Introduction
Edentulousness is a condition in which tooth loss causes a negative aesthetic and biomechanical squeal. Although there has been a decrease in the number of complete denture patients, partially edentulous patients have increased in number, possibly due to global aging as well as oral health-related prevention policies.
Cast partial dentures (CPDs) produce improved results in terms of retention, stability, comfort, masticatory efficiency, and health of the periodontium of the abutment teeth.1
The number and location of missing teeth have a large impact on how well the prosthesis restores and maintains functions similar to natural dentition.2 Conventional treatment of complete dentures can sometimes result in poor retention, stability, and satisfaction of the patient. In such cases, the patient's confidence and comfort are jeopardized.3
This decline in the use of RPD is attributed to the availability of better treatment modalities such as implant-supported prosthesis.4
The aims of this survey were 1) to know that how many dental practitioners still use CPD as one of the treatment modalities for missing teeth. 2) To determine why the CPD and its use has been declined in past years.
Materials and Methods
The online questionnaire survey containing eight questions was conducted & its was sent through mails, WhatsApp to the dentists in Maharashtra. The link was sent to 200 dentists in Maharashtra.
The online survey comprised of seven close ended questions. The aim of study was also stated at the beginning of survey. The communications were done through Emails or WhatsApp. Verbal response was strictly prohibited.
The first two questions Q1 and Q2 were related to most frequently encountered group of edentulism and suggested treatment modalities for partial edentulism. The next two questions Q3 and Q4 were related to how often patients agrees to CPD and the reason for rejection of CPD by patient. The next two questions Q5 and Q6 were related to know whether dental practitioner is aware of components and techniques of CPD and the number of RPDs delivered in one year. And the last was question was descriptive to know the opinion of dentist regarding decreasing trend of CPD.
Table 1
Questionnaire regarding use of CPD and its decreasing trend
Results
A total 200 dentists responded to this survey out of which 50 (25%) were prosthodontist and 150(75%) were general dentists. Out of 200 dentists 25(50%) prosthodontists and 85(56.6%) general dentists said that frequently encountered group of edentulism was Kennedy class I. 4 (8%) prosthodontists and 15 (10%) dentists said frequently encountered group was kennedy class II. 9 (18%) prosthodontists and 30 (20%) dentists said frequently encountered group was kennedy class III. 12 (24%) prosthodontists and 20 (13.3%) dentists said frequently encountered group was kennedy class IV. The difference was not statistically significant (p =0.871).Figure 1
Suggested treatment for missing teeth according to 29(58%) prosthodontist was CPD and 87(26%) general dentists opt for temporary RPD. 12 (24%) prosthodontists and 24 (16%) dentists opted for flexible RPD. The difference was statistically significant (p =0.009).Figure 2
According to 16 (41%) of dentists and 13 (44%) prosthodontists rarely patient agrees to CPD. According to 14 (35%) of dentists and 12 (41%) prosthodontists quite often patient agrees to CPD. There was no statistically significant difference. (p =0.093).Figure 3
48 (96%) prosthodontists and 42 (28%) dentists were aware of components and techniques of CPD. There was highly statistically significant difference (p < 0.001).Figure 4
When asked about Problem faced while suggesting Cast partial denture to the patient, 9 (31%) prosthodontists said it was due to aesthetics and 12 (30%) dentists said it was due to lab support.Figure 5
When asked about Removable partial denture delivered in a single year 32 (64%) prosthodontists and 70 (46%) dentists said greater than 20 temporary RPDs are given in single year.
16 (32%) prosthodontists said 10-20 flexible dentures are given in a single year and 123 (82%) general dentists said 1-10 flexible denture are given. The difference was highly statistically significant difference (p < 0.001). 40 (8%) prosthodontists said greater than 20 CPDs are given and 95 (63.3%) dentists said 1-10 CPDs are given in a single year. The difference was highly statistically significant difference (p < 0.001).Figure 6
Discussion
The various treatment modalities for partially edentulous patients with missing varies from a provisional removable partial denture, a definitive cast partial denture, a resin bonded fixed prosthesis, fixed partial denture or an implant. 5 Removable partial dentures (RPDs) are simplest and easiest method for replacing teeth for patients missing their natural teeth. 6 Sometimes, RPDs serve to be the treatment of choice due to some anatomical, cost, and other patient related factors.5 A removable partial denture can be made of acrylic partial denture, CPD, or flexible denture. 7
But due to advent of Implant supported fixed prosthesis and increasing demand for metal free prosthesis, the CPD trend is decreasing.
Conclusion
Change is the only constant thing in the world. World keeps changing with the changing trends.This survey shows that the primary and most often suggested treatment modalities for missing teeth by dentists is Removable partial denture or Cast partial denture still patients are not willing for it due to its high fabrication cost, aesthetics, high cost yet removable. The current and advanced treatment trends for partially edentulous patients with missing single or multiple teeth such as Fixed partial dentures and implants limits the use of CPD in clinical practice.
