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The Effect of Removable Partial Dentures on Periodontal Health of Abutment

and Non-Abutment Teeth

Article  in  Journal of Periodontology · February 2002

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J Periodontol • February 2002

The Effect of Removable Partial

Dentures on Periodontal Health of
Abutment and Non-Abutment Teeth*
Dubravka Knezović Zlatarić, Asja C̆elebić, and Melita Valentić-Peruzović

Background: A removable partial denture (RPD) is a com-

mon treatment available for restoration of partially edentulous
ridges. Longitudinal studies indicate that RPDs have been asso-
ciated with increased gingivitis, periodontitis, and abutment
mobility.
Methods: A total of 205 patients with RPDs participated in
this study. There were 80 males and 125 females aged 38 to

A
removable partial denture (RPD)
89, with 123 maxillary and 138 mandibular RPDs. Patients were is a common treatment available
wearing existing RPDs for different periods ranging from 1 to 10 for the restoration of partially
years. A two-part questionnaire was devised for this study. In the edentulous ridges, where a fixed remov-
first part, patients answered questions on gender; age; smok- able partial denture is not indicated.
ing habits; denture age; denture wearing habits; mouth odor; RPDs, although they serve as an excel-
and problems with food accumulating under the denture base, lent means of replacing missing teeth,
on the outside surface of the denture, and on the outside sur- may pose a serious threat to a patient’s
face of remaining teeth after eating. The Kennedy classification, remaining teeth.
material, denture support, denture base shape, and number of Longitudinal studies indicate that RPDs
teeth in contact, number of existing clasps, and occlusal rests have been associated with increased gin-
were categorized. The quality of denture construction was also givitis, periodontitis, and abutment mobil-
evaluated. In the second part of the questionnaire, baseline ity.1-5 El Ghamrawy,6 Addy and Bates,7
recordings of plaque (PI), gingival (GI), and calculus (CI) indexes and Stipho et al.8 found that RPDs were
were made, and Tarbet index (TI), as well as probing depth associated with increased plaque accu-
(PD), gingival recession (GR), and tooth mobility (TM) were mulation, not only on tooth surfaces in
measured, both on abutment and non-abutment teeth. direct contact with the denture, but also
Results: Significant differences (P <0.01) were noted for PI, on teeth in the opposing arch, and in
CI, GI, PD, TM, and GR between abutment and non-abutment some cases, even on buccal surfaces of
teeth, with abutment teeth showing more disease. teeth.
Conclusions: RPD design plays an important role in the state RPDs may increase the incidence of
of the periodontium. Appropriate design and good oral hygiene caries, damage the periodontium, and
may decrease the appearance of periodontal disease. J Perio- increase the amount of stress on natural
dontol 2002;73:137-144. teeth.9-14 These alterations are attributed
KEY WORDS to poor oral hygiene, increased plaque
and calculus accumulation, and trans-
Denture, partial, removable/adverse effects; follow-up
mission of excessive forces to the peri-
studies; tooth mobility; periodontal diseases/prevention and
odontal structures from occlusal surfaces
control.
of the framework of RPDs.15 Many par-
tial denture framework designs contribute
* Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, to increased or altered oral bacterial flora
Croatia. and formation of dental plaque.16-18
Some textbooks advocate either a lin-
guoplate or a continuous bar major con-
nector when a lingual bar cannot be uti-
lized.19-22 Some investigators suggest
that linguoplate major connectors, which
have increased coverage of gingival and
dental tissues, may increase food reten-

137
1092_IPC_AAP_553082 2/11/02 10:52 AM Page 138
Removable Partial Denture Therapy
tion and promote plaque formation.23 The alternative
to this extensive coverage is the cingulum, or dental
bar major connector, introduced by Carlsson et al.1,24,25
It is possible to reduce the negative effects of remov-
able partial dentures on the periodontium and perform
good oral hygiene.26 Only minor periodontal effects
were noted in patients recalled regularly for support-
ive treatment, including professional oral hygiene.27
Studies suggest that the insertion of a partial den-
ture constitutes a risk factor for abutment and some-
times even for non-abutment teeth. The aim of this
study was to analyze the relationship between age;
gender; smoking habits; denture age and wearing
habits; problems with food accumulation on the RPDs;
mouth odor; RPD construction; and the degree of the
plaque index (PI), gingival index (GI), calculus index
(CI), probing depth (PD), tooth mobility (TM), and gin-
gival recession (GR) on both the abutment and non-
abutment teeth, and the Tarbet index (TI) on the inner
RPD surface.
MATERIALS AND METHODS
A total of 205 patients wearing RPDs (made by dif-
ferent dentists at the Department of Removable
Prosthodontics, School of Dental Medicine, University
of Zagreb, Croatia) participated in this study. The
patients were chosen at random from department files.
Patients were wearing their RPDs for a period of time
ranging from 1 to 10 years. There were 80 males and
125 females between the ages of 38 and 89. The
examined patients had 123 maxillary and 138
mandibular RPDs. The RPDs were of different Kennedy
classification and different denture support. The most
frequent were Kennedy Class I19/tooth-supported den-
tures (81%), and in 48% of the dentures, one or more
of the frontal teeth had been replaced.
A two-part questionnaire was devised for this study.
In the first part, patients answered questions on gen-
der (male, female); age (group 1 = from 1 to 50 years,
group 2 = from 51 to 70 years, and group 3 = more
than 70 years); smoking habits (yes/no); denture age
(group 1 = <1 year, group 2 = from 2 to 5 years, and
group 3 = >5 years); denture wearing habits (group 1
= all the time, group 2 = during the day, group 3 =
during meals, and group 4 = only for going out); prob-
lems with food accumulation under the denture base,
on the outside surface of the denture, and on the out-
side surface of the remaining teeth in the mouth after
meals (1 = no problem, 2 = little problem, 3 = some
problem, 4 = moderate problem, 5 = extreme prob-
lem); and mouth odor (from 0 to 5; 0 = no odor exist-
ing in the mouth, and 5 = the greatest odor in the
mouth).
The dentist determined the Kennedy classification;
material (metal/acrylic); denture support (mucosa-
supported or tooth-supported); maxillary denture base
138
Volume 73 • Number 2
shape (palatal plate-type/U-shaped/single palatal bar/
anterior and posterior palatal bar type); mandibular
denture base shape (linguoplate/half-pear-shaped lin-
gual bar); and number of teeth in contact (3 groups:
1 = up to 10 teeth, 2 = from 10 to 20 teeth, and 3 =
>20 teeth). The dentist also evaluated the denture con-
struction and rated the dentures on the quality of fit,
extension and occlusion, number of clasps, occlusal
rests, partial denture connectors, and quality of frame-
work design by using a scale from 1 to 5 (where 1
designated poor construction and 5 excellent con-
struction). If the denture design (number and place-
ment of rests, clasps, and indirect retainers) was not
planned according to the rules for the teeth and/or
teeth and mucosa support available, the construction
received the lowest grades; if the framework was over-
constructed (too many rests, clasps, minor connec-
tors, etc.), the construction was scored with lower
grades in comparison to the correct construction. The
distance between the denture base and the gingival
margin was also included as a criterion in grading the
construction. Excellent scores were gained in those
subjects whose dentures showed an optimal relation-
ship between gingival margins and the connectors.19
The dentist also determined the number of existing
clasps and occlusal rests. All of the metal frameworks
with free-end saddles were teeth and mucosa sup-
ported with occlusal rests placed on the mesial aspect
of the abutment tooth, with minor connectors carry-
ing the mesial rest; in cases of canines being the dis-
tal abutments, cingulum rests were used. Indirect
retainers were used where necessary.
The majority of the clasps were occlusally approach-
ing clasps (93%), and 7% were gingivally approach-
ing clasps, mostly for frontal teeth or canines. All
acrylic dentures were mucosa supported.
In the tooth and tooth and mucosa-borne metallic
RPDs, the plate was either kept away from the gingi-
val margin by at least 4 mm, or the gingival margin
was covered by the plate with a relief. In acrylic RPDs,
the gingival margin was covered by the plate without
the relief. None of the RPD wearers reported ever using
denture adhesives.
In the second part of the questionnaire, baseline
recordings of plaque index (PI),28 gingival index (GI),29
and calculus index (CI)28 were made at the mid-buc-
cal, mid-palatal, mesio-palatal, and disto-palatal sur-
faces of each abutment and non-abutment tooth (sep-
arately for natural teeth and for the crowns). A
periodontal probe (University of Michigan “O,” with
Williams markings, diameter tip 0.5 mm) was used to
measure probing depth (PD) as well. Scores ranging
from 0 to 3 represented the highest PD observed (0 =
normal sulcular depth of 2 mm or less; 1 = sulcular
depth of more than 2, but not more than 3 mm; 2 =
sulcular depth greater than 3 mm, but less than 5 mm;
1092_IPC_AAP_553082 2/11/02 10:52 AM Page 139
J Periodontol • February 2002
3 = sulcular depth 5 mm or more). Tooth mobility (TM)
was recorded according to a scale from 0 to 3 (0 = no
mobility, 1 = less than 1 mm movement in the hori-
zontal plane, 2 = more than 1 mm movement in the
horizontal plane, and 3 = movement in the apical direc-
tion).
Gingival recession (GR) was measured from the
cemento-enamel junction to the gingival margin (in
mm).
The values for all abutment teeth in the mouth were
totaled, and their mean and the highest values (sepa-
rately for natural abutments and the crowns) were
recorded. The same procedure was followed for non-
abutment teeth (separately for the non-abutments and
non-abutment crowns).
The accumulation of denture plaque was measured
using the Tarbet index (TI)30 on the inner surface of
the RPD.
Prior to the assessment, 3 prosthodontists sepa-
rately evaluated 10 different patients with RPDs for all
the above-mentioned parameters. Kappa test (0.75 to
0.90) revealed sufficient consistency between them,
but it was decided that only one of them should eval-
uate all patients.
A descriptive statistical analysis was made.† The
homogeneity of the population was tested by the one
sample Kolmogorov-Smirnov test, which revealed the
need for non-parametric statistics. The difference
between the independent variables was tested using
K-independent Kruskal-Wallis test. The difference
between the dependent variables was tested by
Wilcoxon test (abutment and non-abutment teeth).
Any difference P <0.05 was considered significant.
RESULTS
More than 50% of the examined patients in this study
were older than 70 years. There were 39% males and
61% females. Twenty percent (20%) of the patients
were smokers and 80% were non-smokers. Just over
half (51%) of the patients were first-time RPD wearers,
33% had their second RPD, 13% their third, 2% their
fourth, and 1% their fifth RPD.
Thirty-nine percent (39%) of the maxillary RPDs
and 37% of the mandibular RPDs were functional less
than 1 year; 42% maxillary and 47% mandibular RPDs
were functional from 1 to 5 years; and 20% maxillary
and 16% mandibular RPDs were functional for more
than 5 years. Most of the patients were wearing the
RPDs only during the day (50% and 48%, respec-
tively).
Most of the maxillary and mandibular RPDs had 2
clasps (55% and 73%, respectively) and 2 occlusal
rests (42% and 38%, respectively).
Almost 35% of RPD wearers reported no problem
with food accumulation under the denture base, 30%
had only minor difficulties, 30% had some difficulties,
Knezović Zlatarić, C̆elebić, Valentić-Peruzović
Figure 1.
Highest values of PI, GI, and CI on natural abutments and non-
abutments.
and 5% had moderate or extreme difficulties. Fifty per-
cent (50%) of RPD wearers had no difficulties with food
accumulation on the outside surface of the denture,
35% reported only minor difficulties, and 15% reported
they had some problems with food accumulation, most
commonly in mandibular RPDs. More than 50% of RPD
wearers had no problem with food accumulation on
the outside surface of the remaining teeth in the mouth
after eating, 40% had only minor problems, and 10%
reported some difficulties with food accumulation.
Most of the examined patients (84%) reported no
problems with mouth odor.
In the maxilla, the most common denture was a
Kennedy Class I, palatal plate-type, tooth-supported,
metal RPD, and in the mandible, a Kennedy Class I,
linguoplate, tooth-supported, metal RPD. The con-
struction of most of the maxillary and mandibular RPDs
received the highest score (43% of the cases). Almost
70% of the patients had 10 to 20 remaining teeth in
contact. Considering TI, 45% of the maxillary and
mandibular RPDs had a score of 1 for plaque accu-
mulation under the denture base (up to 25% plaque).
In the group of examined abutment teeth, most of
the natural abutments (70%) had the highest score (2)
for PI and GI, and score 1 for CI (52%), while the mean
score was 2 for PI and GI (60%) and 1 for CI (51%)
(Fig. 1). The results for the abutments with crowns
were similar (P >0.05, Wilcoxon test). Most of these
abutments (56%) had the highest and mean scores of
2 for PI and GI, and 1 for CI (51%).
Most of the natural abutments (54%) had the high-
est and mean values for PD ≤ 2 mm; the highest mea-
sured GR (29%) was 4 mm, while mean measured GR
was 2 mm in 31% of the patients; and the highest and
mean score for TM was 1 in 50% of the examined
patients (Fig. 2). Abutments with crowns had mean
and highest values similar to natural abutment teeth
(P >0.05, Wilcoxon test).
† SPSS 10.0 for Windows, SPSS Inc., Chicago, IL.
139
1092_IPC_AAP_553082 2/11/02 10:52 AM Page 140

Removable Partial Denture Therapy Volume 73 • Number 2

Most of the natural non-abutment teeth (58%) had measured GR was 3 mm in 43% of the patients; the
the highest score of 1 for PI and CI, and score 2 for GI highest and mean score for TM was 0 in 45% of the
(50%) (Fig. 1), while the mean score was 1 for PI, GI, examined patients (Fig. 2). For non-abutment crowns,
and CI (60%). The results for non-abutment teeth with the highest and mean values were the same as for nat-
crowns were different. Most of the crowns (60%) had ural non-abutments (P >0.05), except for the highest
mean and highest scores of 1 for PI, GI, and CI (P values of the measured GR (40%) that were 3 mm (P
<0.01). <0.01).
Most of the non-abutment natural teeth (82%) had The differences between the periodontal variables
the highest and mean values for PD ≤ 2 mm; the high- for abutment and non-abutment teeth (PI, GI, CI, TM,
est measured GR (25%) was 4 mm, while the mean PD, and GR) and the variables connected with the
patient and the RPDs were tested by Kruskal-Wallis
test.
Only results revealing significant differences between
the variables PI, GI, CI, TM, GR, and PD of the abut-
ment teeth (plus TI of the RPD), and the patient’s age,
smoking habits, denture age, denture wearing habits,
and food accumulation on the RPDs and remaining
teeth are shown in Table 1.
Older patients had significantly higher mandibular
TI scores; smokers had significantly higher GI (high-
est) scores; PD (highest) was greater in older maxil-
lary dentures; and TM, GR, and TI scores were higher
Figure 2. in older mandibular RPDs (P <0.01). PI (highest), CI
Highest values of PD and TM on natural abutments and non- (highest), and PD were higher in patients who com-
abutments.
plained about food accumulation on RPDs, and PI was
higher when patients complained
Table 1. about food accumulation on their
teeth (P <0.01). Patients wear-
Significant Differences Between Periodontal Variables of ing RPDs day and night had sig-
Abutment Teeth (natural teeth and crowns) and Tarbet Index of nificantly higher PD (highest)
RPDs and Variables Connected With the Patient and RPD- scores (P <0.01).
Wearing Habits Only results revealing signifi-
cant differences between PI, GI,
Denture Denture Denture Food Food CI, TM, GR, and PD of abutment
Smoking Age Age Wearing Accumulation Accumulation teeth (plus TI of the RPD), and
Age Habits (maxillary) (mandibular) Habits (RPD) (teeth) the variables connected with RPD
construction (Kennedy classifi-
PI* – – – – – X X
cation, denture base shape, den-
PI † – – – – – – X ture material, construction and
support, and number of clasps
GI* – X – – – – –
and occlusal rests) are shown in
CI* – – – – – X – Table 2.
CI scores were highest in Ken-
TM* – – – X – – –
nedy Class I RPDs in the max-
TM† – – – X – – – illa, and CI and PD were highest
in palatal plate type dentures (P
GR* – – – X – – –
<0.01). The highest PI, CI, GR,
GR † – – – X – – – and PD were registered in lin-
guoplate mandibular RPDs (P
PD* – – X – X X –
<0.01). PD was higher in acrylic
PD † – – – – – X – dentures (P <0.01). Worst grades
for denture construction and high-
TI‡ X – – X – – –
est PI, GI, and CI were registered
* Highest value. (P <0.01) (Table 2). Tooth and
† Mean value.
‡ Mandibular denture.
tooth and mucosa-supported RPDs
X = Significant difference between groups at P <0.01. had significantly lower scores for

140
1092_IPC_AAP_553082 2/11/02 10:52 AM Page 141

J Periodontol • February 2002 Knezović Zlatarić, C̆elebić, Valentić-Peruzović

GI, CI (highest), and PD (P <0.01) than mucosa-sup-
ported dentures (Table 2). With more clasps, higher PI
and TM scores were registered; with more occlusal
rests, lower GI, TM, and GR were registered (P <0.01)
(Table 2). Patients’ gender, food accumulation under
the denture base, and complaints about odor were not
significantly different for PI, GI, CI, TM, GR, and PD of
the abutment and non-abutment teeth (plus TI of the
RPD) (P >0.05).
The only significant difference related to non-abut-
ment teeth (natural teeth and crowns) appeared
between the grades for denture construction and PI
and CI (P <0.01). There were no significant differences
between RPDs with occlusal and gingival-approach-
ing clasps (P >0.05).
DISCUSSION
We studied a number of factors that might be related
to the occurrence of plaque and calculus accumula-
tion; gingival inflammation; changes in PD, TM, and
GR on abutment and non-abutment teeth in patients
wearing RPDs; as well as plaque accumulation on the
RPDs. Differences between abutments and non-abut-
ments were also studied. The data showed that there
is a difference between the abutment and non-abut-
ment teeth for some periodontal disease indexes (Figs.
1 and 2).
The abutment teeth of patients with RPDs demon-
strated a greater degree of PI, GI, CI, PD, GR, and TM
in older dentures and in patients wearing dentures day
and night (Table 1). Higher TI scores were recorded in
older patients and in patients wearing older dentures
(Table 1), which is not a surprising finding. Patient age
did not significantly influence PI, CI, GI, TM, GR, and
PD.
It seems that older patients maintain hygiene of nat-
ural teeth better than denture hygiene, and the results
underscore the need for better instruction on maintain-
ing denture hygiene. Patients who complained about food
accumulation on the outside surfaces of the RPDs had

Table 2.
Significant Differences Between Periodontal Variables of Abutment Teeth
(natural teeth and crowns) and Tarbet Index of RPDs and Variables
Connected With RPD Construction

No Occlusal
Rests
Kennedy Denture Denture (maxillary
Classification Base Shape Base Shape Denture Denture Denture No Clasps and
(maxillary) (maxillary) (mandibular) Material Construction Support (maxillary) mandibular)

PI* – – X – X – X –

PI† – – X – X – X –

GI* – – – – X X – X

GI† – – – – X X – X

CI* X X X – X X – –

CI† X X X – X – – –

TM* – – – – – – X X

TM† – – – – – – X X

GR* – – X – – – – X

GR† – – X – – – – X

PD* – X X X – X – –

PD† – X X X – X – –

TI‡ – – X – – – – –
* Highest value.
† Mean value.
‡ Mandibular denture.
X = Significant difference between groups at P <0.01.

141
1092_IPC_AAP_553082 2/11/02 10:52 AM Page 142
Removable Partial Denture Therapy
higher scores for PI, CI, and PD, and patients who com-
plained about food accumulation on their teeth had
greater PI scores (Table 1).
Considering the results of this study, Kennedy clas-
sification, denture base shape, denture construction,
and especially the number and position of the clasps
and occlusal rests also influence periodontal deterio-
ration. The results of this study coincide with some
other investigations.12-15,31
Patient gender, food accumulation under the denture
base, and complaints about odor made no significant
differences for the variables PI, GI, CI, TM, GR, and
PD of the abutment and non-abutment teeth (plus TI
of the RPD) (P >0.05).
We expected higher PI, GI, and CI scores, as well as
higher PD scores, in patients who complained about
odor, but this was not proved by our results. Only a
small number of patients reported odor (16%), which
was less than we expected considering the scores for
PI, GI, and PD obtained in this study. This could be
attributed to the patients’ subjective opinion and
increased tolerance or unawareness about odor. Frank
et al.32 reported complaints about odor to be twice as
common in patients younger than age 60 and in those
with poor health, which points to the importance of
considering patients’ subjective factors. Younger
patients might be more aware of the odor, and patients
with poor health may not be able to maintain proper
oral hygiene.
Denture support significantly influenced the degree
of GI, CI, and PD (Table 2), with scores higher in
mucosa-borne dentures that covered the gingival mar-
gin without relief. In tooth and mucosa-borne RPDs,
there was no significant difference between the den-
tures that covered the gingival margin with the relief
and those that were at least 4 mm from the gingival
margin.
These results are in accordance with our previous
report on higher Newton index scores for the inflam-
mation of the oral mucosa under mucosa-borne RPDs
in comparison to tooth or tooth and mucosa-supported
RPDs, because mucosa-supported dentures tend to
settle down and mechanically damage the tissue.33
Although tooth and/or tooth and mucosa-supported
dentures offer more surfaces (minor and major con-
nectors, rests, clasps) for plaque accumulation in com-
parison to the simple design of a mucosa-supported
denture, it seems that mechanical pressure on the soft
tissue adjacent to the abutments and to oral mucosa
under the saddles of the mucosa-supported RPDs plays
a major role in increasing mucosal inflammation and
GI and PD scores. In addition, mucosa-borne RPDs
closely contact the gingival margin, which adversely
affects gingival health, mostly due to the mechanical
pressure.
Bissada et al.31 reported that gingival health was
142
Volume 73 • Number 2
adversely affected by RPDs, with it being most severe
where the appliance closely contacted the gingival
margin. They concluded that the optimum relationship
occurred when the denture base was placed as far
from the gingival margin as possible. McHenry et al.18
also suggested that the placement of an RPD major
connector has an important impact on the condition
of the adjacent gingival tissues. According to their
results, the differences in gingival inflammation
between the plate and dental bar designs suggest that
covering more gingival tissue promotes development
of gingivitis, which may subsequently predispose the
area to periodontal disease.
Our results point out that tooth support is more
important for gingival health than covering the gingi-
val margin, especially if it is covered with a relief. It
seems that the design which prevents denture settling,
although it has many surfaces for plaque accumula-
tion in tooth and tooth and mucosa-borne RPDs, offers
more advantages for preventing mechanical trauma
to the soft tissue of the abutment and non-abutment
teeth than the mucosa-borne RPDs, especially if
patients maintain proper hygiene.
It is well known from the literature that the design
of the RPD affects the composition of the microor-
ganisms in the plaque, increasing the number of motile
rods and spirochetes.34 Linguoplate coverage of the
teeth and gingiva may also prevent the flow of saliva
into this area and limit its neutralizing effects. Some
studies in both cariology and periodontology suggest
that the quantity of plaque alone does not determine
the caries rate, degree of gingival inflammation, or
periodontal status, but that the quality of plaque may
be a more significant factor.35-37
The results of this investigation showed significant
increases in PI, GI, CI, TM, and GR in abutments com-
pared to non-abutment teeth (both the natural abut-
ments and crown abutments), which has been proven
in other investigations.6-8,15 The study by Rissin et al.
comparing patients with RPDs, patients with no pros-
thesis, or patients with fixed partial dentures showed
the greatest plaque and calculus deposition, peri-
odontal probing depth, and alveolar bone loss on the
abutment teeth in RPD wearers.15
Some studies examined effects of the forces trans-
mitted to abutment teeth, jiggling, and eventual ortho-
dontic tooth movement, and the results showed that
such forces did not induce periodontal disease or pro-
gressive destruction of the periodontium if good
hygiene was maintained.38
Our results showing higher scores of PI, GI, CI, TM,
and PD on natural abutments or abutments having
crowns compared to non-abutment teeth indicate that
it is more difficult to maintain oral hygiene of the abut-
ments with RPDs in the mouth. It would appear that,
where possible, denture base connectors, clasps, and
1092_IPC_AAP_553082 2/11/02 10:52 AM Page 143
J Periodontol • February 2002
rests should terminate from the gingival margin and the
denture should be tooth supported. The results also
indicate the need to prevent tooth extraction and main-
tain good periodontal health in order to construct tooth
or tooth and mucosa-supported RPDs instead of
mucosa-borne RPDs. The results highlight the need
for further studies to clarify the optimum relationship
of RPD design to the gingiva, since all denture shapes
must come into close approximation to the gingival
margin of one or more abutment teeth. Furthermore,
the influence of denture support and design on changes
of the microbial population under the denture and on
tissues adjacent to the abutment teeth should be stud-
ied.
CONCLUSIONS
RPDs do affect the health of the periodontium. Signif-
icant differences were noted for PI, GI, CI, PD, TM, and
GR between abutment and non-abutment teeth (for
natural abutments and crown abutments). RPD design
also influences the health of the periodontium. Cover-
age of the gingival margin had a detrimental effect on
gingival health. Where possible, the RPD should be
located far from the gingival margin and the denture
should be tooth supported. Appropriate design and
good oral hygiene may decrease the appearance of
periodontal disease.
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32. Frank RP, Milgrom P, Leroux BG, Hawkings NR. Treat- Send reprint requests to: Dr. Dubravka Knezović Zlatarić,
ment outcomes with mandibular removable partial den- Department of Prosthodontics, School of Dental Medicine,
tures: A population-based study of patient satisfaction. University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croa-
J Prosthet Dent 1998;80:36-45. tia. Fax: 38514802159; e-mail: dkz@email.hinet.hr.
33. Ćelić R, Knezović Zlatarić D, Baučić I. Evaluation of den-
ture stomatitis in Croatian adult population. Coll Antropol Accepted for publication July 18, 2001.
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Department of Periodontology, University of Gothenburg;
1978. 78 p.

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