Supervisors info:
Πολυζώης Γρηγόρης, Καθηγητής, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ
Συκαράς Νικήτας, Επίκουρος Καθηγητής, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ
Σαραφιανού Ασπασία, Επίκουρη Καθηγήτρια, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ
Summary:
Statement of problem: Complete dentures are usually fabricated with the use of a well-established conventional protocol. The conventional method requires six clinical sessions including the preliminary and the final impression, the recording of maxillomandibular relationships, the anterior and the posterior try-in, and finally the delivery of the denture. The final impression is a challenging and demanding session, requiring significant time. Due to its complexity, the conventional protocol has been challenged and simplified methods with the omission of the final impression stage have been proposed. Insufficient evidence exists on the necessity of the final impression in complete denture fabrication, as well as on its significance for the success of the restoration.
Purpose: The aim of this systematic review is to compare the conventional with the simplified method according to masticatory performance and ability, patient satisfaction, oral health related quality of life (OHRQoL), denture quality, time, and cost.
Material and Methods: An electronic search of the MEDLINE-PubMed, Scopus and Europe PMC databases was conducted by two independent researchers (P.E. and S.A.) for randomized clinical trials, cohort clinical studies and clinical studies of complete dentures fabricated either with the conventional or the simplified method. As simplified method was characterized every protocol of fabrication of complete dentures which did not include a final impression.
The PICO question was formed as such: ‘Does the simplified technique for fabrication of complete dentures provide equal or even better outcomes than the conventional technique in the treatment of edentulous patients?’ Patients in need of a complete denture (Participants/Population) were divided in two categories, named those who were treated with a complete denture fabricated by the simplified technique (Intervention) and those who were treated with a complete denture fabricated by the conventional technique (Comparison). Between these two categories a variety of Outcomes were examined: masticatory performance and ability, patient satisfaction, Oral Health Related Quality of Life (OHRQoL), time, and cost.
The risk of bias for each study was assessed with ROBINS-I and ROBINS 2 tools. The risk of bias across the studies was assessed with the GRADE system.
Results: The electronic search of databases produced 19 articles which fulfilled the inclusion criteria. Moreover, two systematic reviews and one meta-analysis of the same topic were included. The studies examined different variables and therefore were compared in subgroups.
Conclusions: The null-hypothesis was confirmed in terms of cost and time but rejected in all the other factors. Cost and time differed significantly between the two methods favoring the simplified protocol, while masticatory performance and ability, patient satisfaction, Oral Health Related Quality of Life (OHRQoL) and denture quality are not affected by the method of fabrication.
Keywords:
Conventional complete dentures, Simplified complete dentures, Patient satisfaction, Clinical outcomes
