Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.004 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".