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01.12.2014 | Original Article | Ausgabe 9/2014

Clinical Oral Investigations 9/2014

The randomized shortened dental arch study: temporomandibular disorder pain

Zeitschrift:
Clinical Oral Investigations > Ausgabe 9/2014
Autoren:
Daniel R. Reissmann, Guido Heydecke, Oliver Schierz, Birgit Marré, Stefan Wolfart, Joerg R. Strub, Helmut Stark, Peter Pospiech, Torsten Mundt, Wolfgang Hannak, Sinsa Hartmann, Bernd Wöstmann, Ralph G. Luthardt, Klaus W. Böning, Matthias Kern, Michael H. Walter

Abstract

Objectives

The aim of this multi-center, randomized controlled trial was to assess the impact of missing posterior support on the risk for temporomandibular disorder (TMD) pain by comparing patients with either shortened dental arches (SDA) or molar replacement by removable dental prostheses (RDP).

Methods

A sample of 215 patients with bilateral molar loss in at least one jaw was consecutively recruited in 14 prosthodontic departments of dental schools in Germany. Of the initial sample, 152 patients (mean age: 59.7 years; 53.9 % female) received randomly allocated interventions (SDA: n = 71; RDP: n = 81). Presence of TMD pain was assessed using patients’ self-reports and was verified by physical examination and by pain intensity, as the mean of current pain, worst pain, and average pain in the last 6 months, with 10-point ordinal rating scales. Assessments were performed before treatment and at follow-ups until 60 months after treatment. Impact of interventions on TMD risk and pain intensity was computed by applying logistic and linear random-intercept models.

Results

Tooth replacement (RDP) did not significantly change the risk for self-reported (odds ratio [OR]: 1.1; confidence interval [CI]: 0.4 to 3.4) or clinically verified (OR: 0.7; CI: 0.1 to 4.3) TMD pain compared to no tooth replacement (SDA). Mean characteristic pain intensity was virtually identical in both groups (Coeff: 0.01; CI: −0.30 to 0.32).

Conclusion

Retaining or preservation of an SDA is not a major risk factor for TMD pain over the course of 5 years when compared to molar replacement with RPDs.

Clinical relevance

Seemingly, missing molars do not have to be replaced in order to prevent TMD pain.

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