Notice bibliographique
Résumé
What Is the Issue? Partial and complete edentulism, or tooth loss, affects millions of people in Canada. It can influence the ability to chew and speak, change facial structure and appearance, and affect physical and mental health. Treatment options for edentulism include removable partial and complete dentures. Removable denture bases are conventionally made with acrylic or cast metal. Newer materials, including thermoplastics, are of more interest as they create more flexible dentures and may provide better function, aesthetics, and comfort. However, they may be more expensive than conventional dentures. The relative clinical and cost-effectiveness of removable flexible thermoplastic dentures compared to conventional dentures is unclear. The need for this review was identified by a policy decision-maker, and this review is a response to that request. What Did We Do? We conducted a Rapid Review to summarize evidence comparing the clinical effectiveness and cost-effectiveness of removable partial or complete flexible dentures to removable conventional (acrylic or metal) partial or complete dentures. We also sought to identify evidence-based guidelines regarding the use of removable partial or complete flexible dentures for this patient population. We searched key resources, including journal citation databases, and conducted a focused internet search for relevant evidence published since 2019. We also screened literature included in a previous Canada’s Drug Agency (formerly CADTH) report. What Did We Find? We identified 7 randomized controlled trials and 1 nonrandomized controlled study evaluating the clinical effectiveness of removable flexible partial or complete dentures compared to removable conventional partial or complete dentures. No cost-effectiveness evaluations or evidence-based guidelines that met our inclusion criteria were identified. No identified studies were conducted in Canada; studies were conducted in Africa, Asia, and Europe and included diverse participants in terms of number and locations of missing teeth, and diverse denture materials. Findings from the included studies suggest that, compared to removable conventional dentures, removable flexible dentures may improve several clinical outcomes (e.g., aesthetics and overall satisfaction), may be comparable for others (e.g., speech, pain while eating, and prosthesis fractures or discoloration), and may be inferior for others (e.g., denture retention). The comparative clinical effectiveness between these devices for other outcomes (e.g., chewing ability, oral health-related quality of life, and effort for maintenance) was inconsistent across studies and measurement methods. The included clinical studies may be at risk of bias given that many outcomes were measured subjectively with methods of unknown validity, and patients and outcome assessors were aware of the treatments received. We did not identify studies with sufficient follow-up to inform the relative durability of these devices over a denture’s lifespan, and there is uncertain generalizability of the evidence to the context in Canada. What Does This Mean? The evidence informing the comparative clinical effectiveness of removable partial or complete flexible dentures and removable partial or complete conventional dentures is inconsistent across the outcomes of primary interest to patients, clinicians, and payers. While there is evidence that removable flexible dentures may be similar or superior to removable conventional dentures for some outcomes, they may be inferior for others. Due to their relative cost, comparative cost-effectiveness research would help inform the potential role of these denture options in Canada. Future research should focus on large, well-designed clinical trials and cost-effectiveness research in health systems within Canada with validated outcome measurement tools, clear reporting, and longer follow-up. Additionally, it is important to explore the relative value placed on outcomes for different groups, including patients, clinicians, and payers and how these may differ by factors such as age, degree of edentulism, access to technology and materials, and access to oral health care services and insurance.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,004 |
| Bibliométrie | 0,005 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».