RELATIONSHIP BETWEEN THE

STANDARDS OF REMOVABLE PARTIAL

DENTURE CONSTRUCTION, CLINICAL
ACCEPTABILITY, AND PATIENT
SATISFACTION

Frank et al. 2000 JPD

 INTODUCTION
There is a Statement of Principles, Concepts, and Practices in Prosthodontics (PCPP) , Providing
reference for RPD fabrication.

Purpose:
1- Determine if RPDs made in community practices meet standards of design and fabrication
2- Assess the association of the standards with clinical outcomes and patient satisfaction
3- Determine the importance of individual standards to increased dissatisfaction or clinical
problems.
 ASSESSMENT OF PCPP STANDARDS
8 categories of design and fabrication regarding RPDs were developed from the PCPP for evaluation:

Percentage of RPDs meeting individual PCPP standards.

ASSESSMENT OF RPD ACCEPTABILITY

• Acceptable And the results showed 43 % of the prostheses were clinically acceptable.
• Acceptable with modification And result showed 46 % could be made acceptable by
modifications –
1. Lack of base support
2. Gingival impingement by the framework
3. Presence of indirect retainers
4. Need Reline or framework adjustment
ASSESSMENT OF RPD ACCEPTABILITY

• Unacceptable and needs replacement And result showed 11% of dentures needed
replacement.
1. Grossly inadequate base
2. Severe tissue harm
3. Unreparable fracture
4. Poor occlusion
5. Lack of fit
 ASSESSMENT OF PATIENT SATISFACTION
Satisfaction was determined by a questionnaire • problem with natural teeth,
measure of satisfaction with the mandibular RPD • need for adjustment,
was created by combining the responses to 15
• use for eating,
satisfaction items:
• chewing difficulty,
• general satisfaction,
• limits on choice of foods,
• appearance,
• taste, food under RPD, difficulty keeping mouth
• time worn,
clean,
• fit, • cleanliness of the RPD, and odor.
• speech,
 ASSESSMENT OF PATIENT SATISFACTION
Results:
• 52 % prostheses met 4 or fewer of the 8 standards
• 63 % of the patients examined were satisfied with the dentures.
• The most commonly dissatisfaction was the lack of fit.
• The most common Oral Health Problem was inflammation of the underlying gingival tissue Because
1. Rest form is poor,
2. Base is underextended,
3. Poor Stress distribution,
4. Poor Framework.
RESULT

• There was no relationship between patient satisfaction, clinical acceptability,

and number of standards.
• None of the standards were found to be related to patient satisfaction.
• No statistical relationship was found between acceptability and age of the
denture, years of wearing an RPD, or whether the RPD was worn at night.
RESULT

• Abutment mobility was seldom observed and could not be induced by

movement of the RPD
• Lingual bar was used twice as often as a lingual plate major connector
CUNCLOSION

• The results validated PCPP statements Regarding :

Rest form, Base extension, Stress distribution and framework fit
• Result failed to validate statements relating to:
Occlusion, Base Support, Retention or Force Control.
• Mandibular distal extension not following Principles, Concepts, and Practices in Prosthodontics
are more likely to be associated with lack of tissue health.
• A substantial need exists for more patient education about denture maintenance is needed.
 Thank you

Saleh Alqarni