GRIESS M 1,2, REILMANN B 1, CHANAVAZ M 2 (1 Hammerschmidtbogen 12, D-59556 Lippstadt, Germany; 2 Department of Oral & Maxillofacial Implantology, Lille University, School of Medicin, Hospital B, CHR, 59037 Lille-Cedex, France)
The prosthodontic treatment of handicapped patients is not sufficiently described. An evaluation of long-term aspects of prosthodontics for partially edentulous handicapped patients is necessary to decide about an adequate treatment modality. Prosthodontic long-term studies don't take a handicap of the patient into consideration. One of the main contraindications to successful dental treatment is a compromised oral hygiene, which is a fact in this group of patients and which could lead to early failure of any kind of dental treatment. This study will describe the prosthodontic treatment experience of ten years with special regard to telescopic retained overdentures.
From August 1984 to December 1995 597 patients -mainly severely mentally handicapped and schizophrenic patients, with an average age of 43,6 years- were treated. 180 of these patients received prosthodontics (e.g. bridges, fullarch overdentures etc.). 58 patients with an average age of 55,2 years received 84 telescopic retained overdentures. The control time for these overdentures varied from 1 day to 9,7 years.
The estimation of survival was done according to Kaplan-Meier. The success rate varied after 5 years from 62,8% to 82,3% and after 9,5 years from 47,0% to 70,4%. After 5 years the loss of anchor teeth was 24,9% and after 9,5 years 42,6%. The need of repair varied from 45,4% to 64,6% after 5 years and from 53,1% to 95,6% after 9,5 years.
In studies of nonhandicapped patients a survival rate after 8 years of nearly 85% is reported and after 5 years 35% of the overdentures had a need for repair. The values of this study are not as good as these results, but when the compromised oral hygiene is taken into consideration the prosthodontic treatment of handicapped patients with telescopic retained overdentures could be considered as successful over a period of nearly 10 years.