REMOVABLE PARTIAL DENTURES & PERIODONTAL DISEASE
The relationship between partial dentures and periodontal disease has been investigated. Literature findings support conclusions of negative consequences and the need for research regarding possible alternatives.
Relationship of Partial Dentures to Disease
The relationship between partial dentures and periodontal disease has been demonstrated in several studies. Increases or continuous periodontal breakdown is shown in patients with partial dentures. Increased or altered oral bacterial flora and increased plaque accumulation on tooth surfaces in direct contact with dentures, on teeth in the opposing arch, and on buccal surfaces of teeth, has been associated with removable partial dentures. Removable partial dentures may increase incidence of caries, periodontium damage, and stress on the natural teeth. It has also been stated that it is possible to reduce effects of the dentures on the periodontium; effects have been found in patients recalled regularly for professional oral hygiene (McHenry, Johansson, & Christersson, 1992; Orr, Linden, & Newman, 1992).
Changes in epithelial structure and functional integrity may be related to the development of mucosal inflammation and underlying bone resorption. Normal palatal epithelium is an orthokeratinizing tissue. Harinasuta and Howlett (1992) studied changes in epithelial differentiation beneath dentures. Subjects (26) who wore cobalt chromium bases removable partial dentures for at least six months, demonstrated that samples from beneath the metal denture base had a 50 percent lower orthokeratinization index than did samples from uncovered areas of the palate. Therefore it is stated that removable partial dentures result in a significant shift in the keratinization pattern of the epithelium beneath the prosthesis; the shift is from orthokeratinized to parakeratinized. Possible causes include tissue loading, denture p...