Multicenter randomized trial on dental prosthetic therapies for the shortened dental arch – 15-year follow-up and evaluation of the 10- and 15-year examination time

• Applicants: Professor Dr. Ralph Gunnar Luthardt; Professor Dr. Michael Walter
• Subject Area: Dentistry, Oral Surgery
• Term: from 2018 to 2022
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 398776178

• Final Report Year: 2023

Final Report Abstract

Tooth loss is an increasingly common problem in society as people get older. In addition to various treatment concepts for the replacement of molars, the concept of a shortened dental arch is becoming increasingly important. Due to a lack of long-term data on how this therapy compares with molar replacement, the concept of the shortened dental arch (SDA) was compared with molar replacement using an attachment retained removable dental prosthesis as part of the multicenter clinical trial "Randomized controlled clinical study on the shortened dental arch (RaSDA)". The main outcome measure for evaluating the two comparison groups was (first) tooth loss after incorporation of the restorations. The two groups were also examined with regard to periodontal health, oral health-related quality of life, craniomandibular dysfunction and need of maintenance measures over a total follow-up period of 15 years. The RaSDA study included 215 patients with a mean age of just under 60 years in both treatment arms. Of the 109 patients randomized to treatment with removable dentures and the 106 patients randomized to treatment according to the concept of the shortened dental arch, 81 and 71 patients were treated respectively. After five years, 71 and 61 patients in the two study arms were followed up. At the 10-year follow-up, 44 and 38 patients, respectively, were examined. For the 15-year follow-up, the remaining patient cohort was reduced to 29 and 28 patients respectively, mainly due to age. It was shown that the originally incorporated kinds of restorations in the two study arms, which differed only insignificantly, had a mean survival time of over 14 years. There was a lower incidence of BOPs (bleeding on probing) and less plaque accumulation in the patients who were restored according to the SDA concept, but this did not result in any significant advantages with regard to the main target variable, the occurrence of further tooth loss. No significant differences were found between the groups for the secondary outcomes examined either.

Publications

• Impact of shortened dental arch on oral health-related quality of life over a period of 10 years — A randomized controlled trial. Journal of Dentistry, 80, 55-62.
  Reissmann, Daniel R.; Wolfart, Stefan; John, Mike T.; Marré, Birgit; Walter, Michael; Kern, Matthias; Kohal, Ralf; Nothdurft, Frank; Stark, Helmut; Schierz, Oliver; Wöstmann, Bernd; Hannak, Wolfgang; Mundt, Torsten; Pospiech, Peter; Boldt, Julian; Edelhoff, Daniel; Busche, Eckhard; Jahn, Florentine; Luthardt, Ralph G. ... & Heydecke, Guido
  
• IMPACT OF SHORTENED DENTAL ARCH ON ORAL HEALTH-RELATED QUALITY OF LIFE. Journal of Evidence Based Dental Practice, 21(4), 101622.
  Schierz, Oliver; Reissmann, Daniel R.; Rauch, Angelika; John, Mike T.; Marré, Birgit; Luthardt, Ralph Gunnar; Mundt, Torsten; Hannak, Wolfgang; Kohal, Ralf; Kern, Matthias; Nothdurft, Frank; Hartmann, Sinsa; Böning, Klaus; Boldt, Julian; Stark, Helmut; Edelhoff, Daniel; Wöstmann, Bernd; Wolfart, Stefan; Jahn, Florentine & Walter, Michael Horst
  
• Rehabilitation of shortened dental arches: A fifteen‐year randomised trial. Journal of Oral Rehabilitation, 48(6), 738-744.
  Walter, Michael Horst; Marré, Birgit; Dreyhaupt, Jens; Heydecke, Guido; Rauch, Angelika; Mundt, Torsten; Hannak, Wolfgang; Kohal, Ralf Joachim; Kern, Matthias; Nothdurft, Frank; Hartmann, Sinsa; Böning, Klaus; Boldt, Julian; Stark, Helmut; Edelhoff, Daniel; Wöstmann, Bernd; Wolfart, Stefan; Jahn, Florentine & Luthardt, Ralph Gunnar
  
• HOW TO IDENTIFY SUBGROUPS IN LONGITUDINAL CLINICAL DATA: TREATMENT RESPONSE PATTERNS IN PATIENTS WITH A SHORTENED DENTAL ARCH. Journal of Evidence-Based Dental Practice, 23(1), 101794.
  Schierz, Oliver; lee, Chi Hyun; John, Mike T.; Rauch, Angelika; Reissmann, Daniel R.; Kohal, Ralf; Marrè, Birgit; Böning, Klaus; Walter, Michael H.; Luthardt, Ralph Gunnar; Rudolph, Heike; Mundt, Torsten; Hannak, Wolfgang; Heydecke, Guido; Kern, Matthias; Hartmann, Sinsa; Boldt, Julian; Stark, Helmut; Edelhoff, Daniel ... & Jahn, Florentine