Relationship between the standards of removable partial denture construction, clinical acceptability, and patient satisfaction

Statement of problem. Little is known about the importance of published fab rication standards in determining the outcome of treatment with mandibular distal extension removable partial dentures in patients of community practi ces. Purpose. This study describes mandibular partial dentures worn by patients from King County, Wash., and examines the validity of standards of design a nd fabrication by relating the standards to measures of clinical acceptabil ity and patient satisfaction. Material and methods. Eighty-two people treated in private dental practices who responded to a mail survey about satisfaction with a partial denture w ere examined. Eight standards of fabrication, overall clinical acceptabilit y of the prosthesis, and tissue health were evaluated clinically. Patient s atisfaction was assessed by questionnaire. Associations between variables w ere assessed by contingency tables and odds ratios. Results. Half the prostheses met 4 or fewer of the 8 standards, and these w ere responsible for nearly all the displacement of tissue by the framework. Forty-three percent of the dentures (35/82) were rated clinically acceptab le. Of the remaining dentures, 38 could be made acceptable by modifications . The remaining 9 dentures needed replacement. Sixty-three percent of the p atients examined were satisfied with the dentures. There was a relationship between tissue health and the fabrication standards related to rest form, base extension, stress distribution, and framework fit. This study found no relation between tissue health and other design or fabrication features. N one of the standards were found to be related to patient satisfaction. Conclusion. This study found partial support for the validity of design/fab rication standards for removable partial dentures. The most important stand ards are rest form, base extension, and stress distribution. The standards appear to be unrelated to patient satisfaction.