As natural teeth are lost, this can impact significantly on patients’ oral function( Reference Brodeur, Laurin and Vallee 1 ). With a decreased number of teeth, a reduction in chewing function can result in modifications to food choices and subsequently nutritional state( Reference Sheiham and Steele 2 , Reference Joshipura, Rimm and Douglass 3 ).
This study compared two tooth replacement strategies for partially dentate older patients; removable partial dental prostheses (RPDPs) and functionally orientated treatment based on the shortened dental arch (SDA) concept( Reference Kayser 4 ), in regard to masticatory performance and impact on nutritional state.
Patients aged 65 years and older were randomly allocated to two different treatment groups. For the RPDP-group each participant was restored to complete arches with cobalt-chromium RPDPs to replace missing teeth. For the SDA group, participants were restored to a premolar occlusion of 10 occluding pairs of natural and replacement teeth (OU) using bridgework. Masticatory performance was assessed with a previously validated colour-mixing ability (bolus-kneading) test. Each patient provided haematological samples that were screened for biochemical markers of nutritional status. Each sample was tested for serum Albumin, serum Cholesterol, Ferritin, Folate, Vitamin B12 and Vitamin D. Statistical analysis comprised t-tests and mixed-effect regression models.
Eighty-nine patients completed the test for masticatory performance and provided blood samples at baseline and after 12 months. Masticatory performance (VOH) increased significantly in both groups (p < 0·0001 obtained from one sample t test), but as shown in the table were not different from each other (p = 0·169 obtained from independent sample t test), although OU was higher in the RPDP-group (p < 0·0001 obtained from independent sample t test). The statistical models failed to predict nutritional markers from the masticatory performance (p > 0·05 obtained from regression analysis).
P Value obtained from an independent sample t test
These results indicate that prosthodontic rehabilitation according to the principles of the SDA is equivalent to RPDPs in terms of restoration of chewing capacity for partially dentate older patients. Enhanced masticatory performance alone does not signify improved nutritional state.
