Oral health-related quality of life after prosthodontic treatment for patients with partial edentulism: A systematic review and meta-analysis

Statement of problem. Clinicians are currently unable to quantify the psychosocial, functional, and esthetic effects of prosthetic interventions to replace teeth. Understanding the effects of treatment to replace teeth on oral health-related quality of life (OHRQoL) is important for informed consent. A systematic review of the evidence of OHRQoL improvements with prosthodontic tooth replacement and a comparison of outcomes between treatment modalities is therefore indicated. Purpose. The purpose of this systematic review was to examine the OHRQoL of patients with partial edentulism after different dental prosthetic treatments. Material and methods. Electronic database and manual searches were conducted to identify cohort studies and clinical trials reporting on the OHRQoL of individuals receiving implantsupported crowns (ISCs), implant-supported fixed dental prostheses (IFDPs), implant-supported removable dental prostheses (IRDPs), tooth-supported fixed dental prostheses (TFDPs), and removable partial dentures (RPDs). Two reviewers independently conducted article selection, data extraction, and quality assessment. Random-effects models were used to compare OHRQoL change scores (standardised mean change [SMC], 95% confidence intervals [CI]). Results. Of the 2147 identified studies, 2 randomized controlled trials and 21 cohort studies met the inclusion criteria. Overall, studies were of low or moderate risk of bias. Pooled mean OHRQoL change ≤9 months was 15.3 for TFDP, 11.9 for RPD, and 14.9 for IFDP. Pooled SMC OHRQoL change >9 months was 13.2 for TFDP and 15.8 for IFDP. Direct comparisons ≤9 months between TFDP against IFDP and RPD against IFDP significantly favored IFDP in both cases. Conclusions. TFDP and IFDP had short- and long-term positive effects on OHRQoL. RPDs positively affected OHRQoL in the short-term. IFDP showed greater short-term improvement in OHRQoL than RPD and TFDP.

CLINICAL IMPLICATIONS Clinicians may advise patients with multiple missing teeth that implant-supported FDPs make greater improvements to OHRQoL than tooth-supported FDPs or RPDs. They should also inform patients that, while RPDs improve OHRQoL in the short term, these effects may be less noticeable in the medium term.