Daniel R Reissmann1, Stefan Wolfart2, Mike T John3, Birgit Marré4, Michael Walter4, Matthias Kern5, Ralf Kohal6, Frank Nothdurft7, Helmut Stark8, Oliver Schierz9, Bernd Wöstmann10, Wolfgang Hannak11, Torsten Mundt12, Peter Pospiech11, Julian Boldt13, Daniel Edelhoff14, Eckhard Busche15, Florentine Jahn16, Ralph G Luthardt17, Sinsa Hartmann18, Guido Heydecke19. 1. Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: d.reissmann@uke.de. 2. Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Aachen, Germany. 3. Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA. 4. Department of Prosthetic Dentistry, Technische Universität Dresden, University Hospital Carl Gustav Carus Dental School, Dresden, Germany. 5. Department of Prosthetic Dentistry, Christian-Albrechts University, Kiel, Germany. 6. Department of Prosthetic Dentistry, Albert-Ludwig University of Freiburg, Freiburg, Germany. 7. Department of Prosthetic Dentistry and Dental Materials Sciences, Saarland University, Homburg, Saar, Germany. 8. Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Germany. 9. Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany. 10. Department of Prosthetic Dentistry, Justus-Liebig University of Giessen, Giessen, Germany. 11. Department of Prosthodontics, Geriatic Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Berlin, Germany. 12. Department of Prosthodontics, Gerodontology and Biomaterials, Dental School, Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany. 13. Department of Prosthodontics, University of Würzburg, Würzburg, Germany. 14. Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany. 15. Department of Prosthetic Dentistry, Witten-Herdecke University, Witten, Germany. 16. Department of Prosthetic Dentistry and Dental Material Science, Friedrich-Schiller University of Jena, Jena, Germany. 17. Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany. 18. Department of Prosthetic Dentistry, Johannes- Gutenberg University of Mainz, Mainz, Germany. 19. Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Abstract
OBJECTIVES: To compare oral health-related quality of life (OHRQoL) in patients with either molar replacement by partial removable dental prostheses (PRDP) or with restored shortened dental arches (SDA) over a period of 10 years. METHODS: In this multi-center RCT, a consecutive sample of 215 patients with bilateral molar loss in at least one jaw was initially recruited in 14 prosthodontic departments. Of those patients, 150 could be randomly allocated to the treatment groups (SDA: n = 71; PRDP: n = 79), received the allocated treatment, and were available for follow-up assessments. OHRQoL was assessed using the 49-item version of the Oral Health Impact Profile (OHIP) before treatment (baseline) and at follow-ups after treatment (4-8 weeks and 6, 12, 24, 36, 48, 60, 96, and 120 months). To investigate the course of OHRQoL over time, we longitudinally modelled treatment and time effects using mixed-effects models. RESULTS:OHRQoL substantially improved from baseline to first follow-up in both groups indicated by a mean decrease in OHIP scores of 20.0 points (95%-CI: 12.5-27.5). When compared to the SDA group, OHRQoL in the PRDP group was not significantly different (-0.6 OHIP points; 95%-CI: -7.1 to 5.9) during the study period when assuming a constant time effect. OHRQoL remained stable over the 10 years with a statistically insignificant time effect (p = 0.848). CONCLUSIONS: For patients requesting prosthodontic treatment for their lost molars, treatments with SDA or PRDP improve clinically relevantly OHRQoL and maintain it over a period of 10 years with no option being superior to the other. CLINICAL SIGNIFICANCE: Since there was no significant difference between the two treatment options over the observation period of 10 years, and since results have stayed stable over time, patients can be informed that both treatment concepts are equivalent concerning OHRQoL.
RCT Entities:
OBJECTIVES: To compare oral health-related quality of life (OHRQoL) in patients with either molar replacement by partial removable dental prostheses (PRDP) or with restored shortened dental arches (SDA) over a period of 10 years. METHODS: In this multi-center RCT, a consecutive sample of 215 patients with bilateral molar loss in at least one jaw was initially recruited in 14 prosthodontic departments. Of those patients, 150 could be randomly allocated to the treatment groups (SDA: n = 71; PRDP: n = 79), received the allocated treatment, and were available for follow-up assessments. OHRQoL was assessed using the 49-item version of the Oral Health Impact Profile (OHIP) before treatment (baseline) and at follow-ups after treatment (4-8 weeks and 6, 12, 24, 36, 48, 60, 96, and 120 months). To investigate the course of OHRQoL over time, we longitudinally modelled treatment and time effects using mixed-effects models. RESULTS:OHRQoL substantially improved from baseline to first follow-up in both groups indicated by a mean decrease in OHIP scores of 20.0 points (95%-CI: 12.5-27.5). When compared to the SDA group, OHRQoL in the PRDP group was not significantly different (-0.6 OHIP points; 95%-CI: -7.1 to 5.9) during the study period when assuming a constant time effect. OHRQoL remained stable over the 10 years with a statistically insignificant time effect (p = 0.848). CONCLUSIONS: For patients requesting prosthodontic treatment for their lost molars, treatments with SDA or PRDP improve clinically relevantly OHRQoL and maintain it over a period of 10 years with no option being superior to the other. CLINICAL SIGNIFICANCE: Since there was no significant difference between the two treatment options over the observation period of 10 years, and since results have stayed stable over time, patients can be informed that both treatment concepts are equivalent concerning OHRQoL.