$ % &'( )*+ %, )+ Clinical evaluation of isolated abutment teeth in removable partial dentures

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1 ( % 24 )! " #!! Isolated $ % &'( )*+ %, ) $ &2! )3 -. /-. / / Clinical evaluation of isolated abutment teeth in removable partial dentures Zarrati S 1, Baheri Mghadam T 2, Nematollahi F 3 1- Assistant Professor, Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences 2- Dentist 3- Assistant Professor, Department of Prosthodontics, School of Dentistry, Tehran Eslamic Azad University Background and Aims: Nowadays, removable partial dentures are applied to patients who are not able to use dental implants or fixed prosthesis. Although based on the studies the users of removable partial dentures are in the risk of plaque accumulation and unacceptable changes such as gingivitis, periodontitis and mobility in abutment tooth. It is not clear whether the negative effects of removable partial dentures are more on the isolated teeth which are a kind of abutment adjacent to endentulous area in both sides. The purpose of this study was to investigate the clinical condition of isolated abutment teeth without splinting in comparison to control abutment from the aspects of B.O.P (bleeding on probing), mobility, pocket depth and gingivitis. Materials and Methods: In this cross-sectional study, the prepared questionnaires were filled out by 50 patients who received removable partial dentures in department of removable prosthodontics of dental school of Tehran University of Medical Sciences. The patients had isolated abutment tooth and did not have any systemic disease. The obtained data were analyzed. Using Wilcoxon, exact Fisher and Kruskal-Wallis test. Results: B.O.P (P=0.004), pocket depth (P=0.035), and mobility (P<0.001) in isolated abutments were more than those in control abutments, but there were not significant differences in the degree of caries (P=0.083) and gingivitis (P=0.07). Conclusion: This study showed that clinical condition of isolated abutments is worse than that of control abutments. More attention should be paid to healthiness of isolated teeth without splinting and periodic follow ups should be done in these cases. Key Words: Partial denture; Abutment; Tehran Journal of Dental Medicine-Tehran University of Medical Sciences 2011;24(1): C. /@A%3 0?4 = :;> / %; )8 < :;4. / %7 0 >K= : =;O ;;P 86 Q%! RS 89 :;4. / 0 2AA<?4 G2 H I;I9 JKL 7 F3 F F < Isolated. /. UV ;CT E3 31?A ;CT 89 :;4. / 2. = 3 I> 3 B3 Isolated 3 S> Y E3 Z@4 ; AB/. WG! XL 0 < A. 4 ]> U J% I> B.O.P (Bleeding On Probing) 0 \A< % b!`. 4 2/ a4 _L X/ A4 `L.3_L SYI -?;H ^ < S> Y E3 : ;. / b/ B; -4 - : :\cb d>c farzaneh.nematollahi@yahoo.com :5;> :E? 56

$4 j;> -\ 4< ;G J;= 2;F4 F;. \A< 3 0 ; Isolated 3 (P<0/001) I> (P=0/035) @< J% (P=0/004) B.O.P ; : 5.@ 7.AS? \A< 3 Isolated 3 (P=0/07) ]> U > (P=0/083) JF% F m F F%7 0 < 89 :;4. / UV ;CT : I 3.$ $@A;4 < ;<T 3. /. _L.(10) (2:) U A7 3. / < 0 1 89/12/01 :q o ;3T 89/11/03 :3 _6H 89/06/12 :\H!2! 0.FS dfv :Frm F FG 0. F30 FS 0 F/ 0 F;` \ F%.F=. A/ @4 0.$

2 %/ <... E;S7 89 :;4 3 Isolated. / 4 F F F F. / hv < :;4 3 %; 0? 50 S> Y F01 ;F4 K 01 0.!. 1 ;> 1 A4 :;% 0 j.k. A;0 5;%B;4. %; i;/ 6K % S7.32?4 j;> -\ 4< ;G J;= 2;F4 F;. \A< 3 0 ; Isolated 3 (P<0/001) I> J% (P=0/004) B.O.P ; : 5.@ 7.AS? \A< 3 Isolated 3 (P=0/07) ]> U > (P=0/083) JF% F m F F%7 0 < 89 :;4. / UV ;CT : I 3. / d;s[ A/ l3 :=< FH F F F3 0?4 o 3m ;H 3 3. / : I / E3 ; = 7.. B _L b;b/ (10) (Isolated tooth) -1 % D'E *8,.. B " %C= -2 % 2.'= '# Isolated -.(10) < ;<T 3. /. _L.(10) (2:) U A7 3. / < 0 1 89/12/01 :q o ;3T 89/11/03 :3 _6H 89/06/12 :\H!2! 0.FS dfv :Frm F FG 0. F30 FS 0 F/ 0 F;` \ F%.F=. 0. / F = 3 K30 E;T 37 :] 0. F/ A33 7 A/.(1) A3 F! F = :;> / %; ; 0 :;4 8FF9 :;FF4 C FF 0?FF4.(2)?4. F/ 0 2FAA<?F4 FG2 FH FI;I9 : = ;O ;;P 86 Q%! RS 89 :;4 F F mfl S> Y.(3) AB/ =. /. QF%! h3fg F 8F9 :;4. / 0?4 < A/ F3. F/F V4 86.F\FK= :F = l3 S> Y 0 %/ /.(9) < ^2 \ 3 ;;P 3 a4 S3 [ ` sf 8F9 :;F4. E% \ `. uf4 F; h3fg \ F3. /t;41 2;4 0 b3fg F`L F a3f v Ao < S;KL. /.(57)2 E3 t4 A 8 :;F4. F/ r ` E3 E; E3. F/F. UFV ;CT E3 31?A ;CT 89 F3 F < (Lone standing 3 Pier abutment) 3 (10) (1:) AB/. WG! XL 0 < A Z@4 ; 57

3 ( % 24 )!. F/F. F 4 89 :;4 FG F1 F S7 J;I9 E3 (? 109) G G 0? 50 EF3.K. A;0 5;%B;4. %; i;/ 6K %; E3 : b;wa hv. A4 %; /. S> Y 1998 \ F4 %/ Frank A4 u 4 \ :;% %; 9;[ < 32 ; ;;P %/ 0?4 0 \L 5;G2 zv hv E3 E;FII9 af4 hfv.f :;F4 F 6 :;4 Frank FS> Y u F4 F F; A4 hv E3. :;% FzV : F F< (3) F32 b;wa ; ;;P %/. A/ \ z } `L.A IKL 0 F F3 F ~46< : I 5G 3. / 3 8 b3g J Y EF3 \FA< F3 F. 2;4 \ 3 w 0 \A< F! F 3 3 % %/. 3 S> Y E3 AS3 u= 3 XL (7 H ) 1 F3 ) G2 w u= 3 XL 0 3.( b/ ~46<. \A< F F%A/ F4 53 a4 %/ A3 S.@G2 H B3 a3 A31 U 4 0?4 (15) F<.;20 ^ 7 I> h!a4 30 :@G2! (16) %/ Kratochvil S> Y I> :Grade 0 \A;>< ; 53 0 % :Grade 1 \A;>< ; 53 0 h; I> :Grade 2.% I> %/ F IG I> :Grade J% ;3 U Pocket depth J% A ;` 4.(5) G2 w ; 2. B %< :Grade 0 ; 2-3 E; :Grade 1 ; 3-5 E; :Grade 3 K30 w 0 =. /Modification EB F F F3. /. UV ;CT 1 6.(911) 4 :=` F3 F EF3 0?F4 A/? o < E3 K= o 3 %/ F/ h;f F 3. H F <x? l3 jg t< 1 8F9 F F4 KC h3g s 3 < F;A;< F;! (13) F4 ;I (912) :;4 F3. F/F. b;ifb = < 0 ;F3 4 Q34 t3v E% F F3. / 2 E;%/. EG F= 1. F46< ymf%s E%.;2%. Fz= %7 0 dv :3m ]< A3 7 b> F4 F3. F/F ^F F 5 3 %; :3 % H %/ (Isolated) 3. / y FK7 8F9 :;4 _L ;2 =?4 F. F30 I;I9 <!1 0.(11) `L AK E3 89 :;4 3. / F Isolated F3. / S4 S> Y E; { K 2 30 \A< 3. / B3 F F7 3. / \ 3 t3v ;. F/ 3 4 B3 I / E3 n2;ct dv :. 4 u= 3 XL 3 y Hz 3 FG = 4 L S> Y 2 i;/ 3 F 3. B3 I A;0 E3 S> Y %/. / 3 4 : I :;4 ; F% F! SYI?;H H < S> Y E3 FF 8FF9. FF/ hfv FF FFAA< FFS7 F%; 1386 F 1380 \ F4 0 < 58

4 %/ <... E;S7 89 :;4 3 Isolated. / 4 F F :;F4. / % <.@G2 = F0 < E3 RG! %A/ ; 4 F/ 0. F \A< 3 3. / =. \ I> 2;4 2 F AF4! Pilot study H 01 h; / :;9 =.0 (FG. F/\7 H )?;H. 1 ^ 0 J;I9 E3 JF;= F01 ;4 K 01 L KA4. /^ SPSS G 5%< /.?4 j;> -\ 4< ;G F7. 1. /01.;2b;%z :;9 3!. P-value 5?4 0 \ <.G E4 E; ; S> Y E3 73 FG EF3 E3EB \ 4 56±8 (? 48 3 %96) <.@ \ E37 \ 4 F3. F/ B3 I h/m E3. / G 3 F F3. F/F %54 < \A< 3 É 9> 0? E3 < 2;4. \A<. / 0 %52 B.O.P F; S> Y E3 l3 JKL.(P>0/05) K AS. 1. (P=0/004) \A< 3. / 0 h; 3. / \A< 3. / 3. / J% w 0 F F / F.FAS F? \ F3 \A;> -\ < ÑY4 3. J% ; 3L F3 F \ FB3 J% ; > ; F? \FA< F3 F F F? F]> U F> F; F< F h/mf E3. / G 3 F7 \FA< F3. F/F 3. / E;.AS. F/ E; < S> Y E3 l3 ; F? FI> F; Fw 0 \A< 3 3 FI> F F3. F/F F3L (P<0/001) 7.(1\7) /.; ; 5 0 ; :Grade 3 Muhlman j<fa3 0 Bleeding On Probing F30.F.3 7. ]> ; ;3 U ;<.@2?4 FFF30.FFFA FFF7 u FFF4 FFF B.O.P FFFS FFF; C 30 FFF :(1517).; :Grade 0 F; C 30 F 20 F. YI H.3 :Grade 1 ÄA; 0 S %. / YI 3 : < a H.3 :Grade 2 ÄA; 0 j H G6 \ A3 s].3 :Grade 3.A< L ]> 0.3 :3 % :Grade 4 Å F { Gingival Index FH EF3 F 1.FA F7 F<?4 Loe & Sillness :(14) \ b> 4 ]> :Grade 0 F 8F Ä r7 ;;P zv U > :Grade 1 j%>.3 j%>.3.= a4 U > :Grade 2 F :F3 % b0 ÅV.= 3 U > :Grade 3.3 F F3 F \ %32 u % ; C 30.. F/@F> JF% I> (Bleeding on Probing) B.O.P : G2 w \ %32 u % dv u % -1 : < y KB u % -2 ; 2/3 \0< 0 u % -3 \0< 1/3 0 aig u % -4 0 F \ %32 u % ; \ Fit checker 3 \ %32 u % ; Isolated 3. u F4 F F3. / 2;4.32 5o / ^ 0 F4 F A31 4 0?4 2;

5 ( % 24 ) )% Q2! R! S.! M2 5 '!L( I '!.J K -1 H# z!j P-value NOPL! Isolatd 3 \A< 3 B.O.P ; -2/92 0/004 <.L. 7 \A< Isolated 3. / E;.AS? B.O.P w 0.@4.;.3 ; w E3 0 Isolated 3 Isolated J% \ < ÑY4 / \A< 3 Isolated J% \ 3 ÑY4 / \A< 3 Isolated J% \A;> ÑY4 / \A< 3 Isolated J% \ B3 ÑY4 / \A< 3 Isolated 3 U > ; \A< 3 Isolated 3 I> ; \A< 3-3/482-2/111-2/111-5/59-1/807-3/893 0/000 0/035 0/035 0/57 0/07 0/000 :F I 5FG F }F 1 S 7 E3 %; F;2F% F= F F3 F \ %32 u % ;.(P>0/05) =< T F F3. F/F 4 S> Y E3 E;S7 (Pier abutmemt) < l3.@ \ 4 0 F F3. F/F 2;F4 F7 F F3 F7 w F7.FAS F?. 1 w 0 \A< 3. / : 53 2;4 E3 3 E3 < (P=0/083) / a3 \ 3< G> F/ F. = :;4 `L %7 0 dv : 3nP F%/ Yeung S> Y u % / \ ` 2;FF4 FF; FFo2.(18) FF FF!; E;FF%/ FF; \ < ÑY4 \A< Isolated 3. / J% w 0 \A< 0 ; Isolated \ < J% <.L. 7 1.@4 ÑY4 E;%/ \ 3 ÑY4 \A< Isolated 3. / J% w 0 \A< 0 ; Isolated \ 3 J% <.L. 7 1.@4 ÑY4 E;%/ ÑY4 \A< Isolated 3. / J% w 0 0 ; Isolated \A;> J% <.L. 7 1 \A;>.@4 ÑY4 E;%/ \A< 1 \ B3 ÑY4 \A< Isolated. 7 \A< Isolated 3. / J% w / E;.AS? ]> U > ; w 0.L. 7 \A< Isolated 3. / E;.AS? I> ; w 0.@4.; I> ; w E3 0 Isolated 3 < F F3 \ %32 u % ;CT ; 4 F \ : I ;CT F F3 \0< 4 \ %32 = < B.O.P ; %45/45 u % F3. / : ` E;Av%/.bF3 2 F32 FI> F F; u % 3 X6F F< \ EF3 E; B3 I. /.AS :F ` B.O.P ; E3;.@4. / : I 5G C 3 : I / F F 3 / I> ; E3; 7 S;KL \ F< S> Y E3 l3 E;Av%/ 60

6 %/ <... E;S7 89 :;4 3 Isolated. / 4 UY F. F/; RFS F!. / \ %32 u % VF4 :F;9 VF4 F G [ u4 \ I / u % GL 0.;2 :; F F;> FF G A/ \ z /@; \ %32 XL F3. F/ \ %` h3g 7 Q%! \ F3 Tipping RFS \ F%32 u % < \ FB3 \ 3 86 :; AB/.(11) }[ E;%/ b/ [ ` S> Y 3 h3g F 3. / E; < / h/m E3. / G 3 F7.FAS F? ]> U > ; \A< 3. / < FG 5FB3 FA F / W` o2. FK :F FA ÜFB EF3 F F F]> U F>.F.7 F;> \ F3 a3f A.3. /< G F; F[ ` FS> Y.AFB/ bf 0F F%/ F ; 5;N F? < %6 3. / 3 %/ Zlataric Gingival Index S> Y.AS F F3. F/F F; FI> F[ ` S> Y. F/; 0 F FF F< / \A< 3. / Zlataric FS> Y. 3 ;. 2 UY F3. F/F.F; FI> ; b/ %/ F; F< F [ ` S> Y > 3 ;O. / Zlataric S> Y / I> FI> ; < A< ;3T ; S> Y E3 ; %/ S> 3. / ; 3. / 6.F;; / %/ LaVere F%< F[ ` I> ; < / F< F \L bwa. ; b/ %/ Bergman S> Y.(9) S> Y 3. / / F FF F< %< S> \A<.(19) bwa. \ %32 u % 9 S> Y E3 l3 F F; \ %32 u % ; o ( F3 ;O F3. F/) 2/ %/ Yeung S> Y bwaf Recall < %< S> af4 F<. FS> Y 2;F4 F;.F< ; 3 S> Y FF[ ` FFS> Y FF FF FF FF! FF%/ Isolated 3. / B.O.P ; S> Y E3 l3 JKL FH A< F F< FS> Y. \A< 3. / 0 ; 3 F4 F3. F/F ; G2 FS> Y Wagner Kern.F.F; B.O.P ; / \ F ;O. / 3. / B.O.P ; FS> Y J;I9 l3 < < B3 I.n3 7 0 S. 3. /.; B.O.P ; [ ` F30 F F F E3 < \A< 3. F/ B.O.P ; >.(8) 0?4 (\ 4 10) F3. F/ B.O.P [ ` S> Y A 3 F; H E3 < ; Wagner Kern S> Y. / 3 3. / ; B.O.P ; JF% Fw 0 F< F/ S> Y E3. 3 ÑYF4 \A< 3. / 3. / E;.AS F; F F3. F/ 7 \ 3 \A;> \ < JF% F>.@F4 F; `F J% X6F \FA< F3. F/F F F3. F/F \ B3.A.AS J% %/ Piwowarczyk S> Y l3 F3. J% 0?4 \ F F3. [ ` S> Y \A<.F F Fw :F = < /.%< J% [ ` S> Y F? F3. J% %/ Zlataric S> Y FAo/ (5) F[ ` FS> Y \A< 3 %< B3 I J% [ ` S> Y 3. J% ; ÅV b/ S> Y E3 ÜFB EF3.@F4 F; F3. F/F / E3 61

7 ( % 24 )! : JF% F ; -1. \A< 3 0 ; 3 F 3 (Gingival Index). ]>. /Å -2..AS? \A< 3 5FG F }F 1 S 7 E3 %; -3 F3 F F3 F 3 %A/ ÑY4 u % ; : I.;2% = \A< F F 3. S> Y E3 7 FK F< EF3. F3.b;3 C =. WG Xn` -1 3 E3Ao 4-2 FH F F3 F?F4 o ;H \ ` / F 6F4 Fw 0 tf4 A \ F%32 _YF4.F;2 3 F F! F 3. / ~46< Xn` 3 `L.;2 = ;<T.. /.;; E;Av%/ E S 0 ;4 E3 F= 3! 3 53 t> = S> Y E3! 5%<.2 1- Zarb GA, Bolender CL, Eckert S, Jacob R, Fenton A, Mericske-Stern R. Prosthodontic treatment for edentulous patient. 12 th ed. Washington: Mosby; Wostmann B, Budtz-Jorgensen E, Jepson N, Mushimoto E, Palmqvist S, Sofou A, et al. Indications for removable partial dentures: a literature review. Int J Prosthodont. 2005;18(2): Frank RP, Milgrom P, Leroux BG, Hawkins NR. Treatment outcomes with removable partial dentures: a population-based study of patient satisfaction. J Prosthet Dent. 1998;80(1): Schwalm CA, Smith DE, Erickson, JD. A clinical study of patients 1 to 2 years after placement of removable partial dentures. J Prosthet Dent. 1977;38: Zlataric DK, Celebic A, Valentic-Peruzovic M. The effect of removable partial dentures on periodontal health of abutment lfb F F; 0 FH ; 2/3 \0< 0 E;. /; 3 h/ < 3 ; E3 A 3 7 \ %32 u % ; ; { K. :3S lb F 0 F; J% I> B.O.P FA;0 EF3 F; FS> Y F! F F :F I 5FG Ö A = S> Y E3 l3 JKL E3; B.O.P C 3 F7 FS;KL F : I 5G < 3 0 I> C S;KL. /.4 0.; F; :;4 : 3 :;9 s V4 :%9 0 ; ; E3 ;H 1 0. I> ]> U 53N> J% h3g V4 FS> Y FG FH H 7 s9 E3 A< < 3 7 EF3 %; \ 7 E3. ;H.; u F% F; :F I 5FG F }F 1 S 7.;2% = \ %32 F%; bf< S y Hz S> Y E3. /@ < F` S> Y E3. / 30 Isolated 3. < :U! and non abutment teeth. J Periodontol. 2000;73(2): Rissin L, House JE, Conway C, Loftus ER, Chauncey HH. Effect of age and removable partial denture on gingivitis and periodontal disease. J Prosthet Dent. 1979:42(2): Vanzeveren C, D'Hoore W, Bercy P. Influence of removable partial denture on periodontal indices and microbioligical status. J Oral Rehabil. 2002:29(3): Kern M, Wagner B. Periodontal findings in patients 10 years after insertion of removable partial dentures. J Oral Rehabil. 2001;28(11): LaVere AM, Smith RC, Sarka RJ. Cross-arch bar splint. J Prosthet Dent. 1992;67(1): Hacke G, Stwewark KL, Rudd KD. Clinical removable partial Prothodontics. 2 nd ed. St Louis: Ishiyaku EuroAmerica Inc;

8 %/ <... E;S7 89 :;4 3 Isolated. / Carr AB, McGivney GP, Brown DT. McCracken's removable partial denture prostodontics. 11 th ed. Glenp: Mosby; Tautin FS. Abutment stabilization using nonresilient gingival bar connector. J Am Dent Assoc. 1979;99(6): Phoenix RD, Cagna DR, Defreest CF. Stewart s clinical removable partial prothdontics. 4 th ed. Canada: Quintessence publishing; Frank RP, Milgrom P, leroux BG, Hawkins NR. Treatment outcomes with mandibular removable partial dentures: a population-based study of patient satisfaction. J Prosthet Dent. 1998;80(1): Newman MG, Takei H, Carranza FA. Carranza's clinical periodontology. 9 th ed. Los Angeles: Saunders; Kratochvil FJ, Davidson PN, Guijt J. Five-year survey of treatment with removable partial dentures. Part 1. J Prosthet Dent. 1982;48(3): Phoenix RD, Cagna DR, Defreest CF, Stewart KL. Stewart's clinical removable partial prosthodontics. 3 rd ed. America: Quintessence publishing; Yeung AL, Lo EC, Chow TW, Clark RK. Oral health status of patients 5-6 years after placement of cobalt-chromium removable partial dentures. J Oral Rehabil. 2000:27(3): Bergman B, Hugoson A, Olsson CO. Caries and periodontal status in patient fitted with removable partial dentures. J Clin Periodotol. 1977;4(2): Piwowarczyk A, Kohler KC, Bender R, Buchler A, Lauer HC, Ottl P. Prognosis for abutment teeth of removable dentures: a retrospective study. J Prosthdont. 2007;16(5): Hobo S, Whithsett LD, Jacobi R, Brackett SE, Shillingburg HT. Fundamentals of fixed prosthodontics. 3 rd ed. America: Quintessence publishing;

Evaluation of the Periodontal Status of Abutment Teeth in Removable Partial Dentures

755 Evaluation of the Periodontal Status of Abutment Teeth in Removable Partial Dentures 1 Chair of the DMD Course, Head of Oral Rehabilitation Sciences, Institute of Health Sciences Viseu, Universidade