The Effects of Wearing a Removable-Partial-Denture on the Bite Forces: A Cross-Sectional Study

Abstract

Background: Removable partial dentures are a frequently used prosthetic treatment in the elderly population, but different types or RPDs might guarantee different chewing capabilities. In many studies, the relationship between chewing and aging has been reported and it has been shown that efficient chewing can improve the overall quality of life.

Objectives: In the present study, the relationship between maximum bite force (MBF) and RPDs was studied. A relationship between the body mass index (BMI) and the type of prosthesis was also analyzed.

Methods: 240 elderly patients, 120 males and 120 females, with bilateral posterior edentulism (class 1 of Kennedy classification) who had been wearing an RPD for at least a year, were recruited. Patients were divided into two groups: Group 1: male (n = 60) and female (n = 60) patients with bilateral edentulous areas located posterior to the remaining natural teeth and natural teeth in the opposite dental arch. Group 2: male (n = 60) and female (n = 60) patients with maxillary and mandibular bilateral edentulous areas located posterior to the remaining natural teeth. Their Body Mass Index (BMI) and Maximum bite force (MBF) were measured and compared according to the material and design of their RPD.

Results: In both Groups, patients wearing cobalt-chrome alloy RPDs (Co-Cr-RPD) (Group 1: 20.25 ± 6.7 MBF, p < 0.001; Group 2: 16.0 ± 5.7 MBF, p < 0.001) had an increased MBF when compared to polymethylmethacrylate RPD (PMMA-RPD) (Group 1: 12.9 ± 3.36 MBF; Group 2: 10.4 + 2.8 MBF), and Valplast RPD (V-RPD) (Group 1: 14.3 ± 4.7 MBF; Group 2: 11.3 ± 3.4 MBF) users. There were no significant differences in bite force between patients wearing PMMA-RPD and V- RPD in both Groups. Patients in Group 2 showed a lower MBF than those in Group 1 (Group 1: 16.05 ± 6.13 MBF; Group 2: 12.6 ± 4.84 MBF; p < 0.001).

Conclusions: A reduction in chewing force can lead to choosing softer foods for nutrition, which can lead to an increase in BMI. Our results show that only CoCr-RPD wearers were able to chew consistent food, whereas PMMA- RPD and V-RPD, due to the properties of the materials, their instability, and the possibility of causing pain during mastication, determined a limitation in the choice of food for many of the participants.

Keywords: bite force; body mass index; chewing strength; partial denture; removable prostheses.

Figure 1

Maximal Bite Force according to gender. MBF = Maximal Bite Force; BMI = Body Mass Index; V-RPD = Valplast Removable Partial Denture; CoCr-RPD = Chrome-Cobalt Removable Partial Denture; PMMA-RPD = Polymethyl Methacrylate Removable Partial Denture. * = p < 0.05; ** = p < 0.01.

Figure 2

Maximal bite force according to body mass index classification. (MBF = Maximal Bite Force; BMI = Body Mass Index; V-RPD = Valplast Removable Partial Denture; CoCr-RPD = Removable Partial Denture Cobalt-Chromium; PMMA-RPD = Removable Partial Denture in Polymethyl Methacrylate.* = p < 0.05).

Figure 3

Maximal bite force in the three types of prostheses. (MBF = Maximal Bite Force; V-RPD = Valplast Removable Partial Denture; CoCr-RPD = Cobalt-Chrome Removable Partial denture; PMMA-RPD = Polymethyl Methacrylate Removable Partial Denture. ** = p < 0.01).

Figure 4

Correlations of maximal bite force with the age of the subjects. MBF = Maximal Bite Force.

Figure 5

Correlations of maximal bite force with body mass index. MBF = Maximal Bite Force.