title: The Impact of the Crown-Root Ratio on Survival of Abutment Teeth for Dentures.
abstract: Crown-root ratio (CRR) is commonly recorded when planning prosthodontic procedures. However, there is a lack of longitudinal clinical data evaluating the association between CRR and tooth survival. The aim of this longitudinal practice-based study was to assess the impact of CRR on the survival of abutment teeth for removable partial dentures (RPDs). Data were collected from 147 patients provided with RPDs at a dental hospital in Japan. In total, 236 clasp-retained RPDs and 856 abutment teeth were analyzed. Survival of abutment teeth was assessed using Kaplan-Meier methods and Cox's proportional hazard (PH) regression. The Cox PH regression was used to assess the prognostic significance of initial CRR value with adjustments for clinically relevant factors, including age, sex, frequency of periodontal maintenance programs, occlusal support area, type of abutment tooth, status of endodontic treatment, and probing pocket depth. Abutment teeth were divided into 1 of 5 risk groups according to CRR: A (≤0.75), B (0.76-1.00), C (1.01-1.25), D (1.26-1.50) and E (≥1.51). The 7-year survival rate was 89.1% for group A, 85.9% for group B, 86.5% for group C, 76.9% for group D, and 46.7% for group E. The survival curves of groups A, B, and C were illustrated to be quite similar and favorable. The multivariable analysis treating CRR as a continuous variable allowed estimation of the hazard ratio at any specific CRR value. When CRR = 0.80 was set as a reference, the estimated hazard ratio was 0.58 for CRR = 0.50 (95% confidence interval [CI], 0.36-0.91), 1.13 for CRR = 1.00 (95% CI, 0.93-1.37), 1.35 for CRR = 1.25 (95% CI, 1.02-1.80), 1.53 for CRR = 1.50 (95% CI, 1.15-2.08), or 1.95 for CRR = 2.00 (95% CI, 1.44-2.65). These practice-based longitudinal data provide information to improve the evidence-based prognosis of teeth in providing prosthodontic procedures.
authors.affiliation: Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Japan sayat617@dent.osaka-u.ac.jp.
authors.forename: S
authors.initials: S
authors.lastname: Tada
authors.affiliation: Department of Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, Ireland.
authors.forename: P F
authors.initials: PF
authors.lastname: Allen
authors.affiliation: Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ikebe
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Osaka University Graduate School of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Osaka University Graduate School of Medicine, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Shintani
authors.affiliation: Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Maeda
mesh_terms: D000367:Age Factors; D000368:Aged; D000044:Dental Abutments; D016734:Dental Clasps; D003781:Denture Retention / Q000295:instrumentation; D003832:Denture, Partial, Removable; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000517:prevention & control; D010514:Periodontal Pocket / Q000145:classification; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors; D019228:Tooth Crown / Q000033:anatomy & histology*; D014092:Tooth Root / Q000033:anatomy & histology*; D019553:Tooth, Nonvital / Q000145:classification
keywords: clinical outcome; decision-making; evidence-based dentistry/ health care; prognosis; prosthetics dentistry/prosthodontics; removable prosthodontics