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Factors influencing the treatment options for single missing tooth: A patient preference based study

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Abstract

Objective: To determine factors affecting the patients decision for selecting a particular treatment option for replacement of single missing tooth Study Design: Descriptive analytical study. Place and Duration: Department of Prosthodontics, Altamash institute of dental medicine, Karachi, from 15 June'2019 to 14 December'2019. Methodology: All new patients attending dental OPD in the age group of 18-60 years with only single missing tooth were included in the study. A well-constructed and validated Performa was used to evaluate patient's decision for three different types of prosthesis against different influencing factors including, cost, pain and discomfort, duration, dental phobia, damage to the adjacent teeth and number of visits. Results: Out of the total 397 patients mostly were from 40-50 years with 56.2% males and 43.8% were females. Majority of the participants preferred fixed partial dentures (59.2%) as compared to removable partial dentures (24.4%), dental implants (9.1%) and (7.3%) preferred no treatment option. Cost of treatment (90.9%) was the most common factor in choosing a particular prosthesis majorly with dental implants and fixed partial dentures. Conclusion: The replacement of missing tooth is based on multiple factors amongst fixed partial denture, removable partial denture and dental implants, among which duration of treatment and cost are the most common influencing factors considered by the patient. Additionally, patient's education and awareness level did affect the choice of treatment options.
ORIGINAL ARTICLE Isra Med J. | Vol 13 - Issue 1 | Jan Mar 2021
24
Factors influencing the treatment options for single
missing tooth: A patient preference-based study
Naseer Ahmed1, Maria Shakoor Abbasi2, Fiza Bibi Alavi3, Asma Naz4, Sabeen Masood3, Adil Bin Irfan5
ABSTRACT
Objective: To determine factors affecting the patients decision for selecting a particular treatment option for replacement of single
missing tooth
Study Design: Descriptive analytical study.
Place and Duration: Department of Prosthodontics, Altamash institute of dental medicine, Karachi, from 15 June’2019 to 14
December’2019.
Methodology: All new patients attending dental OPD in the age group of 18-60 years with only single missing tooth were included in
the study. A well-constructed and validated Performa was used to evaluate patient’s decision for three different types of prosthesis
against different influencing factors including, cost, pain and discomfort, duration, dental phobia, damage to the adjacent teeth and
number of visits.
Results: Out of the total 397 patients mostly were from 40-50 years with 56.2% males and 43.8% were females. Majority of the
participants preferred fixed partial dentures (59.2%) as compared to removable partial dentures (24.4%), dental implants (9.1%) and
(7.3%) preferred no treatment option. Cost of treatment (90.9%) was the most common factor in choosing a particular prosthesis
majorly with dental implants and fixed partial dentures.
Conclusion: The replacement of missing tooth is based on multiple factors amongst fixed partial denture, removable partial denture
and dental implants, among which duration of treatment and cost are the most common influencing factors considered by the patient.
Additionally, patient’s education and awareness level did affect the choice of treatment options.
Keywords: Cost, Dental implants, Dental phobia, Fixed partial denture, Pain and suffer, Single missing tooth
How to Cite This:
Ahmed N, Abbasi MS, Alavi FB, Naz A, Masood S, Irfan AB. Factors influencing the treatment options for single missing tooth: A patient
preference-based study. Isra Med J. 2021; 13(1): 24-28.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License
(http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
INTRODUCTION
Tooth loss is physically and psychologically a traumatizing
experience and it has a serious impact on the quality of life of an
individual. The two most common reported causes of tooth loss
are dental caries and periodontal problems; others are
accidental trauma, endodontic complications and congenitally
missing teeth1,2. Maintenance of oral health is very important
though neglected to the point where only emergency treatment
is pursued for pain relief and by that point, the only option left
is to extract that painful tooth, leaving a gap behind and making
the individual partially edentulous. This is probably due to the
lack of awareness of the consequences of missing teeth and
financial constraints as restorative treatment is expensive3,4.
This also corresponds to a study by Samuel AR et al in which the
patients neglected treatment as 70% of them felt it was
expensive and 94% were unaware of the consequences of
missing teeth5. In a study by Shetty M et al, 33.5% reported
treatment to be expensive, 24% reported lack of time and 22%
did not feel any need to replace a missing tooth6.
Several treatment options are available to restore a single
missing tooth which are broadly categorized under two main
domains: fixed and removable prosthodontics7. “Fixed
1. Associate Professor of Prosthodontics,
Altamash Institute of Dental Medicine, Karachi
2. Assistant Professor of Prosthodontics,
Altamash Institute of Dental Medicine, Karachi
3. House Officer,
Altamash Institute of Dental Medicine, Karachi
4. Associate Professor of Prosthodontics,
Jinnah Medical and Dental College, Karachi
5. Registrar of Prosthodontics,
Altamash Institute of Dental Medicine, Karachi
Correspondence:
Naseer Ahmed
Associate Professor of Prosthodontics,
Altamash Institute of Dental Medicine, Karachi
Email: naprosthodontist@gmail.com
Received for Publication: June 29, 2020
1st Revision of Manuscript: September 07, 2020
2nd Revision of Manuscript: September 15, 2020
Accepted for Publication: October 01, 2020
Naseer Ahmed et al Isra Med J. | Vol 13 - Issue 1 | Jan Mar 2021
25
prosthodontic treatment includes conventional Fixed partial
dentures, Cantilevered fixed dental prosthesis, resin bonded
fixed dental prosthesis or implant supported fixed dental
prosthesis. Each option has its merits and demerits along with
particular indications8.
Timely restoration of edentulous spaces is needed to prevent
the adverse consequences of tooth loss. The choice of the
prosthesis for replacing a single missing tooth is determined by
various factors, such as; age, gender, socio economic status,
individual patient’s condition (medical or psychological),
location of the tooth in the arch, quality of ridge and alveolar
bone, empirical evidence of outcomes of treatment, experience
and expertise of clinicians and patient’s preference7,9. Usually,
the bias of the dentist plays a role rather than objective
assessment of the treatment modalities. Treatment decisions
should be made in close consultation with the patients and their
expectations should be addressed if they reflect reality10.
Otherwise, the practitioner will face rejection in their proposed
treatment plans as concluded by studies by Shrirao and Nayana,
where 82% and 73% of patients rejected the proposed
treatment plans in which their desires and requirements were
not addressed11,12. Therefore, in a nutshell, it is very necessary
to address the patient's requirements and desires to ensure the
patient's satisfaction.
Various studies have been carried out in which investigators have
evaluated the dentists’ role in choosing different treatment
modalities available for patients with complaints of a single
missing tooth but investigators have been ignoring the
importance of patients’ perception on deciding the choice of
treatment for the replacement of a single missing tooth as studies
related to patient’s decision are reported less in literature11-14.
Hence, this study was conducted with an objective to determine
the factors affecting the patient’s decision for selecting a
particular treatment option for replacement of single missing
tooth.
METHODOLOGY
This descriptive analytical study was carried out from 15
June’2019 to 14 December’ 2019 for a period of 6 months on the
patients visiting outpatient department (OPD) of Altamash
Institute of Dental Medicine and various dental institutes and
hospitals of Karachi. The participants were informed about
anonymous, voluntary, and non-compulsory nature of the study
and prior consent was taken before their participation in the
study. The simple random sampling technique was used in this
study. All new patients attending dental OPD in the age group of
18-60 years with only single missing tooth were included in the
study. Patients having periodontal diseases, smoking habits,
debilitating diseases, pregnancy and edentulous spaces at the
distal extension base or more than one missing tooth were
excluded.
A well-constructed and validated proforma was used for data
collection. The internal consistency of items analyzed through
Cronbach alpha was (α=0.71). The proforma was divided into
two sections; First section addressed the demographic details
including age, gender, education level along with the preferred
treatment option. The second section consisted of responses
related to treatment options patient did not opt along with the
factors or reasons that influenced their decision namely cost,
pain and suffer, duration, phobia, damage to the adjacent teeth
and the number of visits.
Data Analysis: The IBM SPSS version 21.0 was used for statistical
analysis. Descriptive analysis was carried out for frequency and
percentage calculation while independent T test and Paired T
test was used to analyze the effects of age, gender and
education with different treatment options. A p-value of (≤ 0.05)
was considered statistically significant.
RESULTS
In this descriptive analytical study 397 patients participated. 223
(563.2%) were males and 174 (43.8%) females. Most of the
participants, (57.9%) belonged to <40 years of age. Additionally,
207 (52.1%) were graduates and 197 (47.9%) undergraduates.
Furthermore, out of 397 participants only 26 (6.5%) were using
prosthesis for their missing tooth. When asked about a
treatment option that they will opt for replacement, FPD were
chosen by 235 (59.2%) participants, RPD by 97 (24.4%), Dental
Implants by 36 (9.1%) candidates while no treatment was opted
by 29 (7.3%) participants.
Moreover, cost or expense 361(90.9 %) was the most common
reason of not choosing a timely and particular treatment option
while pain and discomfort was recorded 230(57.9%), duration
64(16.1), compromised dental status such as weak abutment
80(20.1), phobia of dental treatment 96(24.1) and number of
visits by 4(6.34%) participants as described in Table-I.
The gender based distribution of treatment options are
presented in Table-II, the frequency of FPD, RPD, dental implant
and no treatment; opted by male was n=126 (56.5%),
n=57(25.5%), n=16(7.1%),n=24(10.7%) while in female n=109
(62.6%, n=40 (22.9%) , n=20(11.4%), n=5 (2.8%). Hence a
significant difference was found (p = 0.053).
Table -I: Factors Affecting Treatment Options in Relation to Prosthesis type (N=397)
Reasons of not choosing a
particular replacement option
Cost
n (%)
Pain and
suffer, n (%)
Duration
n (%)
Number of
visits, n (%)
Damage to the adjacent
abutments, n (%)
n (%)
Fixed partial denture
70 (17.6%)
4 (1.0%)
4 (1.0%)
2 (0.5%)
76 (19.1%)
Dental Implant
278 (70%)
8 (2%)
60 (15.1%)
2 (0.5%)
4 (1%)
Removable partial denture
4 (1%)
214 (53.9%)
0
0
0
Reason of opting No treatment
9 (2.30%)
4 (10%)
0
0
0
Total
361(90.9%)
230(57.9%)
64(16.1%)
4(6.34%)
80(20.1%)
Naseer Ahmed et al Isra Med J. | Vol 13 - Issue 1 | Jan Mar 2021
26
Table-II: Gender based distribution of Prosthetic treatment
options, (N=397)
Type of prosthesis
Gender
Total
(N)
p
value
Male n(%)
Female n(%)
Fixed Partial Denture
126 (56.5%)
109 (62.6%)
235
0.05
Removable Partial
Denture
57 (25.5%)
40 (22.9%)
97
Dental Implant
16 (7.1%)
20 (11.4%)
36
No treatment
24 (10.7%)
5 (2.87%)
29
Total
223 (100%)
174 (100%)
397
Similarly, when education level was compared with treatment
options such as FPD, RPD, dental implants and no treatment: The
frequency in undergraduate was n=100(52.5%), n=61(32.1%),
n=4(2.1%) and n=25(13.15) while in graduates n=135(65.2%),
n=36(17.3), n=32(15.4%) and n=4(1.9%). Hence, a significant
difference (p = 0.020) was seen subsequently as mentioned in
Table-III.
Table -III: Education level and treatment option consideration,
(N=397)
Type of prosthesis
Education level
Total
P
value
Undergraduate
n (%)
Graduate
n (%)
Fixed Partial
Denture
100 (52.6%)
135 (65.2%)
235
0.020
Removable Partial
Denture
61 (32.1%)
36 (17.3%)
97
Dental Implant
4 (2.1%)
32 (15.4%)
36
No treatment
25 (13.15)
4 (1.9%)
29
Total
190
207
397
The analysis of treatment options and age < 40 years was also
carried out as depicted in Table IV, 40-50 years and > 50 years
comparison revealed no significant difference (p= 0.75). The
majority 235 participants chosen FPD while RPD by (97) and
dental implant (36), no treatment by (29) subsequently.
Table -IV: Comparison of age groups and treatment options,
(N=397)
Type of
prosthesis
Age
Total
(N)
p
value
< 40
years (n)
40-50
years (n)
> 50
years
(n)
Fixed partial
denture
145
64
26
235
0.75
Removable
partial denture
40
36
21
97
Dental Implant
24
12
0
36
No treatment
21
8
0
29
Total
230
120
47
397
DISCUSSION
Out of the total 397 patients, 93.5% were new and had no
previous experience of any kind of prosthesis. For a single
missing tooth, a number of different treatment modalities are
present; with each having its own merits and demerits. As in this
study, patients were evaluated for three different types of
prosthesis against different influencing factors namely cost, pain
and suffer, duration, number of visits, compromised abutments
and phobias. Our study demonstrated that 59.2% of the
participants preferred fixed partial dentures as compared to
removable partial dentures (24.4%), dental implants (9.1%) and
(7.3%) preferred no treatment option which is in
correspondence with a common impression in restorative
dentistry is to go for a fixed prosthesis whenever possible15.
Pommer et al evaluated the advantages of fixed vs. removable
dentures and concluded that the majority (54%) of the
participants felt that Fixed prosthesis were less annoying in the
mouth, 49% were convinced that they were better esthetically,
43% equated fixed dentures with natural teeth in terms of
function and 38% said that they did not feel like foreign bodies16.
Also, a patient rarely accept or desire a removable partial
prosthesis as a replacement option for a single missing tooth15
which is also in agreement with a study by Satpathy et al17, in
which 71.24 % of the total patients expressed discontent with a
removable option as a replacement for missing tooth.
In our study, a significant difference was found (p = 0.05)
suggesting that gender can be one of the patient factors
affecting the decision for the selection of a particular treatment
option. As females are more inclined towards their facial
esthetics whereas males do not give importance to their
appearance much, for them comfort and functionality are prime
concerns. Also, it is difficult for them to take out time from their
busy schedule as in our study striking 10.7% of the males opted
for no treatment as an option which is in accordance with
Natarajan et al18 who concluded that 46.64% male reported lack
of time as the primary reason for not opting any treatment. Our
results were also in agreement with Al-Quran et al19 who
reported a significant difference (p=0.016) between both the
gender in removable partial denture group. Also, in a study by
Shrirao et al11, males opted for the reason “do not feel the need
of treatment” more than females; 11.6% as opposed to 5.5%.
Ahmed et al20 also concluded that esthetic rather than functional
factors determine an individual's subjective need for the
replacement of missing teeth.
In addition to this, the level of education also played a role in
opting for a treatment modality. In our study, a significant
difference (p = 0.020) was found between education levels in
regard to treatment modality chosen which is in accordance
with Al-Quran et al19 who also found significant differences
between levels of education with treatment modality chosen (p
= 0.024). Acceptance of RPD was also decreased with the level
of education (p = 0) in another study by Pommer et al16. In our
study 42.2% of the undergraduate group either opted for a
removable prosthesis or no treatment as an option; a merely 2%
opted for implant as an option as compared to graduate ones
where only 19% opted for removable or no treatment suggesting
the role of education could affect the patient's awareness
regarding the options and importance of tooth replacement17.
On the other hand the analysis of treatment options and age <40
years and 40-50 years and > 50 years the comparison revealed
no significant difference (p= 0.75) which is in contrast with a
study in which significantly higher percentage of young
participants rejected removable dentures (P =0)18. Whereas Al-
Naseer Ahmed et al Isra Med J. | Vol 13 - Issue 1 | Jan Mar 2021
27
Quran et al19 reported no statistically significant differences
between age groups and preferred treatment option (p <0.05).
When patients were asked about factors affecting their choice
of treatment modality overall, cost or expense of the treatment
was the most common deciding factor for choosing a particular
treatment option (90.9 %), which is in accordance with the
research carried out by Samuel et al5, Shetty et al6, Nayana et
al12 and Mohapatra et al21where 70%, 33.5%, 43.2% and 52% of
the participants cited high expenditure as the most determining
factor for a particular choice of prosthesis.
Moreover in our study pain and discomfort was accounted as the
second most important factor (57.9%) followed by phobia of
dental treatment (24.1%), damage to the adjacent abutments
(20.1%), duration (16.1%) and the number of visits by (6.34%)
participants. These findings corroborated with other studies
including Kvale et al22, who found that 40% of the adult
population has been reported to be afraid of dental treatment.
Similarly, Shrirao ND et al11 reported fear of dental treatment as
the second most common deciding factor (17.1%) in their study.
Additionally, as far as Fixed dental prosthesis is concerned,
damage to the adjacent teeth (19.1%) and cost (17.6%) were
reported as the common reasons for not choosing Fixed Partial
denture which is in accordance with Mohapatra et al21 who
concluded that 52% of participants in his study had an objection
to the cost of FDP. It is a proven fact that fixed dental prosthesis
is associated with the risk for additional endodontic treatment
and discomfort because of hypersensitivity and difficult access
for plaque control15.
In the case of implant supported prosthesis 70% of the
participants reported cost as the most influencing factor
affecting its selection followed by duration (15%) which is
corroborated in other studies including; Tepper et al23 who
reported that 80% of the participants felt implants were too
expensive, whereas 15% complained the time for healing and
prosthodontic management was too long. In other
investigations conducted by Pommer et al16 and Satpathy et al17,
high costs were mentioned by 83% and 59% of the total subjects
while long treatment time by 16% and 26%. Hence these two
factors along with need for surgical procedure are major
disadvantages of implant therapy as reported in
literatute16,17,23,24. Similarly Bragger et al found that the required
time span for FPD reconstruction was (3.23±2.64) months
though more time was needed for the reconstruction with
dental implants (5.94±3.29) months and also concluded that
implant reconstruction is cost effective in cases of single‐tooth
replacement compared with conventional FPD24,25.
Furthermore, in this study 24% of the participants opted
removable dentures as a replacement option for single missing
tooth which is in accordance with Al-Quran et al19 in which 34%
of the subjects preferred RPD due to its cost-effectiveness.
Contrarily, 53.9% participants reported pain and discomfort
while 18.9% reported phobia as a major concern for not
selecting removable dentures this prosthesis which is also
supported by other from Shetty et al6, who reported 42.4%
subjects with discomfort and pain and Satpathy et al17 reported
71.24 % participants experiencing pain while wearing single
tooth replacing removable dentures.
In our study, only 7.3% opted no treatment, and they reported
pain and suffer (10%) as one of the leading cause for it followed
by phobia (3%) and high cost of treatment (2.3%) which in
contrast with Trepper et al23 in which 25% felt that replacing
missing teeth was only necessary if the gap was visible and with
by Shetty et al6, in which 33.5% reported treatment to be
expensive, 24% reported lack of time and 22% did not feel any
need to replace the missing tooth6.
Therefore, in a nutshell it is stated that there are multiple factors
that influence the selection of single tooth replacement
restorative options which must be put into Consideration during
the treatment planning phase as they directly affect the
patient’s acceptance of a particular option. In addition, patient’s
knowledge and awareness about the merits and demerits of
different treatment options also play an important role in
outcome of restoration.
CONCLUSION
The replacement of missing tooth is based on multiple factors
amongst fixed partial denture, removable partial denture and
dental implants, among which duration of treatment and cost
are the most common influencing factors considered by the
patient. Additionally, patient’s education and awareness level
did affect the choice of treatment options.
AUTHORS CONTRIBUTION
Ahmed N: Data analysis, Data interpretation, Critical review
Shakoor M: Conceived idea, Designed methodology, Manuscript
writing, Literature review
Alavi FB: Manuscript writing, Literature review
Naz A: Critical review, Final review
Masood S: Manuscript writing
Irfan AB: Data collection and Compilation
Disclaimer: None.
Conflict of Interest: None.
Source of Funding: None.
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... 1 Optimal soft and hard tissues health following prosthetic treatment is a pre requisite for improvement in longevity. 2 Periodontium is considered as the prime determinant to achieve a satisfactory outcome based on adequate function, esthetics and comfort. 3 The interplay between periodontology and restorative dentistry is present at many fronts, including location of restorative margins, crown contours, and response of the gingival tissues to restorative preparations. ...
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OBJECTIVE: The objective of this paper was to evaluate the marginal location preference and periodontal health in extra coronal restoration of anterior and posterior teeth. METHODOLOGY: In this prospective case control study, a total of 652 patients who had crown and bridge for not less than six months were included. The gingival margin location preference and reasons behind choosing a particular gingival margin was asked from the patients. Additionally, the teeth with and without restoration were also examined for periodontal health. Split mouth technique was used as unrestored, healthy contra lateral teeth in the same individual served as controls. Descriptive statistics and Chi square test were used for analysis to formulate the results. RESULTS: Ironically, 92% patients were not given a chance by their dentist to give input about margin location preference. The majority of patients preferred equi gingival margin for their anterior crowns 495 (75.92%) and supra gingival margin 586 (89.87%) for their posterior teeth, with esthetics 547 (83.89%) and hygiene 599 (91.87%) respectively being the most common reasons for selecting the particular margin location. The clinical examination revealed that supra gingival and equi gingival margins demonstrated superior gingival health indices as compared to subgingival margins CONCLUSION: This study concluded that the supra gingival and equi gingival margins demonstrated superior gingival health indices as compared to subgingival margin and in order to achieve optimal periodontal health and patient satisfaction the health professionals should wisely consider the margin location and involve the patient in treatment decisions wherever possible. KEY WORDS: Crown and Bridge, Margin location, Patient preference, Periodontal Health.
... [1][2][3] Using dental implants avoids the biological complications associated with fixed partial denture that requires adjacent teeth to be prepared and serve as an abutment for the bridge, since it may lead to a long term poor prognosis. [4][5][6] With increasing demands of the patients for implant supported prostheses, dental practitioners dealing with this field of dentistry have to face with patients' high expectations concerning excellent esthetics and function. 7 In addition, a dental practitioner's knowledge and attitude towards the treatment can influence the treatment planning and ultimately the oral health of an individual. ...
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OBJECTIVE: To investigate the dental practitioner's knowledge, attitude and practice towards dental implants. METHODOLOGY: This study was carried out from May'2019 - Oct 2019. 752 dental practitioners who were currently practicing were included in the study. A well-structured questionnaire was used for data collection. SPSS-25 was used for statistical analysis. Spearman correlation was used to find the effect of gender, knowledge and attitude. The P <0.05 was considered statistically significant. RESULTS: In this study 80.9% dental practitioners were aware of the appropriate implant material while, 57.9% had knowledge about the types. 30.3% knew about the implant surface modifications whereas 46.1% dentists were aware of possible implant placement approaches. 49.3% believed that the distance between dental implants to be 3mm and between a dental implant and natural tooth to be 1.5 mm. 76% dentists claimed that dental implants have biomechanical complications. Whereas 67.8% knew about the Branemark's theory of osseointegration. Regarding the attitude of dental practitioners, 28.9% had received implant hands on trainings while 9% felt competent to place an implant. CONCLUSION: This study describes that dental practitioners had an appropriate knowledge of each aspect of implantology. Moreover despite the fact majority felt that they are not competent enough to practice it. Thus, it is important that the curriculum, teaching standards, the materials and methods regarding dental implants need to be reviewed and more exposure of hands-on workshops is to be provided not only for the graduates but also the undergraduates during their clinical learning. KEYWORDS: Dental Implants, Dentist's opinion, Knowledge
... 1 Optimal soft and hard tissues health following prosthetic treatment is a pre requisite for improvement in longevity. 2 Periodontium is considered as the prime determinant to achieve a satisfactory outcome based on adequate function, esthetics and comfort. 3 The interplay between periodontology and restorative dentistry is present at many fronts, including location of restorative margins, crown contours, and response of the gingival tissues to restorative preparations. ...
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The majority of patients preferred equiginigval margin for their anterior crowns 495 (75.92%), supraginigival margin 131 (20.09%) and subgingival margin 26 (3.99%). In the posterior teeth supragingival margin 586 (89.87%) equigingival 52 (7.97%), and subgingival 13 (3.98%) were opted. For the crown margin in anterior, esthetics was the main reason for selection of equisingular margin 547 (83.89%). For crown margin in posterior teeth, hygiene 599 (91.87%) followed by durability 26 (3.98%) while esthetics was 19 (2.91%) as the main reasons. Additionally, 92% were not given a chance by the dentist to give input about margin location preference. The teeth with adequate marginal integrity had good periodontal health status when compared with control. Even with cutting edge technology the neck position of an artificial crown and bridge is critical to the health of gingiva. Therefore, for fixed prosthesis restoration it is important to wisely consider the option of subgingival, equigingival or supragingival margins to achieve optimal periodontal health and patient satisfaction. Which will assure permanency of the treatment.
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Introduction: Teeth play a significant part in the maintenance of a healthy personality and an affirmative self-image. Tooth loss is psychologically a very traumatizing and upsetting experience, and is considered to be a serious event in the life of a person, requiring significant psychological readjustment. Objective: Evaluate the prosthetic status and attitude of the patients towards replacement of the teeth among the patients visiting dental department, Noble Medical College and Teaching Hospital (NMCTH) Materials and Methods: A cross sectional study was conducted over a duration of 6 months to determine prosthetic status and attitude of the patients towards replacement of the teeth among all patients visiting Department of prosthodontics, NMCTH. The inclusion criteria was all patients with at least one missing tooth (excluding third molars) and subjects who gave consent for the study. All the Patients were provided with six close ended questionnaire followed by clinical examination by a well trained investigator. Result: The total number of participants was 297. Of them 157 were male and 140 were female. Most frequently encountered age group was 21-30 years Of these, 80.8% of individual were provided with proper information about replacement of teeth whereas 19.2 % were not. 70.7% individual said they will replace only when they find difficulty in their daily activities. 64.6 % of individual wanted to replace teeth for appearance, 20.5% for function and 14.8% for both appearance and function. 79.5 %stated financial problem and 18.2% stated lack of awareness regarding not replacement of teeth. Conclusion: The patients’ attitudes and demand towards the replacement of missing teeth might be different from the clinicians’ assessment. We consider factors such as the preservation of natural teeth and the maintenance of periodontal health as priority but patients tends to prioritize comfort in mastication and improvement of esthetics. Therefore, it is vital to investigate patients’ awareness, need and demand on prosthodontic treatment options.
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To find out and to understand the reasons and the associated problems for not substituting the lost teeth and to make an attempt in reducing the possible cause of not replacing the missing teeth. A total of 300 patients who had visited to the Faculty of Dental Sciences, Sri Ramachandra Medical college & research institute with aged above 25 years with as a minimum of one missing teeth (excluding third molars) not replaced for more than three months and have visited the Institute other than for replacement of the missing teeth were selected. The study includes a predesigned and structured questionnaire containing seven (closed end) questions and followed by clinical examination recording the number and positions of the missing teeth. All the data were statistically analyzed. Statistical analysis shows the 42% of the patients find economical reason as the main hurdle for the replacement of the teeth followed by 33% of patients finds lack of time and remaining 25% of the patients are unaware of replacing the missing teeth. The 62% of male patients were found to be not pleased with their existing oral condition in terms of mastication of food & whereas 61% of female patients were found to be not satisfied with the aesthetics of the present dentition. Out of the various reasons, the economic reasons was the key reason for non- replacement of missing teeth. The patients having missing posterior teeth had more than the one-year duration of edentulousness. It can be suggested that, to reduce the economic burden in replacing the missing teeth, the Government of India and the insurance providers can include the dental treatment in their list of treatment covered by the health insurance. Published by Oriental Scientific Publishing Company
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Objective Our objective was to assess awareness, attitudes, need and demand on replacement of missing teeth according to edentulous space, age, gender, ethnicity, educational level and socio-economical status of the patient. Results 76.2% of the study group was opined that the missing teeth should be replaced by prosthetic means. Majority were keen in getting them replaced mainly for the comfort in mastication. Although 77.9 and 32.9% were aware of the removable prostheses and implants respectively, only 25.2% knew about tooth supported bridges as an option of replacement of missing teeth. Participants’ awareness on tooth and implant supported prostheses is at a higher level. Participants’ opinion on need of regular dental visit was statistically significant when gender, ethnicity and education level were considered. The highest demand for replacement of missing teeth was observed in Kennedy class I and II situations in both upper and lower arches. Demand for fixed prostheses was significantly highest in Kennedy class II in upper and lower arches. In conclusion, although removable prosthodontic options are known to most of the patients, their awareness on tooth and implant supported prostheses is also at a higher level. The highest demand for replacement of missing teeth is by patients with Kennedy class I and II situations whereas Kennedy class II being the category with highest demand for fixed prostheses. We recommend that the location of missing teeth to be considered as a priority when educating patients on the most appropriate prosthetic treatment options. Dentists’ involvement in educating patients on prosthetic options needs to be improved.
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Background: There is a lack of information regarding awareness and knowledge of dental implants within the local population. Materials and Methods: A total of 100 subjects participated in this study. It was a questionnaire-based study. Verbal consent was taken from each patient. SPSS-17 version was used for data analysis. Results: Out of the 100, only 28 (28%) patients were aware of dental implant which is quite low. Dental professional was the prime source provider (15%). High cost is one of the main reasons which prevent subjects from choosing dental implant as a treatment modality. Conclusion: More than half of the subjects have no information about dental implant. It explains that dental professionals need to plan some awareness programs and motivate patients to opt this treatment for replacing missing teeth.
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Introduction: For fabricating dental prostheses that meet patients' demands and have good longevity and function, appropriate treatment planning and decision-making are required. Therefore, not only technical skills and clinical judgment of the dentist are needed, but also patients' attitude toward treatment plays a critical role in posttreatment satisfaction. Aim: The aim of this study is to investigate the factors affecting decision-making and the selection of dental prosthesis by the patients. Materials and Methods: A cross-sectional survey to determine patients' attitudes about replacement of teeth was conducted. This survey was performed with the help of a prevalidated questionnaire, which contained the demographic data of every patient, whether or not they accept the treatment plan proposed by the dentist, and a close-ended multiple choice question stating the reasons cited by them if they decline the proposed treatment plan. Results: The data were subjected to statistical analysis by Chi-square test at a significance level of P< 0.05. A relationship between the demographical information such as age, gender, educational status, marital status, and monthly income of each patient and the single best reason opted by them to not undergo the proposed treatment plan was established. Conclusions: In the sample of population studied, most of the patients declined the proposed treatment plan and accepted the alternate one. High expenditure is the most common reason for this rejection.
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p>The purpose of this clinical study was to determine the level of patients satisfaction after prosthodontic treatment. This cross sectional study was conducted in Altamash Institute of Dental Medicine, a total of 200 partially edentulous patients already restored with removable or fixed prosthesis participated in this study. Patient satisfaction was evaluated by Likert's scale. The Patients were given options of unsatisfied, not very satisfied, neutral, somewhat satisfied and satisfied to evaluate patients level of satisfaction for factors such as phonetics, pain, mastication, taste and esthetics. After statistical analysis, Likert scale score's positively for all factors such as phonetics, pain, mastication, taste and esthetics. After prosthodontic treatment patients show high level of satisfaction with their prosthesis though showing positive impact of prosthesis on oral health.</p
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Aim: This study systematically evaluates existing evidence-based literature covering the topic of patient information about different treatment alternatives for missing single teeth, in order to summarise current evidence. Material and methods: Three scientific databases - Pubmed, OvidSP and Scopus - were searched for publications up to July 2015, relating to patient information on treatment options for missing single teeth. References of publications and the google scholar database were screened additionally leading to a total of 183 journal articles written in English. Following the selection criteria, 33 articles were included. Twenty-nine questionnaire- based publications were compared by descriptive analysis of six key parameters - awareness of treatment options, source of information, knowledge, attitude to treatment, preference of treatment option and reason for refusal. Results: Included studies consisted of data from 23,702 responding participants and which were performed in 16 countries. Mean values and standard deviations revealed variations between and within countries. The level of awareness and attitude to treatment in most countries is acceptable. Insufficient knowledge as well as a high demand for knowledge was found. Clinicians are the most important source of information followed by media, family and friends. Dental Implants and FPDs were preferred and high costs would be the major reason for refusal. Conclusion: Clinicians play an important role in improving awareness and knowledge of patients about treatment alternatives. Non-uniform study designs could lead to variations in results. This systematic review can be considered in further studies, in order to standardise methods using key parameters and a representative study population.