), mean, standard deviation, median, minimum, maximum, inferior limit and superior limit (95% confidence
interval) for probing depth (PD) in the studied groups
Time Point
Direct Retainer
Base line
3 months
6 months
9 months
12 months
Indirect Retainer
Base line
3 months
6 months
9 months
12 months
Control
Base line
3 months
6 months
9 months
12 months
CI (95%)
Lower
Upper
3830
4500
4330
9000
4500
2028
2176
2164
2386
2239
2195
2361
2339
2864
2424
1170
1330
1330
1330
1330
4330
4000
5170
9000
3830
1759
1946
1995
2001
2014
2052
2198
2334
2729
2330
1000
1170
1000
1000
1170
4000
4330
4000
4830
4830
1759
1908
1872
1894
1907
1935
2084
2067
2103
2106
Mean*
Standard deviation
Median
Minimum
Maximum
141
141
141
141
141
211a
226a
225a
262b
233a
05062
05613
05300
1450
05600
2000
2170
2170
2330
2170
1170
1000
1330
1330
1500
58
58
58
58
58
190a
207a.c
216a.c
236b.c
217a.c
05573
04788
06446
1383
06006
1830
2000
2085
2000
2000
99
99
99
99
99
184a
199a
196a
199a
200a
04406
04428
04861
05221
04987
1830
2000
2000
2000
2000
547
B. A.
DO
A M A R A L et al.
Table 5. Sample size (n), mean, standard deviation, median, minimum, maximum, lower and upper limits (95% confidence interval) for
gingival index (GI) in the studied groups
Time Point
Direct Retainer
Base line
3 months
6 months
9 months
12 months
Indirect Retainer
Baseline
3 months
6 months
9 months
12 months
**Control
Time point
Baseline
3 months
6 months
9 months
12 months
Mean*
Standard deviation
Median
Minimum
Maximum
CI (95%)
Lower
Upper
141
141
141
141
141
27199a.c
34021b
24695c
30518a
32000a
12253
18373
13314
17510
18742
25000
29000
25000
33000
28000
3000
7000
0000
6000
9000
62000
69000
57000
75000
96000
25176
30989
22497
27628
28906
29221
37054
26893
33408
35094
58
58
58
58
58
28293a
36379b
27621a
30397a.b
33138a.b
13679
16538
14503
13470
15539
29000
33000
23500
28000
29000
3000
7000
5000
6000
9000
62000
68000
57000
65000
59000
24695
32029
23806
26854
29051
31891
40729
31435
33939
37225
Ranks
Sum of ranks
Median
Minimum
Maximum
25000
28000
17000
33000
33000
3000
7000
5000
8000
9000
59000
69000
54000
75000
96000
104
104
104
104
104
31950a
34250a
22200b
31600a
36000a
12 months. There was a statistically significant difference across groups in terms of time-points: the direct
retainer group had greater PD values at 9 months when
compared with the other time-points; in the indirect
retainer group, PD values increased significantly from
initial assessment to 9 months. The direct retainer
group presented greater probing depth averages than
the other groups at all times, whereas the control group
had the lowest values. Every group demonstrated a
linear trend; that is, values increased over time, as
verified by the ANOVA test for linear trend (P < 0001)
(Table 4, Fig. 1).
28
26
Probing depth
548
24
22
20
18
Baseline
3 months
6 months
9 months
12 months
Time
Direct retainer
Indirect retainer
Control
400
Gingival index
350
300
200
Baseline
3 months
6 months
9 months
12 months
Time
Direct retainer
Indirect retainer
Control
800
750
Plaque index
700
650
600
550
500
Discussion
450
400
Baseline
3 months
6 months
9 months
12 months
Time
Direct retainer
Indirect retainer
Control
549
550
B. A.
DO
A M A R A L et al.
Table 6. Sample size (n), mean, standard deviation, median, minimum, maximum, inferior and superior limits (95% confidence interval)
for plaque index (PI) in the studied groups
Time Point
Direct Retainer
Base line
3 months
6 months
9 months
12 months
Indirect Retainer
Baseline
3 months
6 months
9 months
12 months
Control
Baseline
3 months
6 months
9 months
12 months
CI (95%)
Lower
Upper
10000
95000
99000
99000
99000
44665
56336
59336
60152
68754
51317
60811
65535
66506
73344
0000
17000
21000
9000
40000
10000
95000
99000
99000
99000
44882
48744
58669
52844
63177
57270
58673
69281
64979
70671
0000
20000
12000
9000
40000
99000
86000
99000
99000
99000
40444
53238
53637
53177
65899
47815
57959
61586
60662
71558
Mean*
Standard deviation
Median
Minimum
Maximum
225
225
225
225
225
47991a
58573b
62436b
63329b
71049c
25457
17126
23718
24313
17562
46000
58000
62000
59000
69000
0000
17000
12000
9000
40000
51076a
53709a.c
63975b.c.d
58911a.c.d
66924d
27608
22129
23651
27046
16703
45000
56000
69000
55000
66000
44130a
55599b
57611b
56920b
68728c
23935
15328
25809
24303
18375
43000
56000
55000
52000
68000
79
79
79
79
79
162
162
162
162
162
Table 7. Descriptive statistical analysis of probing depth (PD), gingival index (GI) and plaque index (PI) at baseline. P-values obtained
from analysis of variance. LL, lower limit; UL, upper limit
Group
Probing depth
Direct retainer
Indirect retainer
Control
Total
Gingival index
Direct retainer
Indirect retainer
Control
Total
Plaque index
Direct retainer
Indirect retainer
Control
Total
Mean
Standard deviation
Minimum
Maximum
LL (95%)
218
79
152
449
21047
19536
18794
20019
050559
057854
045114
051122
117
117
100
100
383
433
400
433
20372
18240
18071
19544
218
79
152
449
104
109
093
101
0976
0936
0896
0942
0
0
0
0
4
4
3
4
091
088
079
093
117
130
108
110
0414
218
79
152
449
190
192
163
182
1224
1196
1280
1243
0
0
0
0
4
4
4
4
174
166
143
170
207
219
184
193
0081
UL (95%)
21722
20832
19517
20493
0000
Rank
Sum of ranks
Mean
141
58
99
21587
94845
13480
15310
16353
13616
01700
03300
01700
)1000
)1170
)05000
1500
2330
1170
01203
141
58
104
19535
89345
17587
13854
15404
16911
3000
6000
8000
)43000
)43000
)15000
71000
28000
71000
00255
225
79
162
53014
16129
39669
23562
20416
24487
25000
15000
25000
)37000
)37000
)31000
99000
63000
99000
00833
Median
Minimum
Maximum
551
552
B. A.
DO
A M A R A L et al.
Conclusions
1 Direct and indirect retainer elements tend to undergo
more damaging periodontal effects associated with
RPD use when compared with non-abutment elements, with greater probing depth, gingival index
and plaque index values.
2 Following 1 year of denture use, plaque index values
were significantly higher than before its placement.
Acknowledgments
The authors thank the Coordinators of the Master of
Science in Dentistry Program from the Federal University of Rio Grande do Norte (UFRN) for the support in
the experimental part of this study.
References
1. Jorge JH, Giampaolo ET, Vergani CE, Machado AL, Pavarina
AC, Cardoso de Oliveira MR. Clinical evaluation of abutment
teeth of removable partial denture by means of the Periotest
method. J Oral Rehabil. 2007;34:222227.
2. Zlataric DK, Celebic A, Valentic-Peruzoc M. The effect
of removable partial dentures on periodontal health of
abutment and non-abutment teeth. J Periodontol. 2002;73:
137143.
3. Bergman B. Periodontal reactions related to removable partial
dentures: a literature review. J Prosthet Dent. 1987;58:
454457.