Clinical performance of removable dental prostheses in the moderately reduced dentition: a systematic literature review.
OBJECTIVE
Evidence-based therapeutic recommendations for removable dental prostheses are still lacking. The aim of the present study was a systematic review and meta-analysis of the survival rates of removable dentures in the moderately reduced dentition.


METHODS
In 2014, a systematic literature search in established medical databases (MEDLINE, EMBASE, BIOSIS, SciSearch, Cochrane, FIZ Technik Web) and a hand search of relevant dental journals were conducted. The search terms were relevant MeSH terms, free search terms, and combinations of the two. The search included RCTs, prospective and retrospective studies on survival rates of removable dental prostheses in the moderately reduced dentition with at least 15 participants, an observation period of at least 2 years, and a dropout rate of less than 25 %. The selection of relevant publications was carried out at the title, abstract, and full-text level by at least two of the authors involved. The publications included were tabulated and analyzed.


RESULTS
Of the original 12,994 matches, 1923 were analyzed by title, 650 by abstract, and 111 according to the full text. The final review included 19 publications, of which 6 were multiple publications. Cast-metal framework dentures exhibited failure rates of between 33 and 50 % after 5 years. One study with a 25-year observation period reported failure rates of 50 %. Better results were obtained with proper pretreatment and a good recall scheme. Bilateral attachment prostheses showed failure rates of between 11 and 30 % after 5 years. Unilateral attachment prostheses showed failure rates of 75 % after 5 years. Double-crown prostheses dentures show failure rates of 0 to 21.7 % after 3 to 6 years.


CONCLUSIONS
Heterogeneous study designs and data analyses rendered a meta-analysis impossible, so that an evaluation at the highest level of evidence could not be performed.


CONCLUSIONS
Within the limitations of this study, it would be correct to state that removable dental prostheses, given suitable pretreatment and follow-up regimes, can provide satisfactory solutions. Based on only one paper, they revealed acceptable results even over a very long observation period (25 years).
Department of Prosthetic Dentistry, Center of Dentistry,, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany. ovidiu.moldovan@gmail.com.|Philippine-Welser-Straße 15, 86150, Augsburg, Germany. ovidiu.moldovan@gmail.com.
Ovidiu
http://orcid.org/0000-0001-6898-5377
O
Moldovan
Department of Prosthetic Dentistry, Center of Dentistry,, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
Heike
H
Rudolph
Department of Prosthetic Dentistry, Center of Dentistry,, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
Ralph G
RG
Luthardt
D003442:Crowns; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003781:Denture Retention; D003832:Denture, Partial, Removable; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation*
Meta-analysis; RDP; Removable dental prosthesis; Removable partial denture; Survival rates; Systematical review