Shortened dental arch prosthodontic rehabilitation feasible and cost effective option in elderly

This review was undertaken to evaluate, whether a shortened dental arch (SDA) was a good alternative to a conventional prosthodontic rehabilitation (RPD) in older adults when nutritional and economic factors are compared.

A total of 92 studies were included for the full-text analysis, and finally 4 reports from two RCTs qualified for data extraction and analysis. The final search update was performed on 06.11.2022 and no further searches and updates were performed after this date.

Electronic databases [PubMed (MEDLINE), Embase, CENTRAL] were systematically searched to identify studies comparing nutritional and economic outcomes in partially edentate adults rehabilitated with conventional RPD and SDA therapy. Studies were excluded if there were less than 10 participants per group, and if the subjects were not clinically followed up in recall visits. Two investigators performed the data extraction and were reciprocally blinded. Inter-investigator reliability was assessed using Cohen's unweighted kappa (κ). A meta-analysis could not be performed and the results were reported qualitatively.

Results

The calculated κ ranged between 0.80 and 1.00. Three reports from two studies reported on nutritional outcomes and one report provided information on economic benefits, when comparing between the SDA therapy and conventional prosthodontic rehabilitation. No significant difference was recorded in the nutritional status of patients rehabilitated using the SDA concept compared with RPDs. Higher costs for treatment provision and maintenance for patients in the RPD group was found when compared to SDA treatment.

This systematic review identified the shortened dental arch concept as a reasonable alternative to the conventional prosthodontic rehabilitation where cost-effectiveness and nutrition are concerned based on the limited evidence obtained from current literature. SDA therapy may be considered as a feasible treatment concept in older adults especially in those with complex medical statuses and limited finances.

Reference:

Nils Funke, Nicolas Fankhauser, Gerald J. Mckenna, Murali Srinivasan. Impact of shortened dental arch therapy on nutritional status and treatment costs in older adults: A systematic review. Journal of Dentistry, Volume 133, 2023, 104483, ISSN 0300-5712, https://doi.org/10.1016/j.jdent.2023.104483. (https://www.sciencedirect.com/science/article/pii/S0300571223000696)