Evaluating a Removable Prosthesis Clinical Protocol: Objective and Subjective Outcomes

Objectives:   The purpose was to assess the outcomes of a newly introduced four-visit removable prosthesis protocol that was used with senior dental students in a community-based educational setting. The objectives were to evaluate (a) the objective outcomes with a Test Case Competency Evaluation, and (b) the subjective outcomes as assessed with a patient survey.

Methods:   Senior students who were on rotations in a community dental clinic were introduced to a new four-visit removable dental prosthesis protocol.  Patients were screened using the PDI index, and class I or II patients were enrolled. Intra-oral photographs were taken at all four appointments. Photographs were also taken of the impressions and master models. Dental student performance was evaluated using the “Test Case Competency Evaluation” and photographic comparisons as objective assessment outcomes. Twenty-six patients provided subjective outcome data in baseline, delivery appointment, and one-month post delivery surveys.

Results: Fifty impressions, master models and delivered prostheses were evaluated using the “Test Case Competency Evaluation”. On the four-point test criteria scale with R (= highest evaluation), S, T, and V (= lowest evaluation), 85% of the impressions and master models were scored as R and 15% as S; 90% of the prostheses were scored as R and 10% as S. The patients' oral health-related quality of life (qol) improved from the baseline to the delivery and to the completion appointments (on a scale with 1=best qol and 5=worst qol: 3.01 vs. 1.97 vs. 1.44; p<.001). After completion, the patients evaluated the dentures as very effective overall (4.52), effective in speaking (4.10) and chewing (4.71), and for their looks (4.71). The patients evaluated the dental students’ performance very positively.

Conclusions: The outcome data showed that the treatment provided based on this new four-visit protocol was efficient and assured the delivery of high quality prostheses.