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Prosthetic rehabilitation of partially dentate or edentulous patients

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SBU Assessment

Presents a comprehensive, systematic assessment of available scientific evidence for effects on health, social welfare or disability. Full assessments include economic, social and ethical impact analyses. Assessment teams include professional practitioners and academics. Before publication the report is reviewed by external experts, and scientific conclusions approved by the SBU Board of Directors.

Published: Report no: 204

Conclusions

  • With tooth loss there is an associated deterioration in quality of life. Life becomes restricted – the existence of many people with tooth loss is characterized by loss of self-esteem, lower social status and deterioration in function.
  • Treatment of tooth loss is very important for those afflicted. In several ways, receiving treatment for tooth loss signifies a return to normal lifestyle and improved quality of life.
  • Patients with single tooth loss can be rehabilitated by tooth-supported bridges, resin-bonded bridges or implant-supported crowns. The five-year survival rate* for crowns and implants is over 90 percent.
  • For patients with more extensive tooth loss, rehabilitation can be achieved by bridgework supported by the natural teeth or implants, or alternatively with a removable partial denture. Around 95 percent of implant bridges can be expected to survive for 5–10 years.
  • Patients with edentulism, or maxillary or mandibular edentulism respectively, can be rehabilitated with complete dentures supported by the oral mucosa, or implant-supported constructions. Implant-retained bridge constructions have a five-year survival rate of over 90 percent. For mandibular overdentures,
    over 90 percent of constructions remain after five years.
  • There is an insufficient scientific basis on which to determine which of these treatment methods gives the best results in terms of aesthetics and function, or is the most cost-effective.
  • A survey of established practice by dentists shows that rehabilitation of patients who have lost teeth is today mainly in the form of fixed tooth- or implant-retained prostheses. It is estimated that for the year 2007, implants comprised around 18 percent of the support for fixed constructions.

* survival = the crown or bridge is retained in place and functional.

How to cite this report: SBU. Prosthetic rehabilitation of partially dentate or edentulous patients. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2010. SBU report no 204 (in Swedish).

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Davidson T, Rohlin M, Hultin M, Jemt T, Nilner K, Sunnegardh-Gronberg K, et al. Reimbursement systems influence prosthodontic treatment of adult patients. Acta Odontol Scand 2015;73:414-20.
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Nordenram G, Davidson T, Gynther G, Helgesson G, Hultin M, Jemt T, et al. Qualitative studies of patients' perceptions of loss of teeth, the edentulous state and prosthetic rehabilitation: a systematic review with meta-synthesis. Acta Odontol Scand 2013;71:937-51.
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Rohlin M, Nilner K, Davidson T, Gynther G, Hultin M, Jemt T, et al. Treatment of adult patients with edentulous arches: a systematic review. Int J Prosthodont 2012;25:553-67.
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Sunnegardh-Gronberg K, Davidson T, Gynther G, Jemt T, Lekholm U, Nilner K, et al. Treatment of adult patients with partial edentulism: a systematic review. Int J Prosthodont 2012;25:568-81.
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Hultin M, Davidson T, Gynther G, Helgesson G, Jemt T, Lekholm U, et al. Oral rehabilitation of tooth loss: a systematic review of quantitative studies of OHRQoL. Int J Prosthodont 2012;25:543-52.
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