The Randomized Shortened Dental Arch study (RaSDA): design and protocol.
BACKGROUND
Various treatment options for the prosthetic treatment of jaws where all molars are lost are under discussion. Besides the placement of implants, two main treatment types can be distinguished: replacement of the missing molars with removable dental prostheses and non-replacement of the molars, i.e. preservation of the shortened dental arch. Evidence is lacking regarding the long-term outcome and the clinical performance of these approaches. High treatment costs and the long time required for the treatment impede respective clinical trials.


METHODS
This 14-center randomized controlled investigator-initiated trial is ongoing. Last patient out will be in 2010. Patients over 35 years of age with all molars missing in one jaw and with at least both canines and one premolar left on each side were eligible. One group received a treatment with removable dental prostheses for molar replacement (treatment A). The other group received a treatment limited to the replacement of all missing anterior and premolar teeth using fixed bridges (treatment B). A pilot trial with 32 patients was carried out. Two hundred and fifteen patients were enrolled in the main trial where 109 patients were randomized for treatment A and 106 for treatment B. The primary outcome measure is further tooth loss during the 5-year follow-up. The secondary outcome measures encompassed clinical, technical and subjective variables. The study is funded by the Deutsche Forschungsgemeinschaft (German Research Foundation, DFG WA 831/2-1, 2-2, 2-3, 2-4, 2-5).


CONCLUSIONS
The particular value of this trial is the adaptation of common design components to the very specific features of complex dental prosthetic treatments. The pilot trial proved to be indispensable because it led to a number of adjustments in the study protocol that considerably improved the practicability. The expected results are of high clinical relevance and will show the efficacy of two common treatment approaches in terms of oral health. An array of secondary outcome measures will deliver valuable supplementary information. If the results can be implemented in the clinical practice, the daily dental care should strongly profit thereof.


BACKGROUND
The trial is registered at ClinicalTrials.gov under ISRCTN68590603 (pilot trial) and ISRCTN97265367 (main trial).
Luthardt
Ralph G
RG
Clinic of Prosthetic Dentistry, Ulm University, University Hospital, Department of Dentistry, Ulm, Germany. ralph.luthardt@uniklinik-ulm.de
Marré
Birgit
B
Heinecke
Achim
A
Gerss
Joachim
J
Aggstaller
Hans
H
Busche
Eckhard
E
Dressler
Paul
P
Gitt
Ingrid
I
Hannak
Wolfgang
W
Hartmann
Sinsa
S
Heydecke
Guido
G
Jahn
Florentine
F
Kern
Matthias
M
Mundt
Torsten
T
Pospiech
Peter
P
Stark
Helmut
H
Wöstmann
Bernd
B
Walter
Michael H
MH
D000328:Adult; D003724:Dental Arch / Q000601:surgery*; D003757:Dental Implantation / Q000295:instrumentation / Q000379:methods*; D003830:Denture, Partial, Fixed; D003832:Denture, Partial, Removable; D005858:Germany; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000601:surgery*; D017060:Patient Satisfaction; D010865:Pilot Projects; D011474:Prosthesis Design; D011788:Quality of Life; D012107:Research Design; D013997:Time Factors; D016388:Tooth Loss / Q000517:prevention & control / Q000601:surgery*; D016896:Treatment Outcome