Long-term assessment of the periodontal health of removable partial denture wearers: A systematic review and meta-analysis.

ABSTRACT

STATEMENT OF PROBLEM: The long-term effects of wearing removable partial dentures (RPDs) remain unclear. PURPOSE: This systematic review addressed the question "Is the long-term use of RPDs deleterious to the remaining teeth?" MATERIAL AND METHODS: This review was guided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. Six databases and nonpeer-reviewed literature were searched in April 2024 without language or follow-up restrictions. Only clinical studies evaluating RPD long-term use were included. The risk of bias and evidence certainty were assessed (RoB 2.0; ROBINS-I; GRADE), and meta-analyses were conducted for survival rate and periodontal health (α=.05). RESULTS: A total of 5577 records were identified, and 46 studies covering data from 4359 prostheses and 4072 participants (mean age 60 ±5.2 years) were included. A low to moderate risk of bias was found. A 5-year survival rate of 95.1% (ER=0.951; 95% CI=0.900 to 0.977; P<.001) and 91.7% (ER=0.917; 95% CI=0.870 to 0.948; P<.001) was found for cast-clasp RPD and RPDs retained by telescopic crowns respectively, with no difference between them (P=.71). Abutments (OR=1.99, 95% CI=1.32 to 3.01; P=.001) and nonvital teeth (HR=2.961; 95% CI=2.023 to 4.335; P<.001) presented a higher risk of extraction after 5 years. Tooth mobility (P=.98) and probing depth (P=.50) remained unchanged, while the gingival index increased (MD=0.477 (95% CI=0.12 to 0.83; P=.008). CONCLUSIONS: A high survival rate was found for both cast-clasp RPD and RPDs retained by telescopic crowns, with few periodontal changes to the remaining teeth.