Multicenter randomized trial on dental prosthetic therapies for the shortened dental arch – 15-year follow-up and evaluation of the 10- and 15-year examination time

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The ongoing change in paradigm towards preventive and minimal invasive treatment strategies increasingly favors the preservation of a functionally acceptable shortened dental arch (SDA). As data on a high level of evidence were missing, in the year 2000 the “Randomized shortened dental arch study” - a multicenter randomized controlled clinical trial - was started in order to compare two treatment options.Patients were treated with either partial removable dental prostheses (PRPD) or alternatively by preserving or restoring the premolars resulting in a shortened dental arch (SDA).In the light of the 10-year results achieved so far, removable and fixed dental prostheses do not show any difference in this patient collective. Based on the present results, both treatment options can be classified as clinically sound concepts.Against the background of the first 10-year results(1) partial removable dental prostheses – when looking at the precision attachment prostheses in the study at hand – can neither be judged as second-choice therapynor can(2) renouncing molar replacement be judged as being deficient.Thus, scientifically validated knowledge shows that patients’ choice has to be of particular importance in shared decision making in this patient cohort. Furthermore, the high impact of periodontal health as co-factor for the success of prosthodontic therapy could be confirmed.Limiting factor for partial removable dental prostheses is the higher follow-up effort.A multicenter clinical trial on two specific treatment concepts with such a patient collective was successfully carried out worldwide for the first time over such a long time span.The so far most topical review on this subject [Khan S, Musekiwa A, Chikte UM, Omar R. Differences in functional outcomes for adult patients with prosthodontically-treated and -untreated shortened dental arches: a systematic review. PLoS One. 2014 Jul 3;9(7):e101143. doi: 10.1371/journal.pone.0101143] still states a persisting lack of highest evidence level studies and missing statements on the survival of the different treatment options.This knowledge gap shall be closed with the ongoing follow-up treatment of the RaSDA study patients, with complementing the existing data, with an advanced investigation, and with the comprehensive biometrical analysis of the primary and secondary study outcomes.