Prevalence And Pattern Of Partial Edentulism According To Kennedy’s Classification - A Retrospective Study
P. Deeksheetha1, Kiran Kumar Pandurangan2*, Nashra Kareem3
1 Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
2 Senior Lecturer, Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
3 Senior Lecturer, Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
*Corresponding Author
Dr. Kiran Kumar Pandurangan,
Senior Lecturer, Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, 162, P.H Road
Chennai 600077, Tamil Nadu, India.
Tel: +91-7010782807
E-mail: kirankumar.sdc@saveetha.com
Received: July 30, 2021; Accepted: August 11, 2021; Published: August 18, 2021
Citation:P. Deeksheetha, Kiran Kumar Pandurangan, Nashra Kareem. Prevalence And Pattern Of Partial Edentulism According To Kennedy’s Classification -
A Retrospective Study. Int J Dentistry Oral Sci. 2021;8(8):4114-4118. doi: dx.doi.org/10.19070/2377-8075-21000840
Copyright: Dr. Kiran Kumar Pandurangan©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Partial edentulous patients require replacement of missing teeth in order to restore function and aesthetics. The pattern of tooth loss due to trauma, dental caries, compromised periodontal health, poor oral hygiene maintenance. There are numerous methods of classification of partially edentulous arches of which the most commonly used is Kennedy's Classification. The prevalence and pattern of partial tooth loss is foremost important to identify the need for prosthetic replacement and the studied community. Therefore, the objective of this study is to determine the prevalence of partial Edentulism among dental patients according to Kennedy’s Classification. A retrospective study was conducted among dental patients by reviewing the 86,000 patient records between June 2019 to November 2019 from which 665 patients of partial edentulism and assessed for pattern, age, gender and arch of partial edentulism. The collected data was tabulated in the excel sheet and the data was transferred to the SPSS version 20 for statistical analysis. Among the 665 patients 366 were males and 299 were females. The prevalence of partial edentulism is more among 41-50 years of age with male predilection. The most prevalent pattern is Kennedy’s Class III followed by Class II. The prevalence of age and Kennedy’s classification shows a positive correlation.
2.Introduction
3.Conclusion
4.References
Keywords
Kennedy’s Classification; Oral Health; Partially Edentulous; Tooth Loss.
Introduction
Edentulism is an oral health indicator of a population [1]. Partial
edentulism indicates to which one or more teeth are missing.
The pattern of tooth loss due to the following factors such as
caries, periodontal problems, traumatic injuries, impactions, supernumerary
teeth, neoplastic and cystic lesions [2]. Few studies
have reported that dental caries as the major inductive agent for
tooth loss [3] Maintenance of oral health has a great contribution
towards the quality of life. Tooth loss affects the diet and nutrition
of an individual which may result in poor general health [4]
Partial edentulism can impede the chewing ability and esthetics
[5] Replacement of missing teeth is essential to restore the aesthetics,
function, phonetics [6] Incidence of tooth loss has been
reduced significantly in many countries in recent decades [7] In
dentistry, Aloe vera has been used for anticipation of periodontal
and gum diseases [8].
They are feasible combinations of partial edentulism are more
than 65,000 depending on their prevalence in maxillary and mandibular
arches [8, 9]. Prevalence of the various classes of partial
edentulism should be checked routinely to provide teaching instructions
[8-10] The goal of classification is to facilitate communication
among dentist and laboratory technicians[11].
Various methods of classification of partially edentulous arches
such as Avant, Applegates, Neurohar, Kennedy, Eichner, ACP
(American College of Prosthodontics). Kennedy’s classification
is the most widely accepted classification [11, 12], due to
its immediate visualization of the edentulous site and helps to
design the prosthesis [13]. Although it is very difficult in every
situation that is suggested by Applegate aimed at integrating the
clinical situations [14]. Many studies of partial edentulism have
been determined in different countries among various populations [14, 15]. Prevalence of tooth loss on epidemiologic studies
differs between geographic regions within countries and
between countries [14-16]. Several studies have been done to
record patient details through questionnaires and clinical examination.
Previously our team has a rich experience in working
on various research projects across multiple disciplines.
[17-31]. Now the growing trend in this area motivated us to pursue
this project. Hence, the aim of this present study was to determine
the prevalence and pattern of partial edentulism according
to Kennedy’s classification.
Materials and Methods
A retrospective study was conducted among dental patients by
reviewing the 86,000 patient records between 01stJune 2019 and
30thNovember 2019 from which 665 patients of partial edentulism
and assessed for pattern, age, gender and arch of partial
edentulism. The ethical clearance was obtained from the institutional
review board, IEC approval number: SDC/SIHEC/2020/
DIASDATA/0619-0320 and also informed consents were obtained
from the patients. The patients were grouped into five
groups, Group 1- 21 to 30 years; Group 2- 31 to 40 years; Group
3- 41 to 50 years; Group 4- 51 to 60 years; Group 5- >60 years.
Patients aged 21–80 years and both genders were included in the
study. Patients having modifications, complete edentulism, missing
third molars and incomplete data were excluded from the
study. Clinical examinations of the maxillary and mandibular arch
of the patients were analyzed. The data obtained were cross verified
with intra oral photographs by another examiner. The data
were obtained and tabulated in excel sheets which were imported
to SPSS version 20 (IBM corporation). Descriptive statistics and
Chi square test was used to determine the correlation between the
variables where P value < 0.05 is considered statistically significant
with a confidence interval of 95%.
Results & Discussion
A total of 665 patients with the partial edentulism 366 were males
(55.04%) and 299 females (44.96%) aged between 21 and 80 years
which shows that male predilection (Figure 1). Among age groups
41-50 years (26.32%) of age showed high prevalence of partial
edentulism and least prevalence age groups 21-30 years (12.33%)
(Figure 2). The incidence of various patterns of partial edentulism
was found to be Class III type (50.23%) followed by class
II (18.65%), class I (15.64%) and class IV (15.49%) (Figure 3).
The results showed the incidence of Class III partial edentulism
was more in both the maxillary arch (48.2%) and mandibular arch
(51.8%) when compared to others (Figure 4). Similarly, the Class
III Kennedy’s was found more in all age groups respectively (Figure
5). In the study, the occurrence of Class III Kennedy’s was
high in both male and female patients of about 55.1% and 44.9%
(Figure 6). Males showed higher prevalence than females in both
the arches (Figure 7). Among age groups 41-50 years showed
more prevalent in both the arches.
Previously our team has conducted numerous original studies [32-
45] over the past 5 years. The idea for this study stemmed from
the current interest in our community. Oral hygiene is a key indicator
towards the quality of life such as psychological , biologic
and social levels [46].
In the present study, among 665 patients with the partial edentulism 366 males and 299 females. We observed that the prevalence
of partial edentulism was more in males when compared
to females and similar study seen by Gupta et al, [15] The present
study is consensus with previous studies of D’ Sousa et
al, (3,46). The most common age groups with the prevalence of
partial edentulism was 41-50 years of age group. Similar studies
were done by Agarwal et al., [47] and by Hama et al., [48]. In contrast,
with the previous studies were done by Madhakumar et al, [7], Araby et al, [49], Akinboboye et al, [50], with the average age
of 36.5 years. Kennedy’s Class III pattern is the most common
of partial edentulism in this present study. Based on the arch, the
prevalence of Kennedy’s Class III was observed more in both the
genders.
The prevalence of the Class III pattern of partial edentulism
was more common in both arches. The result of the present
study is in accordance with the studies of Shah et al., [51]Arivan
Mahmood Hama et al., [48]. Based on age, there is more prevalence
of Class III Kennedy’s in 41–50 years and less prevalence
of Class IV Kennedy’s in 21–30 years. These results are disparity
to study by Prabhu et al. [48, 52]. According to the genders, the
prevalence of Kennedy’s Class III was observed more in male
than females and the similar study was done by Prabhu et al., [52]
wherein Kennedy’s Class III type was more prevalent in males.
The result is contradictory with the study of Rana B et al., [53].
The present study shows a significant correlation between age and
Kennedy’s classification. Few studies have concluded that there is
significant correlation between gender and partial edentulism of
Kennedy's classification Medina-Sollis et al, [54] ,Vadavadagi et
al, [55]. However, the present study shows no significant association
between gender and partial edentulism of Kennedy’s classification.
Our institution is passionate about high quality evidence
based research and has excelled in various fields [56-66]. We hope
this study adds to this rich legacy.
The limitations of the present study is the limited sample size
and was conducted in an institution-based set-up.This was a single
centred study and was geographically restricted.Hence, further
study is required to explore multi centred aspects of partial edentulism
in a larger population along with the assessment of the
socio-economics status and the nutritional status.
Figure 1. This bar chart depicts gender wise distribution of partial edentulism patients. The X axis represents gender of the patients, Y axis shows the number of Patients with partially edentulous arches. A total of 299 female patients (Blue colour) and 366 Male patients (Red colour) were observed. Male predominance was observed among partially edentulous patients.
Figure 2. This bar chart depicts age wise distribution of partial edentulism patients. Prevalence of partial edentulism was more in the age groups of 41-50 years (26.32%) (Green colour), followed by 51-60 years (24.96%) (Orange colour), above 60 years (22.11%) (Yellow colour), 31-40 years (14.29%) (Red colour) and 21-30 years (12.33%) (Blue colour).
Figure 3. This bar chart depicts various classes of Kennedy’s classification among partial edentulism. The incidence of various patterns of partial edentulism was more in Class III type (50.23%) (Green colour), followed by Class II (18.65%) (Red colour), Class I (15.64%) (Blue colour) and Class IV (15.49%) (Orange colour).
Figure 4. This bar chart depicts the association between Kennedy’s Classification and partially edentulous Site.X axis represents partially edentulous site and Y axis represents the Number of Patients with partially edentulous arches. Blue colour represents Class I, red colour represents Class II, green colour represents Class III, orange colour represents Class IV. Class III more predominant in both maxillary and mandibular arches. Incidence of Class III 51.2% in mandibular arch and 48.2% in maxillary arch. In this graph, Class III is more prevalent in mandibular arch. Chi square test shows statistically not significant. [Pearson’s Chi-square test showing p value=0.835 (p >0.05)]
Figure 5. This bar chart depicts the association between age of the patients and Kennedy’s classification. X axis denotes age of the patients and Y axis denotes the number of Patients with partially edentulous arches. Blue colour denotes Class I, red colour denotes Class II, green colour represents Class III, orange colour denotes Class IV. In this graph, Class III Kennedy’s most prevalent in the 41-50 years age group. Overall incidence of class III 50.23%. Chi square test shows statistically significant. [Pearson’s Chi-square test showing p value = 0.000 (p <0.05)]
Figure 6. This bar chart depicts the association between gender of the patients and Kennedy’s classification. X axis denotes gender of the patient and Y axis denotes the Number of Patients with partially edentulous arches. Blue colour denotes Class I, red colour denotes Class II, green colour denotes Class III, orange colour denotes Class IV. In this graph, Class III Male (55.1%) female (45.9%), incidence of class III in Male patients was found to be more than females. Chi square test shows statistically not significant. [Pearson’s Chi-square test showing p value =0.401 (p >0.05)].
Figure 7. This bar chart depicts the association between genders and edentulous arches X axis denotes partially edentulous sure and Y axis denotes the Number of Patients with partially edentulous arches.Blue colour denotes female patients, while the red colour denotes male patients. In this graph,Partial Edentulism in maxillary and mandibular arches more commonly in male patients than female patients. Chi square test shows statistically not significant. [Pearson’s Chi-square test showing p value = 0.78 (p> 0.05)].
Figure 8. This bar chart depicts the association between age and edentulous arches X axis denotes partially edentulous sure and Y axis denotes the Number of Patients with partially edentulous arches. Blue colour denotes 21-30 years of age, red colour denotes 31-40 years of age, green colour denotes 41-50 years of age, orange colour denotes 51-60 years of age and yellow colour denotes above 60years of age. Highest incidence of partial edentulism in maxillary (49.7%)and mandibular (51.3%) arches belong to the 41-50 years of age patients. Incidence of class III slightly higher in the mandibular arch than maxillary arch. Chi square test shows statistically not significant. [Pearson’s Chi-square test showing p value =0.779 (p >0.05)].
Conclusion
Within the limits of the study, it can be concluded that the Class
III was the most common type of Kennedy’s classification and
prevalence of partial edentulism is more among 41-50 years of
age with male predilection. Information on tooth loss is needed
to form a generalized database for the partial edentulism patterns.
It will help us to identify the causes of such tooth loss and its
prevention.
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