Pattern of partial edentulism, design acceptability and level of patients satisfaction of with provided Acrylic Removable Partial Dentures at Muhimbili University dental clinic, Dar es salaam

Abstract

Background: The most common treatment option available for the replacement of missing teeth in partially edentulous patients in developing countries like Tanzania is the acrylic removable partial dentures (ARPD). The ARPD is clinically considered as an interim treatment option but is provided as a definitive treatment in this setting. Being an interim denture, most times the practitioners do not consider the design and the long-term use of these ARPD’s could become detrimental to the soft and hard structures of the oral cavity. A good design based on biomechanical considerations that considers patients’ satisfaction seems to be essential for achieving a beneficial ARPD that can be used as a definitive prosthesis. Objective: Aim of this study was to determine the pattern of partial edentulous, design acceptability and level of patient’s satisfaction with provided ARPD at Muhimbili University, Dental Clinic, Dar es Salaam. Methodology: This cross-sectional study was conducted at the MUHAS dental clinic in Dar es Salaam, Tanzania. The estimated sample size of 173 registered dental patients aged 18 and above, provided with acrylic removable partial dentures as from of January 2019 to January 2021 were recalled using the convenient sampling technique. Data was obtained using a structured questionnaire and clinical examination was performed to those who consented. Gathered data were analyzed using SPSS, version 20.0. The characteristics of assessed variables were described using frequency distribution for categorical variables and in the case of discrete variables; the mean and standard deviation were applied. Chi-square test was used to compare proportions and logistic regression determined any association between independent and dependent variables. Level of statistical significance will be set at p < 0.05. Results: Of the n= 173 enrolled participants, 88 participants had only upper ARPD, 34 lower and 51 both, giving a total of 134 upper and 85 lower ARPD. The most prevalent pattern was Kennedys Class III in both arches with 61.9% for the upper arch and 30.9% for the lower arch. Of the assessed SDF, 62.4% of participants were female and participants with a minimum of secondary education (66.5%) were two times more than those with less. The younger group age (18-51 years old) had statistically significantly higher prevalence of partial edentulism of the upper jaw than those in the higher age group. Slightly more than a third (39.6%) of ARPD in the upper jaw had acceptable design in comparison to 21.2% on the lower denture. More than three quarters of participants were satisfied with their upper (89.9%) and lower (87.1%) ARPD. Although there were a statistically significant association between the denture design of the upper ARPD (p=0.009) and level of education of participants with lower ARPD (p=0.045) and the patient’s satisfaction, logistic regression shows no relationship between patients’ satisfaction and design denture. Conclusion: The study reported that the most prevalent pattern of partial edentulism in both upper and lower jaw was Kennedys class III, and ARPD dentures with an acceptable design was low for both upper and lower jaw, with (21.2%) of lower and more than third (39.6%) for upper having an acceptable design. Age group, denture design of the upper ARPD, level of education of the lower ARPD were found to be significantly statistically associated to the level of patients’ satisfaction. Recommendations: An appropriate students-teacher ratio will be necessary in order to maximize the supervision, teaching and instruction to the dental student on the importance of biomechanically designed denture required for patients seeking tooth replacement with ARPD