Wolfart S, Müller F, Gerß J, Heyedcke G, Marré B, Böning K, Wöstmann B, Kern M, Mundt T, Hannak W, Brückner J, Passia N, Jahn F, Hartmann S, Stark H, Richter E J, Gernet W, Luthardt R G, Walter M H
Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany,
Clin Oral Investig. 2014;18(2):525-33. doi: 10.1007/s00784-013-0991-6. Epub 2013 May 17.
Although the shortened dental arch (SDA) concept is a widely accepted strategy to avoid overtreatment, little is known on its impact on oral health-related quality of life (OHRQoL). This multicenter randomized controlled trial aimed to investigate the OHRQoL for removable partial dental prostheses (RPDP) with molar replacement versus the SDA concept.
In both groups, missing anterior teeth were replaced with fixed dental prosthesis. Two hundred fifteen patients with bilateral molar loss in at least one jaw were included. The Oral Health Impact Profile (OHIP-49) was completed before; 6 weeks (baseline), 6 months, and 12 months after treatment; and thereafter annually until 5 years.
Of the initial cohort, 81 patients were assigned to the RPDP group and 71 to the SDA group (age, 34 to 86 years). Before treatment, the median OHIP score was similar in both groups (RPDP, 38.0; SDA, 40.0; n.s.). Results indicate marked improvements in OHRQoL in both groups between pretreatment and baseline (RPDP, 27.0; SDA, 19.0; p ≤ 0.0001) which continued in the RPDP group until the 1-year follow-up (p = 0.0002). These significant reductions in OHIP scores are reflected in its subscales. No further differences were seen within and between groups during the remainder observation period.
Both treatments show a significant improvement in OHRQoL which continued in the RPDP group until the 1-year follow-up. No significant differences were seen between groups.
For improving OHRQoL, it is not necessary to replace missing molars with a RPDP.
尽管短牙弓（SDA）概念是一种广泛接受的避免过度治疗的策略，但关于其对口腔健康相关生活质量（OHRQoL）的影响却知之甚少。这项多中心随机对照试验旨在研究可摘局部义齿（RPDP）替代磨牙与SDA概念相比对OHRQoL的影响。
两组中，缺失的前牙均用固定义齿修复。纳入了215例至少一侧颌骨双侧磨牙缺失的患者。在治疗前、治疗后6周（基线）、6个月和12个月以及此后每年直至5年时完成口腔健康影响量表（OHIP - 49）。
在初始队列中，81例患者被分配到RPDP组，71例被分配到SDA组（年龄34至86岁）。治疗前，两组的OHIP评分中位数相似（RPDP组为38.0；SDA组为40.0；无统计学差异）。结果表明，两组在治疗前至基线期间OHRQoL均有显著改善（RPDP组为27.0；SDA组为19.0；p≤0.0001），RPDP组这种改善持续到1年随访（p = 0.0002）。OHIP评分的显著降低在其各个子量表中均有体现。在剩余观察期内，组内和组间均未观察到进一步差异。
两种治疗方法均显示OHRQoL有显著改善，RPDP组这种改善持续到1年随访。两组之间未观察到显著差异。
为改善OHRQoL，无需用RPDP替代缺失的磨牙。
