longitudinal study of removable partial dentures and hygiene habits

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38 Cienc Odontol Bras 2007 jul./set.; 10 (3): 38-43

Longitudinal study of removable partial dentures and hygiene habits

Estudo longitudinal de prteses parciais removveis e hbitos de higiene

Ms Br Frds ds SantoSUndergraduate Student S Js ds Caps Dental Schl UNESP S Paul State Universit S Js dsCaps SP Brazil

R Mrqs d CaRvalhot Sckw d S Cmrg GuiMaReSUndergraduate Student Universit Vale d Paraiba UNIVAP S Js ds Caps SP Brazil

Jrbs Frcsc Frds ds SantoSGraduate Student S Js ds Caps Dental Schl UNESP S Paul State Universit S Js ds Caps SP BrazilAssistant Pressr Universit Vale d Paraiba UNIVAP S Js ds Caps SP Brazil Universit Taubat UNITAU Taubat SP Brazil

lrd MaRChiniAssistant Pressr Universit Vale d Paraiba UNIVAP S Js ds Caps SP Brazil Universit Taubat UNITAU Taubat SP Brazil

Summary

The revable partial dentures (RPD) are used t reestablish the phnetics, aesthetics and asticatr unctin rpartiall dentate patients, ainl thse wh cpund the Brazilian prest ppulatin, since RPD presents a relativel

lw cst. The rehabilitatin gne t be successull when besides the planning, the dentist rientate hgiene habits tthe patient, and prserve the case. The present paper evaluates hgiene habits and RPD planning ang a saple RPD wearers, in a crss-sectinal design. A questinnaire was applied and a clinical exainatin was perred btw previusl calibrated exainers. The saple was cpsed b 83 patients, and 25 were ales. It was veried that49.4% the patients brush their teeth three ties per da and that 28.9% tk apprxiatel 4 inutes r each teethbrushing, 95.2% use ther hgiene resurces, besides tthbrushing, as dental crea (98.7%), dental fss (79.7%) anduthrinses (55.7%). Hwever 56.6% shwed bacterial plaque and 21.7% presented caries at clinical exa. Abut thedentures, 74.7% was denitive RPD and 96.4% shwed bilateral design. The requisites stabilit, retentin, cclusinand aesthetics was classied as gd, in the ajrit the cases; the hgiene was classied as gd t regular. In 24% the dentures, the base was dered r ractured, 50.6% presented articial teeth with detritins. Instead patientsadequate ral hgiene habits and satisactin with RPD, re cprehensive explanatins abut ral care and rerequent llw-ups shuld be cnsidered t iprve plaque index and peridntal health ang RPD wearers.

unitermS

Revable partial dentures; ral hgiene.


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Ss MBF, Cr RM, Gmrs tSSC, Ss JFF, Mrc l

LoNGITUDINAL STUDy o REmoVABLE PARTIAL DENTURES AND HyGIENE HABITS

Cienc Odontol Bras 2007 jul./set.; 10 (3): 38-43

introduction

Revable partial dentures (RPD) are the chea-pest wa r prsthetic rehabilitatin; it is knwn that

RPD is generall indicated r the peple with lwince10. Therere RPD are cnsidered nn-aestheticand se authrs have related that the shuld daagethe reiniscent ral structures12.

The dentures just cause daage t the stha-tgnatic sste when the biechanical principles supprt, retentin and stabilit were nt bserved andwhen the clinical and/r labratrial steps r RPDaking are neglected, resulting in pr adaptatin4,9.

During RPD planning, the expectatins the pa-tient shuld be als cnsidered, ainl regarding RPDaesthetics. I the dentists d nt bserve the individual

necessities, the treatent shuld be unsuccessul 6.RPD ailures are cnsequences destructive actin

bad designed device, due t the apparent siplicitand acilit it anuacturing10. man dentists haven attentin with planning and delegate it t dental tech-nicians. Analzing casts n dental labratries, Duarte& Paiva (2000) bserved that ajrit the did ntpresent adequate teeth preparatin, as rest niches, teethre-cntur, r guide planes3. Dental technicians have ake rle in the success RPD. Hwever, the d nthave adequate knwledge the bilgical structuresand cclusin, which is need t well distribute astica-

tr rces adequatel. Then, RPD shuld be designedand planned b dentists. Nevertheless, it was shwn thatjust 10% the cases that ce t labratr presentedteeth preparatins, and less than 25% the dentistsveried RPD waxing, neglecting the prcess and thenallwing technical ailures5.

other actr that was presented as relevant tRPD lngevit is the establishent crrect hgieneprgra and llw-up. The iprtance hgieneshuld be ephasized, because ajrit these pa-tients lst their teeth due t an absence explanatinr tivatin r dental hgiene habits4. When patients

are cnscius the plaque pathgenicit, the are ablet practice the hgiene ethds t reve it1.

Evaluating 74 patients which wre 101 RPD, itwas veried that nl 36.6% was cnsidered succes-sul, 23.8% presented a scre partial success and39.6% ailed. onl a third part the ttal did ntshw hgiene prbles r technical ailure, and 50% these dentures a expect 10 ears vertie11.

Cnsidering the iprtance planning and hgie-ne habits r RPD success and lngevit, the present

paper ais t evaluate these actrs ang a saple RPD wearers r S Js ds Caps, Brazil.materialandmethod

SbjcsThe saple was cpsed b 83 RPD wearers

that ce t UNIVAP dental clinics in the peridr Deceber 2003 t Deceber 2004. All RPDwearers that did NoT want t change their dentureswere invited t participate n the stud.

The prject this research was apprved b thepertinent ethical cittee, accrding with the prt-cl nuber L032/2004/CEP, and the prcedures wererealized nl ater the ree cnsent the patients.

D ccA direct questinnaire was applied and a clinical

exainatin was perred, in which peridntalanalsis was realized based n Peridntal DiagnsticSste (PSR)2, realized during prbing prcedurewith a recended sunding lead (621 omS), andthe scres 0 4, which identies bleeding, dentalcalculus and peridntal pcket, were attributed teach sextant. All questinnaires and clinical exaswere dne b tw previusl calibrated exainers.The exainers interviewed the patients in agreeentwith the questinnaire, which asked abut requenc returns in a surgen dentist, hgiene rientatinsreceived abut the prsthesis and the pinin their

wn prsthesis. During the clinical exainatin it wasveried aspects like peridntal cnditin, analsis hgiene, stabilit, retentin, cclusin and aesthetics the prsthesis. In relatin prsthetic planningit was veried the existence rest prepare, distalextensin, rest lcalizatin, racture r deratin an eleent the prsthesis.

The btained data were tabulated and statisticallanalzed, using the Chi-square distributin r the in-dependence n the vericatin pssible assciatin tw variables and its levels.

reSultS

Descriptive analysis

or d dr yg bsIt was analzed 83 RPD wearers, r which 58

were eales. It was bserved that 33.7% all saplereturn n the dentist r peridical exainatins eversix nths (Graph 1).

orientatin r dentures hgiene was reprted b


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86.7% and 78.3% als reprted rientatin r ralcavit hgiene. 49.4% the saple brush the teeththree ties a da (Graph 2), and that 44.6% spentapprxiatel tw inutes ding it; 50.6% usesdental brush with st bristles, and 69.9% changetthbrushes ever three nths.

The ajrit argued patients (98.8%) en-tined that the reve the dentures during teethbrushing and 95.2% ared that uses ther hgieneethds, besides tthbrushing, ainl the use dental crea (98.7%).

RPD hgiene had a gd classicatin in 43.4% the cases (Graph 3).

Dr pgCnsidering all saple, 62 (74.7%) were de-

nitive and 21 (25.3%) prvisr, and 80 (96.4%)

presented bilateral design, while nl 3 (3.6%) wereunilateral RPD. In relatin t denitive dentures, itwas evidenced that 71% the patients had rest ni-ches, and 93.5% the RPD presented rigid ppsingars. Cnsidering dentures that were cantilevered,the rest n the ain attachents teeth were lcated inthe esial n 81.7% (Graph 4), and 67.3% presentedindirect rest.

In this saple, 24% the dentures had basisderatin r basis racture. Between the denturescpnents, the articial teeth shwed great nuber prbles, and teeth abrasin was encuntered in

50.6% the cases.The dentures als were evaluated and classiedb the exainers in gd, regular r bad, in regardt their stabilit, retentin, cclusin and aesthetics.Stabilit and retentin had 50.6% gd classica-tin, cclusin were cnsidered regular in 33.7%

the dentures, and aesthetics received 38.6% gdclassicatin, 36.1% regular and 25.3%, bad.

Regarding the kind dental service where thedentures have been realized, the predinance wasin particular services (47%).

During clinical exas, it was bserved the existen-ce bacterial plaque in 56.6% the individuals, and78.3% had absence active caries. At the peridntalexa (PSR) it was evidenced a inial prprtin peridntal health (0.8%).

In relatin patient satisactin, 45.8% cnside-red their dentures as regular t bad. Prbles regar-ding stabilit were related b 50% the saple, andlack retentin, b 47.4%.

ayss f pssb rsps mg rbs

Retentin and stabilit presented an expressivepsitive relatinship (p


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diScuSSion

Accrding t Tdescan (1998)10, the edentulusindividuals wh seek r dental treatent generallpresent lw level hgiene habits, and this actrshuld be the st iprtant causal actr r dentalutilatin. Hwever, 33.7% ur saple aredthat visit peridicall the dentist, the ajr prtin

the saple (79.5%) related that the brush the teeththree r ur ties a da and 95.2% als uses therhgiene ethds besides tthbrushing, as dentalcrea (98.7%) and dental fss (79.7%).

r wall et al. (2002)7, during the cnectin the RPD, the preventin and hgiene shuld beephasized, althugh the literature is cused inbiechanical aspects. Tdescan (1998)10 stated thatpatients shuld be tivated r ral hgiene, in rdert allw a higher lngevit r RPD therap. Regar-

ding this issue, we bserved that 86.7% the saplereceived rientatin r ral hgiene and 78.3% abutthe iprtance dentures hgiene, but nl 33.7%was riented the wa t adequate clean the dentures.This act pinpints ailures in the prcess ralhgiene learning, whse instructin and inratin

depends n the dentist.Regarding dentures planning, it was earl veried

that 87.2% the dentures ade b particular serviceswere denitive and 93.6% the dentures realized indental institutins wn rest prepare, while 6% thedentures realized b a prsthetic technician d ntwn rest prepare, because the d nt knw abutRPD biechanics and planning rules3.

In 100% the cases with ree extreit realizedin institutins, the rest were lcated in esial, eviden-

Graph 2. Brushing teeth requenc.

Graph 3. Hgiene classicatin.


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cing a great cntrl and rientatin dental studentsabut planning (Graph 4). Still wrking with this kind dentures 67.3% presented indirect rest, which isrelevant t the success the rehabilitatin4.

Rest niches was bserved in 71% the cases,cntrariwise mats (2002)5, wh ared that nl10% casts received b dental labratries presentedadequate teeth preparatins. It was nt encuntered

a psitive relatin between rest niches and cariespresence (p=0.404), ppsing an dentists that dnt realize rest niches b cnsidering it a niche rplaque accuulatin.

The incidence ailures in each cpnent RPD decrease b the llwing rder: clasps, articialteeth, basis, cnectrs8. The present paper bservedthat the ailures incidence decrease r clasps(14.5%) t cnnectrs (9.7%), but the basis presentedthe higher percentage ailures (24%).

RPD were als analzed regarding cclusin, and itwas nt bserved direct relatinship between cclusal

actrs and the presence detritins articial teeth.Hwever when retentin and stabilit were analzed, itwas bserved a psitive relatinship with gd classi-catin (p


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As prteses parciais revveis (PPR) s usadas para restabelecer ntica, esttica e un e pacientesparcialente dentads, principalente para aqueles que cpe a ppula pbre brasileira, vist que asPPR apresenta baix cust de cnec. Para que a reabilita seja be sucedida, al d planejaentcrret, rientaes quant higiene bucal, das prteses e prserva d cas se aze necessrias. o pre-sente estud avaliu hbits de higiene e planejaent das PPR de ua astra de prtadres de PPR, e

estud transversal. Para tant i utilizad questinri e exae clnic realizads pr dis exainadrespreviaente calibrads. ra analisads 83 pacientes, 25 d sex asculin, vericu-se que 49,4% dspacientes escvava s dentes trs vezes a dia e que 28,9% leva cerca de 4 inuts para a escva,95,2% usava utrs eis de higieniza, al da escva, c: cree dental (98,7%), dental (79,7%)e clutris (55,7%). Pr, bservu-se que 56,6% apresentava placa bacteriana e 21,7% crie a exaeclnic. Quant s prteses 74,7% era denitivas e 96,4% era bilaterais. os requisits de estabilidade,reten, clus e esttica ra classicads c bns, na airia ds cass; j a higiene teve igualprpr para b e regular. E 24% das prteses, a base encntrava-se raturada u derada, 50,6%apresentava s dentes articiais c desgaste. Ebra a airia ds pacientes cnsiderasse sua prteseba, explicaes ais cpletas sbre s cuidads rais e air reqncia de visitas a dentista deve sercnsiderads para elhrar a sade peridntal e cntrle de placa e usuris de PPR.

unitermoS

Prtese parcial revvel; higiene ral.

referenceS

1. Asckar Em, Vieira L, Bnachela WC. Estud lngitudinal de pacientesprtadres de prteses parciais revveis (PPR) e rela as dentescntrles, retentres priris e retentres secundris c acpan-haent prssinal. odntlgia US. 1999; 17:63-77.

2. Cnde mC, Saraiva mCP, Kn S, Tdescan JH, Pustiglini E. Utd siplicad de diagnstic peridntal. Rev Assc Paul CirDent. 1996; 50(2):139-42.

3. Duarte C, Paiva H. Avalia d nvel de cnhecient e cnscientiza- d cirurgi dentista e d tcnic e prtese dental, e rela aplanejaent e a execu de prteses parciais revveis estudlabratrial. Rev ABo Nac. 2000; 8(4):232-7.

4. Klieann C, oliveira W. manual de prtese parcial revvel. SPaul: Sants; 1999.

5. mats RL, Pagnan Vo, Ribeir R, matts mGC. Avalia da inte-ra cirurgi dentista/ tcnic n prcess de cnec de prteseparcial revvel. RPG Rev Ps Grad. 2002;9(1):63-9.

6. mazurat Nm, mazurat RD. Discuss bere abricating: cunicatingthe realities partial denture therap. Part II: clinical utces. J CanDent Assc. 2003; 69(2):96-100.

7. owall B, Budtz-Jrgensen E, Davenprt J, mushit E, Palqvist S,Renner R, et al. Revable partial denture design: a need t cus nhgienic principles? Int J Prsthdnt. 2002;15(4);371-8.

8. Sait m, Ntani K, miura y, Kawasaki T. Cplicatins and ailuresin revable partial dentures: a clinical evaluatin. J oral Rehabil.2002; 29(7):627-33.

9. Taaki T. Prtese parcial xa e revvel. S Paul: Sarvier; 1982.

10. Tdescan R, Bernardes EEB, Silva oJ. Atlas de prtese parcial re-vvel. S Paul: Sants; 1998.11. Wagner B, Kern m. Clinical evaluatin revable partial dentures

10 ears ater insertin: success rates, hgienic prbles, and technicalailures. Clin oral Investig. 2000;4(2):74-80.

12. Walter JD. Planejaent de prtese parcial revvel. S Paul:Sants; 1991.

Recebid e: 03/02/07Aprvad e: 10/08/07

mateus Bertlini ernandes ds SantsR. Eng J nseca, 123 ap.34SJCaps 12243-620, SP, Brazil

[email protected] (55 12) 3913-2791

longitudinal study of removable partial dentures and hygiene habits

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