Patient Satisfaction and Marginal Bone Loss Of Different Treatment Modalities Of Mandibular Kennedy Class II Cases

Objectives: This research was carried out to evaluate patient satisfaction and marginal bone loss of different treatment modalities (using double OT attachment, double OT with posterior implant and conventional partial denture) of Kennedy class II cases.
Materials and Methods: Totally, twenty-one patients with unilateral distal extension partially edentulous lower arches were randomly assigned into three groups (Group A, B&C). Group (A): patients were rehabilitated with removable partial denture retained by unilateral double OT attachment. Group (B): patients were rehabilitated with removable partial denture retained by unilateral double OT attachment and a dental implant placed in a second molar area with 3.7 mm diameter and 10 mm length. Group (C): patients were rehabilitated with a conventional removable partial denture. Patients were selected with following criteria: Patients with mandibular Kennedy class II with the second premolar as last standing abutment, The remaining teeth should be free from periodontal diseases , Patients should exhibitied sufficient interarch space, with healthy supporting structures and abutments with 1:1.5 crown root ratio, and should have sufficient bone height > 12mm and bone width > 6mm for implant placement. In this study, marginal bone height changes around premolar teeth were evaluated at the time of prostheses insertion, six months and one year later and patient satisfaction was evaluated one month after insertion.
Results: Insignificant difference was detected between the three groups at the different follow-up intervals, regarding marginal bone loss. After one year follow up, bone loss was 0.17±0.04, 0.14±0.054 mm for group A, 0.09±0.05, 0.11±0.043 mm for group B and 0.15±0.034, 0.13±0.044 mm for group C on the distal and mesial sides of the second premolar respectively. On the other hand, regarding ease of cleaning, group C showed higher median value (86) compared to group A (64) and group B (51) and Kruskal Wallis test showed sig difference between group C and group B. Overall patient satisfaction and comfort during eating group A and group B showed statistically significant higher median value compared to group C and Kruskal Wallis test showed signigcant difference between group C and other groups. Conclusion: Within the limitations of this study, it could be concluded that for unilateral partially edentulous patients, all the treatment modalities constructed in this study are reliable options regarding marginal bone loss, but for overall patient satisfaction and comfort with eating, unilateral partial dentures retained by double OT attachment with or without posterior implant are better than conventional removable partial dentures however regarding ease of cleaning conventional partial dentures showed better results.