Zaid Ali1, Sarah R Baker2, Shirin Shahrbaf3, Nicolas Martin4, Mario V Vettore5. 1. Specialty registrar, Department of Restorative Dentistry, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, and Doctoral student, School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom. Electronic address: Zaid.ali@sth.nhs.uk. 2. Professor of Psychology as applied to Dentistry, School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom. 3. Academic clinical lecturer in restorative dentistry, School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom. 4. Professor and Honorary Consultant in Restorative Dentistry, School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom. 5. Senior Lecturer in Dental Public Health, School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom.
Abstract
STATEMENT OF PROBLEM: Clinicians are currently unable to quantify the psychosocial, functional, and esthetic effects of prosthetic interventions to replace teeth. Understanding the effects of treatment to replace teeth on oral health-related quality of life (OHRQoL) is important for informed consent. A systematic review of the evidence of OHRQoL improvements with prosthodontic tooth replacement and a comparison of outcomes between treatment modalities is therefore indicated. PURPOSE: The purpose of this systematic review was to examine the OHRQoL of patients with partial edentulism after different dental prosthetic treatments. MATERIAL AND METHODS: Electronic database and manual searches were conducted to identify cohort studies and clinical trials reporting on the OHRQoL of individuals receiving implant-supported crowns (ISCs), implant-supported fixed dental prostheses (IFDPs), implant-supported removable dental prostheses (IRDPs), tooth-supported fixed dental prostheses (TFDPs), and removable partial dentures (RPDs). Two reviewers independently conducted article selection, data extraction, and quality assessment. Random-effects models were used to compare OHRQoL change scores (standardized mean change, 95% confidence intervals). RESULTS: Of the 2147 identified studies, 2 randomized controlled trials and 21 cohort studies met the inclusion criteria. Overall, studies were of low or moderate risk of bias. Pooled mean OHRQoL change ≤9 months was 15.3 for TFDP, 11.9 for RPD, and 14.9 for IFDP. Pooled standardized mean change OHRQoL change >9 months was 13.2 for TFDP and 15.8 for IFDP. Direct comparisons ≤9 months between TFDP against IFDP and RPD against IFDP significantly favored IFDP in both cases. CONCLUSIONS: TFDP and IFDP had short- and long-term positive effects on OHRQoL. RPDs positively affected OHRQoL in the short term. IFDP showed greater short-term improvement in OHRQoL than RPD and TFDP.
STATEMENT OF PROBLEM: Clinicians are currently unable to quantify the psychosocial, functional, and esthetic effects of prosthetic interventions to replace teeth. Understanding the effects of treatment to replace teeth on oral health-related quality of life (OHRQoL) is important for informed consent. A systematic review of the evidence of OHRQoL improvements with prosthodontic tooth replacement and a comparison of outcomes between treatment modalities is therefore indicated. PURPOSE: The purpose of this systematic review was to examine the OHRQoL of patients with partial edentulism after different dental prosthetic treatments. MATERIAL AND METHODS: Electronic database and manual searches were conducted to identify cohort studies and clinical trials reporting on the OHRQoL of individuals receiving implant-supported crowns (ISCs), implant-supported fixed dental prostheses (IFDPs), implant-supported removable dental prostheses (IRDPs), tooth-supported fixed dental prostheses (TFDPs), and removable partial dentures (RPDs). Two reviewers independently conducted article selection, data extraction, and quality assessment. Random-effects models were used to compare OHRQoL change scores (standardized mean change, 95% confidence intervals). RESULTS: Of the 2147 identified studies, 2 randomized controlled trials and 21 cohort studies met the inclusion criteria. Overall, studies were of low or moderate risk of bias. Pooled mean OHRQoL change ≤9 months was 15.3 for TFDP, 11.9 for RPD, and 14.9 for IFDP. Pooled standardized mean change OHRQoL change >9 months was 13.2 for TFDP and 15.8 for IFDP. Direct comparisons ≤9 months between TFDP against IFDP and RPD against IFDP significantly favored IFDP in both cases. CONCLUSIONS:TFDP and IFDP had short- and long-term positive effects on OHRQoL. RPDs positively affected OHRQoL in the short term. IFDP showed greater short-term improvement in OHRQoL than RPD and TFDP.
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