Partial Edentulism and its Correlation to Age, Gender, Socio-economic Status and Incidence of Various Kennedy's Classes- A Literature Review.

Partial edentulism, one or more teeth missing is an indication of healthy behaviour of dental practices in the society and attitude towards dental and oral care. The pattern of partial edentulism has been evaluated in many selected populations in different countries by different methods. Most of the studies have evaluated partial edentulism by surveying of Removable Partial Dentures (RPDs), patients visiting clinics, clinical records and population in particular locality. The objective of the study is to review the prevalence of partial edentulousness and its correlation to age,gender, arch predominance, socio economic factors and incidence of various Kennedy’s Classes. Key observations drawn from the review are as below. There is no gender correlation for partial edentulism. Prevalence of partial edentulism is more common in mandibular arch than maxillary arch. Younger adults have more Class III and IV RPDs. Elders have more distal extension RPDs Class I and II. Keywords: Edentulousness, Removable partial denture, Survey Introduction Partial edentulousness is a dental arch in which one or more but not all natural teeth are missing. Generally, it occurs by caries, periodontal problems, traumatic injuries, impactions, supernumerary teeth, neoplastic and cystic lesions [1–4]. Some studies have reported caries as the main causative agent for tooth loss [5–7]. According to Zaigham et al., and Abdel Rahman et al., dental caries and periodontal disease were the major causes of tooth loss in early childhood and adolescence [2,4]. Also, studies have documented that age correlates positively with partial edentulism [1,3,4]. Partial edentulism leads to several drawbacks to the subjects including clinical challenges and lifestyle compromises. Clinically, partial edentulism results in drifting and tilting of adjacent teeth, supra eruption of opposing teeth, altered speech, changes in facial appearance and tempero-mandibular disorders [1,2,8]. Also, the loss and continuing degradation of the alveolar bone, the adjacent teeth and also the supporting structures will influence the difficulty to achieve an adequate restoration in a partially edentulous patient [9]. On the lifestyle compromises, partial edentulism restricts dietary options, which leads to weight loss. Further, it leads to lack of confidence and confined social activities, which may adversely affect the quality of life and lead to psychological dissatisfaction [1]. Partially edentulous arches have been Classified by various methods. The possible combinations of partial edentulism are more than 65,000 depending on their incidence in maxillary and mandibular arches [2,10]. The primary objective of the classification is to facilitate the communication about the combination of missing teeth to edentulous ridges among students, dental practitioners and laboratory technicians [1,4,10–15]. Among the various methods of classification like Kennedy, Applegates, Avant, Neurohar, Eichner, ACP (American College of Prosthodontics) etc, Kennedy’s classification is widely studied and clinically accepted by Dental Community [2,3,9,14]. As per Kennedy’s classification, there are four main types of partially edentulous arches as Class I, Class II, Class III and Class IV. Kennedy’s classification is widely accepted due to its advantages of immediate visualization and recognition of prosthesis support [2,3,10]. The patterns in the incidence of the various Classes of removable partial dentures should be reviewed periodically to serve as teaching guidelines [2,16]. Partial edentulism is one of the widely studied topics in dentistry. The pattern of partial edentulism has been evaluated in many selected populations in different countries. Several studies have analysed the correlation between partial edentulism and its influencing factors like socio-economic parameters, age, gender, etc, [1,2,4–6,8,12,15,17–20]. Few studies also have analysed the awareness among the subjects to replace the missing teeth [1,5,7,8,16–20]. Surveying of RPDs, patients visiting clinics, clinical records and population in a particular locality have been the common method of evaluation of partial edentulism. Most commonly, studies have been done by recording patient details through questionnaire and then by clinical examination. The aim of this literature review was to analyse the prevalence of partial edentulousness and its correlation with gender, age, socio-economic factors, arch predominance and incidence of various Kennedy’s Classes by reviewing various surveys to identify the factors of significant influences. Selection of studies There are numerous scholarly articles available on partial edentulism in various journals of international and national publishers. For this study, articles were selected by web searching pubmed indexed and non-indexed journals with key words like “Partial Edentulism”, “Survey of Partial edentulism”, “incidence of Kennedy’s Classes”, etc. Studies with surveys on partial edentulism and its various impacting factors like age, gender, socio-economic status and incidence Kennedy’s Classes were selected from 1990 till 2014.