Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR; Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, 50603 Kuala Lumpur, Malaysia.
Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR.
J Dent. 2022 Dec;127:104351. doi: 10.1016/j.jdent.2022.104351. Epub 2022 Oct 21.
To summarise evidence on the change in oral health-related quality of life (OHRQoL) before and after rehabilitation with removable partial dentures (RPDs) amongst partially edentulous adults.
Studies assessing OHRQoL amongst patients aged ≥18 years, before and after rehabilitation with RPDs of any type and design, were included. The quality of included studies was evaluated using the Cochrane risk of bias tools. Meta-analysis was conducted using a random-effect model.
MEDLINE, EMBASE and CENTRAL, up to March 29, 2022.
Thirteen studies were eligible and eight were included in the meta-analysis. The studies had moderate to serious risk of bias. There was a very low level of certainty that OHRQoL, as measured using OHIP-14, improved 3 months after RPDs were fitted (222 participants, MD: -12.0, 95% CI: -16.1, -7.9, p<0.001) and after 6 months (101 participants, MD: -10.5, 95% CI: -16.4, -4.6, p<0.001). At 12 months post-treatment, RPD rehabilitation did not result in statistically significant improvement in OHIP-14 scores (62 participants, MD: -12.7, 95% CI: -26.1, 0.6, p = 0.06). However, the assessment using OHIP-49 at 12 months showed significant improvement (87 participants, MD: -34.8, 95% CI: -41.9, -27.7, p<0.001), with low certainty of evidence.
Based on the limited evidence available, this review found that RPD rehabilitation appear to improve OHRQoL in the short term up to 6 months, with a very low level of certainty. The long-term effect of RPD treatment on OHRQoL after 12 months is inconclusive. There is currently insufficient evidence on the effect of RPD treatment on OHRQoL. This review highlights the need for more and better quality studies.
Data on RPD outcomes are summarised, aiding clinicians in providing evidence-based patient-centred care that matches patients' needs and expectations. Recommendations for future research were also highlighted.
PROSPERO CRD42022328606.
总结成年人部分缺牙患者使用可摘局部义齿(RPD)修复前后口腔健康相关生活质量(OHRQoL)变化的证据。
纳入评估年龄≥18 岁患者使用任何类型和设计的 RPD 修复前后 OHRQoL 的研究。使用 Cochrane 偏倚风险工具评估纳入研究的质量。使用随机效应模型进行荟萃分析。
MEDLINE、EMBASE 和 CENTRAL 数据库,截至 2022 年 3 月 29 日。
共有 13 项研究符合条件,其中 8 项研究被纳入荟萃分析。这些研究存在中度至严重的偏倚风险。有极低的证据确定性表明,使用 OHIP-14 量表测量,RPD 修复后 3 个月(222 名参与者,MD:-12.0,95%CI:-16.1,-7.9,p<0.001)和 6 个月(101 名参与者,MD:-10.5,95%CI:-16.4,-4.6,p<0.001)后 OHRQoL 有所改善。治疗后 12 个月时,RPD 修复并未导致 OHIP-14 评分有统计学意义的改善(62 名参与者,MD:-12.7,95%CI:-26.1,0.6,p=0.06)。然而,使用 OHIP-49 进行的 12 个月评估显示出显著改善(87 名参与者,MD:-34.8,95%CI:-41.9,-27.7,p<0.001),但证据确定性较低。
基于现有有限的证据,本综述发现 RPD 修复在短期至 6 个月内似乎能改善 OHRQoL,但其证据确定性非常低。RPD 治疗对 12 个月后 OHRQoL 的长期影响尚无定论。目前关于 RPD 治疗对 OHRQoL 的影响证据不足。本综述强调了需要更多和更高质量的研究。
总结 RPD 治疗结果,帮助临床医生提供基于证据的以患者为中心的护理,满足患者的需求和期望。还提出了对未来研究的建议。
PROSPERO CRD42022328606。