PURPOSE:To evaluate the soft tissue response to the placement of additively manufactured subperiosteal jaw implants (AMSJI) in the severely atrophic maxilla and to identify possible risk factors for soft tissue breakdown. MATERIALS AND METHODS:An international multicenter study was conducted, and 15 men (mean age: 64.62 years; SD: ± 6.75) and 25 women (mean age: 65.24 years; SD: ± 6.77) with advanced maxillary jaw resorption (Cawood and Howell Class V or more) were included in this study. General patient data were collected, and all subjects were clinically examined. Inclusion criteria were patients who underwent bilateral AMSJI placement in the maxilla at least 1 year prior. Exclusion criteria were patients who did not have patient, surgeon, or dentist consent to participate in the study before their inclusion. RESULTS:A total of 40 patients were enrolled, with a mean follow-up period of 917 days (SD: ± 306.89 days). Primary implant stability was achieved postoperatively in all cases, and all implants were loaded with a final prosthesis. At the time of the study, only 1 patient showed mobility (> 1 mm) of the bilateral AMSJI. Due to mucosal recession, exposure of the framework was seen in 26 patients (65%) and was mainly in the left (21.43% of 26) and right (18.57% of 26) midlateral region. A thin biotype and the presence of mucositis were found to be risk factors (P < .05). Although not significant, smokers had a risk of developing a recession that was nearly seven times (odds ratio: 6.88; P = .08) greater than that of nonsmokers. CONCLUSIONS:Twenty-six (65%) patients presented with a recession in one (or more) of the seven regions after oral rehabilitation with bilateral AMSJI placement. Several risk drivers were evaluated. The collapse of soft tissues around the AMSJI that led to caudal exposure of the arms was correlated with a thin biotype and the presence of mucositis.
Subperiosteal implants (SIs) were first developed by Dahl in 1941 for oral rehabilitation in case of severe jaw atrophy. Over time, this technique was abandoned due to the high success rate of endosseous implants. The emergence of patient-specific implants and modern dentistry allowed a revisitation of this 80-year-old concept resulting in a novel “high-tech” SI implant. This study evaluates the clinical outcomes in forty patients after maxillary rehabilitation with an additively manufactured subperiosteal jaw implant (AMSJI®). The oral health impact profile-14 (OHIP-14) and numerical rating (NRS) scale were used to assess patient satisfaction and evaluate oral health. In total, fifteen men (mean age: 64.62 years, SD ± 6.75 years) and twenty-five women (mean age: 65.24 years, SD ± 6.77 years) were included, with a mean follow-up time of 917 days (SD ± 306.89 days) after AMSJI installation. Patients reported a mean OHIP-14 of 4.20 (SD ± 7.10) and a mean overall satisfaction based on the NRS of 52.25 (SD ± 4.00). Prosthetic rehabilitation was achieved in all patients. AMSJI is a valuable treatment option for patients with extreme jaw atrophy. Patients enjoy treatment benefits resulting in high patient satisfaction rates and impact on oral health.
The clinical outcomes of maxillary rehabilitation with the additively manufactured sub-periosteal jaw implant (AMSJI; CADskills BV) were evaluated in edentulous patients with a Cawood–Howell atrophy classification ≥5 in all regions of the maxilla. Fifteen consecutive patients were included in the study and followed up for 1 year. They were interviewed using a survey protocol and were examined clinically and radiographically preoperatively (T0) and at 1 (T1), 6 (T2), and 12 (T3) months after permanent upper prosthesis placement. The patients reported an increased oral health-related quality of life. The overall mean Oral Health Impact Profile-14 score at T0 was 17.20 (standard deviation (SD) 6.42). When results at T0 were compared to those at T1 (mean 8.93, SD 5.30), a statistically significant difference was seen (P = 0.001). At T3, the mean value was 5.80 (SD 4.18). Compared to T0, there was also a statistically significant difference at T3 (P = 0.001). General satisfaction based on the numerical rating scale was a mean 49.93 at T1, which was less than patient expectation prior to treatment at T0 (52.13). A higher overall value was seen at T3 (53.20) when compared to T0. Within the constraints of the short follow-up, the AMSJI appears to be a promising tool for patients with extreme jaw atrophy. The high patient expectations were met without complications.
PURPOSE:To clinically evaluate oral implant restorations placed by undergraduate students in the dental clinical curriculum at KU Leuven (Belgium) in terms of function and esthetics.MATERIALS AND METHODS:A retrospective observational cohort study was designed. The esthetic and functional evaluations of implant-supported restorations placed in the framework of the undergraduate implant dentistry clinical training program using White/Pink Esthetic Score (WES/PES) and visual analog scale (VAS) scoring was performed. Furthermore, complications were registered based retrospectively on the patient's medical file. The following research questions were stipulated: (1) How well do implant-supported restorations placed by undergraduate students perform esthetically? and (2) Which complications occurred and how were these managed?RESULTS:Between August 2008 and July 2014 (6 academic terms), 251 implants (Brånemark System Mk III, Nobel Biocare) were placed in 113 patients by 155 students (> 40% of all students enrolled in the training program). Of these implants, 228 were restored in 101 patients by 118 students with varying restoration types. Esthetic scoring of the restorations in 83 of these patients revealed a satisfying mean WES of 8.14 ± 2.09 (out of 10) and PES of 9.56 ± 3.14 (out of 14). Complications were registered in 18.9% of the cases.DISCUSSION:Clinical training in implant dentistry for undergraduates contributes to the development of advanced skills in the dental student's Master education. Overall, patients were satisfied with their implant-supported restorations. Implant and restoration success rates and complication incidence were confirmed by long-term data in the oral implant literature.
Additively manufactured subperiosteal jaw implants (AMSJI) are patient-specific, 3D-printed, titanium implants that provide an alternative solution for patients with severe maxillary bone atrophy. The aim of this study was to evaluate the bony remodeling of the maxillary crest and supporting bone using AMSJI. Fifteen patients with a Cawood–Howell Class V or greater degree of maxillary atrophy were evaluated using (cone beam) computed tomography scans at set intervals: one month (T1) and twelve months (T2) after definitive masticatory loading of bilateral AMSJI implants in the maxilla. The postoperative images were segmented and superimposed on the preoperative images. Fixed evaluation points were determined in advance, and surface comparison was carried out to calculate and visualize the effects of AMSJITM on the surrounding bone. A total mean negative bone remodeling of 0.26 mm (SD 0.65 mm) was seen over six reference points on the crest. Minor bone loss (mean 0.088 mm resorption, SD 0.29 mm) was seen at the supporting bone at the wings and basal frame. We conclude that reconstruction of the severely atrophic maxilla with the AMSJI results in minimal effect on supporting bone. Reduced stress shielding with a biomechanically tuned subperiosteal implant does not induce radiographically significant crestal bone atrophy.
PURPOSE:To prospectively assess marginal bone loss and implant survival with Astra Tech (Dentsply Sirona, Charlotte, NC, USA) (group A) and Brånemark (Nobel Biocare, Zurich, Switzerland) (group B) implants in a split-mouth study conducted over a 20-year follow-up period.MATERIALS AND METHODS:A total of 95 implants (n = 50, group A and n = 45, group B) were randomly placed in the left or right side of the maxilla or mandible in 18 patients. Clinical and radiographic examinations were performed, and results were reported at 5, 10, 15 and 20 years after insertion of the prosthesis.RESULTS:Ten patients were followed up for 20 years (n = 26 implants, group A and n = 25 implants, group B). No implant loss or prosthetic failures were observed. After 20 years of follow-up, no significant differences in marginal bone loss were found between both implant groups (P = 0.25). The proportion of marginal bone loss ≥ 0.5 mm was not significantly different between implant types (P > 0.05), and no statistically significant relationships were found between marginal bone loss and time (P ≥ 0.05). More specifically, there was no significant difference in marginal bone level between year 20 and baseline in group A (P = 0.70), whereas a difference of 0.5 to 1.0 mm was found in group B (P = 0.15).CONCLUSIONS:After 20 years of follow-up, marginal bone loss around screw-shaped titanium implants was clinically insignificant. Furthermore, no significant differences in survival and marginal bone loss were found between group A and B implants over the follow-up period.
The objective of this study is to examine the effect of low-magnitude, high-frequency(LMHF) loading, and anti-osteoporosis medications such as parathyroid hormone(PTH) and bisphosphonates on peri-implant bone healing in an osteoporosis model, and to assess their combined effects on these processes. Thirteen-week-old ovariectomized rats(n = 44) were divided into three groups:PTH, alendronate, and saline. After 3 weeks of drug administration, titanium implants were inserted into the tibiae. Each group was subdivided into two groups: with or without LMHF loading via whole-body vibration(50 Hz at 0.5 g, 15 min per day, 5 days per week). Rats were killed 4 weeks following implantation. Removal torque test, micro-CT analyses(relative gray(RG) value, water = 0,and implant = 100), and histomorphometric analyses(bone-to-implant contact(BIC) and peri-implant bone formation(bone volume/tissue volume(BV/TV))) were performed. Removal torque values and BIC were significantly differed by loading and drug administration(ANOVA). Post hoc analysis showed that PTH-treated groups were significantly higher than the other drug-treated groups. BV/TV was significantly enhanced by PTH administration. In cortical bone, RG values were significantly increased by loading.In trabecular bone, however, RG values were significantly increased by PTH administration. These findings suggest that LMHF loading and PTH can act locally and additively on the bone healing process, improving the condition of implant osseointegration.
STATEMENT OF PROBLEM:Implant-based prosthetic solutions can be time consuming. If implants can be loaded immediately, treatment time can be reduced. PURPOSE:The purpose of this prospective randomized controlled trial was to monitor the survival rate of Ankylos implants, comparing conventional with immediate loading by using abutments with the SynCone concept for screw-retained removable prostheses in the edentulous maxilla. MATERIAL AND METHODS:A total of 90 implants were placed in 15 study participants. The participants were randomly assigned to the immediate or conventional loading treatment group. Radiographic and clinical parameters were recorded at the time of permanent prosthesis installment and at 1- and 2-year follow-up examinations, and participants' satisfaction was measured by using questionnaires before and after prosthesis installation. A linear mixed model was used to measure differences. RESULTS:One implant in the conventional group was lost during abutment placement; hence, 89 implants could be followed for 2 years. Approximately 90% of these implants showed no bone loss or even bone gain at 1 and 2 years follow-up. Mean values for the immediate group were, respectively, 0.09 ±0.35 mm and 0.13 ±0.38 mm and 0.01 ±0.41 mm and -0.06 ±0.32 mm for the conventional method. No significant differences (P=.053) were found in bone level alterations between the groups. For all participants, the mean number of surfaces (4 per implant) with bleeding on probing (BoP) and plaque were 0.76 ±0.81 and 0.16 ±0.42 at 1 year follow-up and 0.44 ±0.66 and 0.02 ±0.15, respectively, at the second-year follow-up. The mean pocket probing depths were 2.05 ±0.54 mm at 1 year and 2.18 ±0.64 mm at 2 years. For both groups, a significant rise in satisfaction and quality of life was observed (P≤.001) at 1 and 2 years compared with pretreatment. CONCLUSIONS:Ankylos implants placed in the edentulous maxilla, immediately or conventionally loaded by a detachable prosthesis, showed favorable bone-level preservation after 2 years of follow-up. No significant differences could be found between the immediate and conventional groups. A significant increase in quality of life was observed for both loading modes.
Objective. To assess the influence of surface treatment and thermal annealing on the four point bending strength of two ground dental zirconia grades.Methods. Fully-sintered zirconia specimens (4.0 x 3.0 x 45.0 mm(3)) of Y-TZP zirconia (LAVA Plus, 3M ESPE) and Y-TZP/Al2O3 zirconia (ZirTough, Kuraray Noritake) were subjected to four surface treatments: (1) 'GROUND': all surfaces were ground with a diamond-coated grinding wheel on a grinding machine; (2) 'GROUND + HEAT': (1) followed by annealing at 1100 degrees C for 30 min; (3) 'GROUND + Al2O3 SANDBLASTED': (1) followed by sandblasting using Al2O3; (4) 'GROUND + CoJet SANDBLASTED': (1) followed by tribochemical silica (CoJet) sandblasting. Micro-Raman spectroscopy was used to assess the zirconia-phase composition and potentially induced residual stress. The four-point bending strength was measured using a universal material-testing machine.Results. Weibull analysis revealed a substantially higher Weibull modulus and slightly higher characteristic strength for ZirTough (Kuraray Noritake) than for LAVA Plus (3M ESPE). For both zirconia grades, the 'GROUND' zirconia had the lowest Weibull modulus in combination with a high characteristic strength. Sandblasting hardly changed the bending strength but substantially increased the Weibull modulus of the ground zirconia, whereas a thermal treatment increased the Weibull modulus of both zirconia grades but resulted in a significantly lower bending strength. Micro-Raman analysis revealed a higher residual compressive surface stress that correlated with an increased bending strength.Significance. Residual compressive surface stress increased the bending strength of dental zirconia. Thermal annealing substantially reduced the bending strength but increased the consistency (reliability) of 'GROUND' zirconia. (C) 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
Purpose: The aim of this study was to compare the 5-year outcomes of glass fiber composite with cast posts and cores for the restoration of endodontically treated teeth. Materials and Methods: A total of 143 patients in need of 203 full ceramic restorations on endodontically treated teeth were included. After primary stratification based on the need for post or no post, teeth were randomly allotted to test group 1 (prefabricated glass fiber posts), 2 (custom-made glass fiber posts), or 3 (composite cores without posts). The control group was treated with gold alloy-based wrought posts and cast cores. Success (original present) and survival (present after intervention) probability lifetime curves, corrected for clustering, were drawn over the entire data set. Results: The mean follow-up time was 5.8 years (range: 0.5 to 7.2 years). At 5 years, the success and survival probabilities were 85.2% and 91.5%, respectively. Lifetime curves did not show any significant differences between the test and control groups for success (P = .85) or survival (P = .57). Moreover, no significant differences for success or survival could be found among the four groups (the three test groups and the control group). Conclusion: After 5 years of follow-up, cast gold and composite post-and-core systems on teeth with ceramic full restorations provided with a ferrule performed equally well.
In general, it can be said that the higher the gold content of an alloy, the better the quality of fit of the cast restoration. Spark erosion, grinding, and selective laser sintering are recently introduced new technologies in dentistry for metal-based restoration manufacturing. The main advantage of the ceramo-metal restoration over the all-ceramic restoration is its resistance to fracture. New developments in high-strength core ceramic systems using new materials are challenging a clinical situation that for the last 50 years was dominated by the ceramo-metal restoration. A combination of esthetic and high-strength ceramics would be ideal as this removes the high reliance on the bond and also provides the opportunity to develop resin-bonded ceramic bridges. CAD–CAM technology has already changed dentistry and will replace more and more of the traditional techniques in fabricating dental restorations.
Micro-computed tomography can be applied for the assessment of the micro-architectural characteristics of the cortical and trabecular bones in either physiological or disease conditions. However, reports often lack a detailed description of the methodological steps used to analyse these images, such as the volumes of interest, the algorithms used for image filtration, the approach used for image segmentation, and the bone parameters quantified, thereby making it difficult to compare or reproduce the studies. This study addresses this critical need and aims to provide standardized assessment and consistent parameter reporting related to quantitative jawbone image analysis. Various regions of the rat jawbones were screened for their potential for standardized micro-computed tomography analysis. Furthermore, the volumes of interest that were anticipated to be most susceptible to bone structural changes in response to experimental interventions were defined. In the mandible, two volumes of interest were selected, namely, the condyle and the trabecular bone surrounding the three molars. In the maxilla, the maxillary tuberosity region and the inter-radicular septum of the second molar were considered as volumes of interest. The presented protocol provides a standardized and reproducible methodology for the analysis of relevant jawbone volumes of interest and is intended to ensure global, accurate, and consistent reporting of its morphometry. Furthermore, the proposed methodology has potential, as a variety of rodent animal models would benefit from its implementation.
PURPOSE:To assess the light irradiance (LI) delivered by two light-curing units and to measure the degree of conversion (DC) of three composite cements and one flowable composite when cured through zirconia or ceramic-veneered zirconia plates with different thicknesses.MATERIALS AND METHODS:Three dual-curing composite cements (Clearfil Esthetic Cement, Panavia F2.0, G-CEM LinkAce) and one light-curing flowable composite (G-aenial Universal Flo) were investigated. Nine different kinds of zirconia plates were prepared from three zirconia grades (YSZ: Aadva and KATANA; Ce-TZP/Al2O3: NANOZR) in three different thicknesses (0.5- and 1.5-mm-thick zirconia, and 0.5-mm-thick zirconia veneered with a 1.0-mm-thick veneering ceramic). Portions of the mixed composite cements and the flowable composite were placed on a light spectrometer to measure LI while being light cured through the zirconia plates for 40 s using two light-curing units (n = 5). After light curing, micro-Raman spectra of the composite films were acquired to determine DC at 5 and 10 min, 1 and 24 h, and at 1 week.RESULTS:The zirconia grade and the thickness of the zirconia/veneered zirconia plates significantly decreased LI. Increased LI did not increase DC. Only the Ce-TZP/Al2O3 (NANOZR) zirconia was too opaque to allow sufficient light transmission and resulted in significantly lower DC.CONCLUSION:Although zirconia-based restorations attenuate the LI of light-curing units, the composite cements and the flowable composite could be light cured through the YSZ zirconia. LI is too low through Ce-TZP/Al2O3 zirconia, necessitating the use of self-/dual-curing composite cements.
Osteoporosis could potentially complicate oral implant treatment because of disease-specific characteristics such as the abnormal bone condition, poor healing ability caused by bisphosphonates (BPs), and bisphosphonate-related osteonecrosis of the jaw (BRONJ). These problems must be resolved to ensure that oral implant treatment is successful in osteoporotic patients. As a novel therapeutic option for increasing the success rate of oral implantation in patients with osteoporosis, we focused on parathyroid hormone (PTH) and low-magnitude high-frequency (LMHF) loading. Compared to BPs, which inhibit osteoclastic bone resorption and suppress bone turnover, PTH stimulates osteoblastic bone formation and promotes bone turnover. Intermittent PTH administration is a new class of anabolic therapy for the treatment of severe osteoporosis. LMHF loading, which elicits a positive effect on skeleton, has been proposed as a nonpharmacological and adjunctive intervention in the treatment of osteoporosis. Previous investigation reported that both intermittent PTH administration and LMHF loading have an independent osteogenic effect on peri-implant bone healing and implant osseointegration. In addition, our recent study reveals their combined therapy acts locally and synergistically on peri-implant bone healing process, strengthening osseointegration. Therefore, this can be a new therapeutic option for oral implant treatment in osteoporotic patients without any problems.
Objective. The aim was to evaluate the optical properties, mechanical properties and aging stability of yttria-stabilized zirconia with different compositions, highlighting the influence of the alumina addition, Y2O3 content and La2O3 doping on the translucency.Methods. Five different Y-TZP zirconia powders (3 commercially available and 2 experimentally modified) were sintered under the same conditions and characterized by X-ray diffraction with Rietveld analysis and scanning electron microscopy (SEM). Translucency (n = 6/group) was measured with a color meter, allowing to calculate the translucency parameter (TP) and the contrast ratio (CR). Mechanical properties were appraised with four-point bending strength (n = 10), single edge V-notched beam (SEVNB) fracture toughness (n = 8) and Vickers hardness (n = 10). The aging stability was evaluated by measuring the tetragonal to monoclinic transformation (n = 3) after accelerated hydrothermal aging in steam at 134 degrees C, and the transformation curves were fitted by the Mehl-Avrami-Johnson (MAJ) equation. Data were analyzed by one-way ANOVA, followed by Tukey's HSD test (alpha = 0.05).Results. Lowering the alumina content below 0.25 wt.% avoided the formation of alumina particles and therefore increased the translucency of 3Y-TZP ceramics, but the hydrothermal aging stability was reduced. A higher yttria content (5 mol%) introduced about 50% cubic zirconia phase and gave rise to the most translucent and aging-resistant Y-TZP ceramics, but the fracture toughness and strength were considerably sacrificed. 0.2 mol% La2O3 doping of 3Y-TZP tailored the grain boundary chemistry and significantly improved the aging resistance and translucency. Although the translucency improvement by La2O3 doping was less effective than for introducing a substantial amount of cubic zirconia, this strategy was able to maintain the mechanical properties of typical 3Y-TZP ceramics.Significance. Three different approaches were compared to improve the translucency of 3YTZP ceramics. (C) 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
The aim of this study was to evaluate whether partial removable denture use indeed leads to improved oral health related quality of life and masticatory function.Materials and Methods: Partially edentulous patients presenting for removable denture treatment at the Prosthodontics Service in the Hospital Affiliated to Kinshasa University (Democratic Republic of Congo) were assessed for enrolment in this study.After applying exclusion criteria, 378 patients were included in the study, and randomly assigned into 2 groups.Oral health related quality of life (OHIP-23) and mastication time (MaT), number of chewing cycles (MaC), mastication frequency (MaF), and the sizes of the peanut fragments (FraS) were compared in both groups.Statistical significance was set at p < 0.05.Results: The average MaC, MaT, MaF, and FraS were 119 (± SD 53.70), 86.75 (±SD 35.35), 1.38 (±SD 0.25), and 3.3 (±SD 3.25) for the denture group and 77.9 (±SD 23.9), 60.2 (±SD 17.91), 1.29 (±SD 0.15), and 1.5 (±SD 0.7) for the non-denture group, respectively.Conclusion: The overall oral health related quality of life was best in the non-denture than denture.
OBJECTIVE:This study aims to evaluate dental decay incidence and DMF index, plaque index and gingival index, and to assess the satisfaction/dissatisfaction in acrylic removal partial denture wearers (ARPD) and in partial edentate no wearers. It aims to improve the therapeutic management in prosthetic oral rehabilitation in DR Congo.MATERIAL AND METHODS:This prospective cohort interventional randomized study on 376 patients enrolled and divided into two groups (with and without denture prosthesis) was performed in University Clinics of Kinshasa, Kinshasa Medical Center and Clinic Glory during the period August 2008 to August 2010.RESULTS:Three hundred seventy-six patients (376) with 163 men (47 ± 16 years) and 213 women (42 ± 15 years) were followed. Of the 376 patients randomized, 189 were of "prosthesis" group and 187 were in the group "without aid". Both groups were regularly reviewed every 6 months for 2 years. Ten thousand four hundred and fifty-two (10452) teeth were examined (5149 teeth to the group "prosthesis" and 5303 for the teeth "without prosthesis" group. On hundred and twenty-nine (129) teeth that presented caries, 110 (82.96 per cent) are decayed teeth in the "prosthesis" group and 19 (17.04 per cent) are in the group "without prosthesis" (p = 0.00). The index Tooth Decayed, Missing, Filled (CAD) to start of the study for each group was 0.2. Two years after the index rose to 0.3 for the group "prosthesis" and remained steady (0.2) for the group "without prosthesis". The "prosthesis" group showed plaque index (PI) and gingival index (GI) above 0.99 (SD: ± 0.28) and 1.27 (SD: ± 0.43) than normal compared to those of the "no aid" group (0.46 ± 0.15 and 0.32 ± 0.12). The differences were statistically significant for both indices between the two groups (p = 0.00). Overall satisfaction rate for the "prosthesis" group was 26.4% while for the group "without prosthesis" satisfaction rate is 80.9%.CONCLUSION:This study shows that improved oral hygiene and regular check of the RPD acrylic resin carriers become a concern for establishing a true oral health policy.
Alendronate therapy has been associated with serious side effects. Altering the alendronate concentration and combining with high-frequency loading as mechanical intervention was explored in this animal study as a treatment for osteoporosis. The bone anabolic potency of high-frequency loading was overruled by the different alendronate dosages applied in the present study. Further exploration of reduced hormonal therapy associated with mechanical interventions in osteoporosis treatment should be sought.
Objective: The goal of the removable partial denture is to restore impaired esthetics and masticatory function by replacing missing teeth. The aim of this study was to establish a possible correla-tion between removable partial denture in acrylic resin use after 5 years and dental diseases. Materials and Methods: Partially edentulous patients presenting for removable denture treatment at the Prosthodontics service of the Affiliated Hospital of Kinshasa University, Democratic Republic of Congo were assessed in this study. Patients were randomly assigned into 2 groups: Denture and non-denture group. Caries and periodontal diseases were compared between both groups. Statistical significance was set at p < 0.05. Results: The average age in the denture and non-denture-group was 53.15 (±SD 22.05) and 31.59 (±SD 11.98) years. Out of 160 teeth were decayed, both 110 teeth (68.75%) in the denture-group and 50 teeth (31.25%) in the non-denture group. The DMFT index calculated at start time of the study was 0.2 for both groups, after five years was 7.1 for the denture-group and 2.6 for the non-denture-group. The plaque index in the denture-group had an index of 1 and that of non-denture-group was 0.5. Conclusion: The relationship has been found between patients' wearers a RPD and dental diseases.