|Year : 2018 | Volume
| Issue : 3 | Page : 84-87
Evaluation of clinical consequences postpartial edentulism in patients of Ranchi District: An epidemiological study
Surender Kumar1, Prashant Gupta2, Vivek Gupta3, Bhavana Gupta4
1 Department of Prosthodontics, Crown Bridge, Aesthetic Dentistry and Oral Implantology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
2 Department of Oral Medicine and Radiology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
3 Department of Periodontology and Oral Implantology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
4 Department of Oral Pathology, Microbiology and Forensic Odontology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
|Date of Web Publication||19-Nov-2018|
Department of Periodontology and Oral Implantology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi - 834 009, Jharkhand
Source of Support: None, Conflict of Interest: None
Aim: Partial edentulism is a state of missing one or more teeth in the dental arch and can arise due to multiple reasons including caries, periodontal disease, and trauma leading to deterioration of general health and lifestyle of the patient. Few studies have been documented regarding the behavior of the patients toward the consequences of partial edentulism and span of partial edentulism, but still, there is a paucity of information regarding the clinical findings among various age groups of partially edentulous patients of various regions in India. This study thereby aims to determine the various clinical consequences postpartial edentulism, among different age groups in Ranchi district of Jharkhand, India. Materials and Methods: About 1550 patients were screened and 120 partially edentulous cases were enrolled in this study. General information of the patient was entered in data sheet, and radiograph (orthopantomograph) was done. Information was gathered regarding various periodontal findings including proximal bone loss, drifting of adjacent teeth, supraeruption along with other clinical conditions such as difficulty in chewing, facial collapse, type of partial edentulism (Kennedy's class) to be correlated with age, and period of edentulousness. Results: Among 120 partially edentulous patients, 54.1% males and 45.8% females participated in the study. Among gender correlations, males predominated in Kennedy's Class I, II, and IV pattern of partially edentulousness whereas females showed greater Class III pattern which was statistically significant (P = 0.006). Maximum patients had difficulty in chewing (60%) whereas least presented with facial collapse (17.5%). Proximal bone loss was noted in elderly participants having >1 year of edentulousness (39.1%). Conclusions: Partial edentulousness results in multiple difficulties if not rehabilitated in the right time, thereby onus will be on the dental surgeon to motivate the patient regarding the importance of prosthetic rehabilitation.
Keywords: Kennedy's classification, partial edentulousness, proximal bone loss
|How to cite this article:|
Kumar S, Gupta P, Gupta V, Gupta B. Evaluation of clinical consequences postpartial edentulism in patients of Ranchi District: An epidemiological study. J Dent Res Rev 2018;5:84-7
|How to cite this URL:|
Kumar S, Gupta P, Gupta V, Gupta B. Evaluation of clinical consequences postpartial edentulism in patients of Ranchi District: An epidemiological study. J Dent Res Rev [serial online] 2018 [cited 2018 Dec 16];5:84-7. Available from: http://www.jdrr.org/text.asp?2018/5/3/84/245681
| Introduction|| |
Partial edentulousness is the state of missing one or more but not all natural teeth in the oral cavity which could arise from multiple reasons including most commonly caries and periodontal diseases as stated by Zaigham and Muneer and Abdel-Rahman et al.,,, Others are trauma, failed root canal treatments, supernumerary, congenital absence, tumor, cyst, and neoplastic lesions.,,, Partial edentulism adversely affects the neighboring teeth gradually causing drifting and supraeruption of opposing arch teeth into the edentulous space. Patient encounters difficulty in speech, inadequate mastication, altered facial features, and temporomandibular joint dysfunction leading to dietary alteration lacking nutrients resulting in poor physical and mental health.,,, Prolonged edentulousness gradually leads to deterioration of bone morphology and supporting periodontium eventually causing difficulty in prosthetic rehabilitation. Facial collapse has also been reported by Tallgren et al. in these type of patients. Few studies have been done on consequences postpartial edentulism in different population section in different countries,, in order to raise awareness among patients regarding consequences of partially edentulism; till date, there are no data regarding the correlation of various clinical findings with age, gender, and type (Kennedy's class) in partially edentulous patients in Ranchi district of Jharkhand population. Therefore, the aim of this study was to evaluate the clinical consequences postpartial edentulism in patients of Ranchi district, Jharkhand, India.
| Materials and Methods|| |
Patients reporting to the Outpatient Department of Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, were screened during the morning session between the months February and May 2018. About 1550 patients were screened out of which 120 patients reported with either single or multiple missing teeth in the upper or lower arch were selected. Completely edentulous patients were not enrolled in the study. After recording the general information of the patient in data sheet, informed consent was obtained from these patients and patients were subjected to orthopantomograph (OPG) (Orthophos XG, Sirona, Germany). Cause and duration of edentulousness, proximal bone loss of abutment teeth, difficulty in mastication, supraeruption, tooth drifting, and facial collapse were recorded. We also analyzed the correlation between age, sex, and the type of partial edentulousness as per Kennedy's classification. The collected data were subjected to the Statistical Package for the Social Sciences (SPSS) (IBM SPSS statistics for Windows, Version 19.0. Armonk, NY; IBM Corp.), and Chi-square test was performed. P < 0.05 was considered statistically significant.
| Results|| |
Among 120 partially edentulous patients, 54.1% males and 45.9% females participated in the study. According to age group, 15% patients were in Group A (21–30 years), 45% patients were in Group B (31–40 years), and 40% patients were in Group C (41–50 years) among which males predominated in Groups A and B whereas Group C showed the maximum number of female participants [Figure 1]. As per Kennedy's classification of partially edentulousness, majority of the patients were having Class III (40.8%) pattern and Class IV pattern was lowest among the studied participants (13.3%). While correlating type of edentulousness with gender, it was found that males predominated in Classes I, II, and IV while females predominated in Class III, and overall maximum number of patients were recorded having Class III partially edentulousness which was statistically significant (P = 0.006). Group B (31–40 years) revealed maximum patients exhibiting Class III pattern which was highly significant [Figure 2]. Depending on the duration of edentulousness, 51 patients had <6 months, 37 patients had 6–12 months, and 32 patients had more than 1 year of edentulousness. Among 120 patients, 60% reported with difficulty in chewing, 57.5% patients had supraeruption of teeth from opposite arch, 70% patients had drifting of adjacent abutment tooth, whereas 17.5% patients had facial collapse, and according to Chi-square analysis, it was found to be statistically significant [Table 1] and [Figure 3]. Among 120 patients, proximal bone loss was observed through OPG in abutment teeth adjacent to the edentulous ridge. It was found that 39% of studied population showed proximal bone loss out of which 59.6% patients had horizontal and 40.4% showed vertical pattern of bone loss. Maximum patients of bone loss were recorded in patients having more than 1 year of edentulousness.
|Figure 1: Correlation of gender and age among partially edentulous patients|
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|Table 1: Distribution of various clinical findings in partially edentulous patients|
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|Figure 3: Correlation of various clinical findings with duration of edentulousness|
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| Discussion|| |
In this study, 120 patients were enrolled of which there were 65 males and 55 females. There was no significant correlation between gender and partial edentulism similar to the study by Abdurahiman et al., although it was observed that maximum participants had Kennedy's class III pattern followed by Classes II and I and the least with Class IV pattern in the age group of 31–40 years which was similar to observations of Prabhu et al. and Sadig and Idowu. This can be because females have more incline toward facial esthetics and eager to go for tooth rehabilitation.
Among gender distribution, females dominated with Class III partial edentulism over males and it was most frequent type of classification among total participants similar to observations of D'Souza and Aras. In this study, we noted male participants having greater prevalence of Classes I, II, and IV whereas AL-Dwairi noted Kennedy's Class II and Class III pattern more frequent among males than females.
In this study, maximum patients had difficulty in chewing (60%) whereas facial collapse had the least participants (17.5%). This could be because patients while chewing daily can sense missing tooth and encounter difficulty during mastication but tooth drifting and supraeruption if minimal cannot be appreciated by the patient. The facial collapse is usually more pronounced in completely edentulous patients which are excluded from this study. Facial collapse is also evident in Kennedy's Class I pattern which was found to be in less majority (18.3%) mostly in elderly population. These observations were similar to Dosumu et al.
This study also revealed proximal bone loss in elderly participants (39%). This could be due to the loss of proprioceptors present in the periodontal ligament which absorbs the occlusal stress and stimulates bone remodeling, maintaining the bone mass and density. The absence of these proprioceptors after tooth loss leads to lack of stimulation causing alveolar bone resorption. Excessive occlusal load during mastication over the edentulous space aids in progressive bone resorption on the abutment teeth adjacent to edentulous ridge.
| Conclusions|| |
Dentist while extracting natural tooth should educate and motivate the patient regarding the consequence of missing tooth because longer the duration of edentulousness more the number of complications, so it is the responsibility of the dental surgeon to make patient aware about the problems associated with missing tooth and encourage them to go for rehabilitation of the missing tooth so that periodontal and functional complications can be avoided. The patient should go for early rehabilitation so that esthetic problems such as facial collapse can be prevented and functions of the missing tooth are restored.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Zaigham AM, Muneer MU. Pattern of partial edentulism and its association with age and gender. Pak Oral Dent J 2010;30:260-3.
Abdel-Rahman HK, Tahir CD, Saleh MM. Incidence of partial edentulism and its relation with age and gender. Zanco J Med Sci 2013;17:463-70.
Prabhu N, Kumar S, D'souza M, Hegde V. Partial edentulousness in a rural population based on Kennedy's classification: An epidemiological study. J Indian Prosthodont Soc 2009;9:18-23. [Full text]
Reddy NS, Reddy NA, Narendra R, Reddy SD. Epidemiological survey on edentulousness. J Contemp Dent Pract 2012;13:562-70.
Akinboboye B, Azodo C, Soroye M. Partial edentulism and unmet prosthetic needs amongst young adult Nigeria. Odontostomatol Trop 2014;37:47-52.
Muneeb A. Causes and pattern of partial edentulism/exodontia and its association with age and gender: Semi rural population, Baqai Dental College, Karachi, Pakistan. IDJSR 2013;1:13-8.
Ehikhamenor EE, Oboro HO, Onuora OI, Omanah AU, Chukwumah NM, Aivboraye IA. Types of removable prosthesis requested by patients who were presented to the university of Benin teaching hospital dental clinic. J Dent Oral Hyg 2010;2:15-8.
Rosenstial SF, Land MF, Fiyimoto J. Contempory Fixed Prosthodontics. St. Louis: Mosby; 1995.
Jeyapalan V, Krishnan CS. Partial edentulism and its correlation to age, gender, socio-economic status and incidence of various Kennedy's classes – A literature review. J Clin Diagn Res 2015;9:ZE14-7.
McGarry TJ, Nimmo A, Skiba JF, Ahlstrom RH, Smith CR, Koumjian JH, et al.
Classification system for partial edentulism. J Prosthodont 2002;11:181-93.
Tallgren A, Lang BR, Miller RL. Longitudinal study of soft-tissue profile changes in patients receiving immediate complete dentures. Int J Prosthodont 1991;4:9-16.
Davis DM, Fiske J, Scott B, Radford DR. The emotional effects of tooth loss: A preliminary quantitative study. Br Dent J 2000;188:503-6.
Fiske J, Davis DM, Frances C, Gelbier S. The emotional effects of tooth loss in edentulous people. Br Dent J 1998;184:90-3.
Allen PF, McMillan AS. The impact of tooth loss in a denture wearing population: An assessment using the oral health impact profile. Community Dent Health 1999;16:176-80.
Dosumu OO, Ogunrinde JT, Bamigboye SA. Knowledge of consequences of missing teeth in patients attending prosthetic clinic in U.C.H. Ibadan. Ann IB Postgrad Med 2014;12:42-8.
Abdurahiman VT, Abdul Khader M, Jolly SJ. Frequency of partial edentulism and awareness to restore the same: A cross sectional study in the age group of 18-25 years among Kerala student population. J Indian Prosthodont Soc 2013;13:461-5.
Sadig WM, Idowu AT. Removable partial denture design: A study of a selected population in Saudi Arabia. J Contemp Dent Pract 2002;3:40-53.
Sapkota B, Adhikari B, Upadhaya C. A study of assessment of partial edentulous patients based on Kennedy's classification at Dhulikhel hospital Kathmandu University Hospital. Kathmandu Univ Med J 2013;11:325-7.
D'Souza KM, Aras M. Association between socio-demographic variables and partial edentulism in the Goan population: An epidemiological study in India. Indian J Dent Res 2014;25:434-8.
AL-Dwairi ZN. Partial edentulism and removable denture construction: A frequency study in Jordanians. Eur J Prosthodont Restor Dent 2006;14:13-7.
[Figure 1], [Figure 2], [Figure 3]