Rest seat preparation for removable partial dentures: does
professional dental practice reflect undergraduate teaching?

Statement of problem. Dental publications worldwide have reported discrepancies between how removable partial dentures are taught at undergraduate level and how these clinical procedures are performed extramurally, particularly regarding rest seat preparation. Considerable gaps have already been documented between undergraduate teaching and actual implementation in dental practice. Purpose. The aims of this study are to evaluate the presence of mouth preparation (cingulum and/or occlusal rest seats) before fabrication of cast removable partial dentures and explore causes that may contribute to and result in discrepancies between what is taught at undergraduate level and what is later on practiced by qualified dentists. The tested null hypothesis was that there is no difference between the frequency of working casts with and without rest seat preparations evaluated by dental laboratories in our study. Material and Methods. 103 laboratories were identified through an internet search strategy. Each laboratory was subsequently telephoned to determine if they provided cast metal removable partial dentures. Only 36 laboratories were shortlisted and out of these only 24 agreed to take part in our study. Three establishments did not fulfil our inclusion criteria leaving an overall 21 dental laboratories to participate in this study. Laboratory staff were calibrated to inspect, detect, and record the presence or absence of cingulum and/or occlusal rest seats in working casts before fabrication of metal frameworks for removable partial dentures over a one-month period. All 21 calibrated laboratories were given a proforma spreadsheet to record the presence or absence of at least one rest seat preparation per model before fabrication of metal frameworks.Statistical analysis was performed with StataCorp softwareby using the binomial probability test of 1 sample. Results. A total of 1,512 working casts were inspected and 630 (41.70%)displayed rest seat preparations(P< 0.001). The remainder 58.30% of casts examined (882) had no rest seat preparations. Only two laboratories recorded over 80% of casts with rest seat preparations and eight laboratories recorded rest seat preparations in 20% of working casts, or less. Conclusions. Lack of rest seat preparation highlights a rather large proportion of dentists performing inadequate mouth preparation before removable partial denture fabrication. Interacting factors might include shortcomings in undergraduate curricular design for removable partial prosthodontics and a contemporary socioeconomic and cultural burden on the dental profession. These implications for dental education beg the question of how to implement and deliver curricular content emphasizing duty of care and ethics for future generations of competent dental practitioners. CLINICAL IMPLICATIONS The results from this study confirm a vast majority of dental practitioners do not perform suitable pre-prosthetic mouth preparation with regard to rest seats.This has a direct clinical impact on removable partial prostheses hindering successful oral rehabilitation, which is most likely to result in further damage to remaining hard and soft dental tissues.

Citation

American Journal of Multidisciplinary Research & Development (AJMRD), Vol. 3, N° 02 (2021) p. 16-2.

Keywords

Diseño de prótesis dental, Dentadura parcial removible, Educación en odontología

item.page.dc.rights

Atribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)

item.page.dc.rights.url

http://creativecommons.org/licenses/by-nc-sa/3.0/cl/

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