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Objective: this study was conducted to compare the effect of the conventional removable partial dentures (RPDs) and telescopic partial dentures on pocket depths and alveolar bone height of abutment teeth after a follow-up period of one year. Materials and Methods: twenty eight patients with mandibular bilateral free-end saddle were selected for this study, with canines and first premolars as last standing abutments on both sides and an opposing maxillary dentulous arch. They were randomly divided into two groups, group I receiving a conventional RPD, and group II receiving a telescopic partial denture. CAD/CAM technology was used for the fabrication of Polymethylmethacrylate patterns for both copings and frameworks for the two groups followed by casting in the conventional manner. Radiographic bone height measurements and pocket depth measurements were performed for the two groups at denture delivery and after one year. Results: there was no significant difference in percentage bone loss and pocket depth between the two groups after one year. However, only group II showed a significant increase in pocket depth after one year of follow-up. There was also an increase in bone loss in both groups after one year but it was not significant. Conclusion: Minor changes in pocket depths and alveolar bone height were observed in both groups. However, the telescopic partial denture showed signs of gingival inflammation and increased pocket depths, while the conventional removable partial denture showed more favorable results. (1020) Ahmed Fayyad and Nagla Nassouhy E.D.J. Vol. 63, No. 1 reliable long-term outcomes for up to 10 years (3-4). However, their use could be associated with several problems. Complaints regarding esthetic outcomes, masticatory performance and patient satisfaction are common with partial denture patients (5-7). In addition, RPDs – especially distal extension base partial dentures – are known for their negative impact on the remaining oral structures, mainly abutment teeth and the residual ridge (8-11). Studies have shown that RPDs might contribute to periodontal problems in abutment teeth(3,12-13). Amaral et al. reported that direct and indirect retainers increased plaque accumulation, gingival inflammation and probing depths on abutment teeth when compared to non-abutment teeth after one year follow-up (11). Higher caries incidence was also reported with clasp-retained RPDs (14-16). One study by Wagner and Kern showed that caries occurred in abutment teeth twice as frequently as in nonabutment teeth after one year of clinical use (3). In another study that reported results after 5 years of use, caries incidence was six times higher in RPDs than in fixed restorations(4). These problems could be attributed to the effect of clasps and other denture components on biofilm formation (3-4). Poor hygiene habits and lack of frequent recall visits were found to aggravate these dental and periodontal problems in RPD wearers over prolonged periods of use(3,9). The importance of regular recall visits and hygiene measurements have been emphasized in the literature as they had a significant effect on preserving the periodontal and dental health of the remaining teeth(3). Some clinical studies demonstrated that with a proper recall and maintenance program as well as hygiene motivation and persistence, RPDs might not have any damaging effects on the periodontium of abutment teeth. In a 10-year longitudinal study by Bergman et al. where patient cooperation was high and maintenance recall visits were consistent, there was no significant deterioration in the periodontal and dental conditions of the abutment teeth(1). Isidor and Budtz-Jorgenson reported no change in probing depths and a minor amount of bone loss after 5 years of use (2). Kapur et al. emphasized that proper design and construction of RPDs in addition to regular maintenance and oral prophylaxis offer satisfactory treatment outcomes for a follow-up period of 5 years (6). Telescopic removable partial dentures have been successfully used for the treatment of partially edentulous patients (17-18). They consist of a primary coping, which is cemented to the abutment teeth, and a secondary coping which lies within the removable partial denture(19). Telescopic partial dentures achieve retention through friction between the walls of the primary coping and the secondary coping. Telescopic copings could be parallel-walled or conical with a well-defined degree of taper. Retention is achieved through friction between the parallel walls, whereas conical crowns exhibit friction when completely seated (19-21). Telescopic partial dentures were found to enhance esthetics by completely eliminating clasps on abutment teeth. They also provide complete tooth coverage which offers protection against caries, thereby decreasing its incidence(3). Furthermore, force distribution is more favorable with telescopic partial dentures as forces are transferred along the long axis of abutment teeth, thereby stabilizing the prosthesis against vertical and horizontal forces (22-23). On the other hand, telescopic partial dentures are technically more challenging to fabricate, requiring more laboratory and clinical skills than the simpler conventional clasp-retained RPDs, thereby increasing the cost of treatment to the patient. They also required more maintenance procedures than conventional RPDs(24). Loss of cementation of the primary coping followed by veneer chipping of the secondary coping are the most common complications observed with telescopic partial dentures (25-26). Furthermore, oral hygiene measures COMPARISON BETWEEN THE EFFECT OF CONVENTIONAL REMOVABLE (1021) may sometimes be compromised by over contouring of the telescopic copings, resulting in gingival inflammation and increased pocket depths (24). In conclusion, conventional RPDs might be simpler, more conservative and less costly than telescopic RPDs. However, their effect on the health of periodontium of abutment teeth might be more detrimental. This in-vivo study was conducted to compare the effects of clasp-retained RPDs and telescopic RPDs on alveolar bone height and pocket depths of abutment teeth after a follow-up period of one year. MATERIALS AND METHODS This study was designed to be a parallel randomized clinical trial. Twenty eight partially edentulous patients were selected after recording their medical and dental histories as well as performing proper intra and extra-oral examination and radiographic assessment. All the included patients had mandibular Kennedy class I arches with the first premolar as a last standing abutments bilaterally and completely dentulous upper arches. Patients were divided into two equal groups; patients of Group I received a mandibular distal extension removable partial denture retained by conventional clasps, while patients of Group II received a mandibular distal extension removable partial denture retained by telescopic crowns. After proper diagnosis, all patients that were selected to be included in the study were requested to sign an informed consent. Maxillary and mandibular primary impressions* were made in a properly selected stock tray and poured in dental stone** to obtain diagnostic casts. Mounting of the diagnostic casts was performed using tentative jaw relation record to evaluate the occlusion, presence of super eruption or tilted teeth and to verify the available inter-arch space in order to perform any adjustments required before starting the prosthetic phase.

egyptian dental journal /egyptian dental journal

COMPARISON BETWEEN THE EFFECT OF CONVENTIONAL REMOVABLE PARTIAL DENTURES AND TELESCOPIC REMOVABLE PARTIAL DENTURES ON POCKET DEPTHS AND ALVEOLAR BONE HEIGHT OF ABUTMENT TEETH