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The randomized shortened dental arch study: temporomandibular disorder pain

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Abstract

Objectives

The aim of this multi-center, randomized controlled trial was to assess the impact of missing posterior support on the risk for temporomandibular disorder (TMD) pain by comparing patients with either shortened dental arches (SDA) or molar replacement by removable dental prostheses (RDP).

Methods

A sample of 215 patients with bilateral molar loss in at least one jaw was consecutively recruited in 14 prosthodontic departments of dental schools in Germany. Of the initial sample, 152 patients (mean age: 59.7 years; 53.9 % female) received randomly allocated interventions (SDA: n = 71; RDP: n = 81). Presence of TMD pain was assessed using patients’ self-reports and was verified by physical examination and by pain intensity, as the mean of current pain, worst pain, and average pain in the last 6 months, with 10-point ordinal rating scales. Assessments were performed before treatment and at follow-ups until 60 months after treatment. Impact of interventions on TMD risk and pain intensity was computed by applying logistic and linear random-intercept models.

Results

Tooth replacement (RDP) did not significantly change the risk for self-reported (odds ratio [OR]: 1.1; confidence interval [CI]: 0.4 to 3.4) or clinically verified (OR: 0.7; CI: 0.1 to 4.3) TMD pain compared to no tooth replacement (SDA). Mean characteristic pain intensity was virtually identical in both groups (Coeff: 0.01; CI: −0.30 to 0.32).

Conclusion

Retaining or preservation of an SDA is not a major risk factor for TMD pain over the course of 5 years when compared to molar replacement with RPDs.

Clinical relevance

Seemingly, missing molars do not have to be replaced in order to prevent TMD pain.

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Acknowledgements

This study was supported by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG), grant DFG WA 831/2-1 to 2-6 and grant DFG WO 677/2-1.1 to 2-2.1. We acknowledge the contribution of the following members of the RaSDA-study group: W. Reinhardt, F. Jahn (Department of Prosthetic Dentistry and Dental Material Science, University of Jena), W. Gernet (Department of Prosthetic Dentistry, Ludwig-Maximilians University Munich), E.-J. Richter (Department of Prosthetic Dentistry, Julius-Maximilians University of Würzburg), E. Busche (Department of Prosthetic Dentistry, Witten-Herdecke University) in study design, study implementation and data collection.

Conflict of interest

The authors report no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg–Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Daniel R. Reissmann & Guido Heydecke

  2. Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA

    Daniel R. Reissmann

  3. Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany

    Oliver Schierz

  4. Department of Prosthetic Dentistry, University Hospital Carl Gustav Carus, Dental School, Technische Universität Dresden, Dresden, Germany

    Birgit Marré, Peter Pospiech, Klaus W. Böning & Michael H. Walter

  5. Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Aachen, Germany

    Stefan Wolfart

  6. Department of Prosthetic Dentistry, Albert-Ludwig University of Freibur, Freiburg, Germany

    Joerg R. Strub

  7. Department of Prosthetic Dentistry, University of Bonn, Bonn, Germany

    Helmut Stark

  8. Department of Prosthodontics, Gerodontology and Biomaterials, Dental School, Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany

    Torsten Mundt

  9. Department of Prosthodontics, Geriatric Dentistry and CMD, Charité Universitätsmedizin Berlin, Berlin, Germany

    Wolfgang Hannak

  10. Department of Prosthetic Dentistry, Johannes-Gutenberg University of Mainz, Mainz, Germany

    Sinsa Hartmann

  11. Department of Prosthetic Dentistry, Justus-Liebig University Giessen, Gießen, Germany

    Bernd Wöstmann

  12. Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany

    Ralph G. Luthardt

  13. Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University Kiel, Kiel, Germany

    Matthias Kern

Authors
  1. Daniel R. Reissmann
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  2. Guido Heydecke
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  4. Birgit Marré
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  13. Ralph G. Luthardt
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  14. Klaus W. Böning
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  15. Matthias Kern
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  16. Michael H. Walter
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Correspondence to Daniel R. Reissmann.

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Reissmann, D.R., Heydecke, G., Schierz, O. et al. The randomized shortened dental arch study: temporomandibular disorder pain. Clin Oral Invest 18, 2159–2169 (2014). https://doi.org/10.1007/s00784-014-1188-3

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  • DOI: https://doi.org/10.1007/s00784-014-1188-3

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