Multifactorial determinants of complications and patient-reported outcomes in metal clasp-retained removable partial dentures

Abstract

PURPOSE. This cross-sectional study aimed to evaluate the distribution of complications in clasp-retained removable partial dentures (C-RPDs) and to investigate the influence of denture design parameters, denture age, and Kennedy and Eichner classifications on complication patterns and patient-reported outcomes. MATERIALS AND METHODS. 134 patients wearing 205 metal C-RPDs were included. Biological and mechanical complications were recorded. Denture design parameters (major connector type, clasp type and number, and rest number) were documented. Oral health-related quality of life Oral health-related quality of life (OHRQoL) and patient satisfaction were assessed using the OHIP-14 and a visual analog scale (VAS). Associations between complication patterns, design parameters, denture age, classifications and patient-reported outcomes were statistically analyzed. RESULTS. Mechanical complications were the most frequently observed complications. Mechanical complications and ulcerations were significantly associated with reduced OHRQoL. Denture age demonstrated a significant association with mechanical complications and patient-reported outcomes. Classifications showed limited associations with complications and did not influence patient-reported outcomes. Palatal plate and anteroposterior palatal strap designs were associated with physical pain and reduced speech satisfaction. In the mandible, dentures incorporating both circumferential and bar clasps demonstrated higher satisfaction, whereas the exclusive use of bar clasps was associated with increased physical disability. Higher numbers of rests and clasps were associated with lower overall OHIP-14 scores. CONCLUSION. Denture age and design characteristics were associated with complication patterns and patient-reported outcomes. Mechanical complications were more frequently observed in older dentures and, together with mucosal ulcerations, were associated with reduced OHRQoL. These findings suggest that individualized design strategies, regular follow-up, and timely maintenance may contribute to better mechanical stability and patient-centered outcomes in C-RPDs.