Abstract
Many treatment options are available for the management of the free end saddle. This paper reviews past and current treatment methods for management of this situation.
References
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Treatment options for the free end saddle
From Volume 38, Issue 6, July 2011 | Pages 382-388
Article
Figures published by the World Health Organization (WHO) reveal that the proportion of older people aged over 65 is currently growing at a faster rate than any other age group.1 As practitioners we are therefore far more likely to encounter partially dentate patients, highlighting the importance of being fully aware of methods of restoring the dentition.
A functional dentition has been defined as that which allows an individual to eat, speak, and socialize without active disease, discomfort or embarrassment.2,3 According to the WHO, a minimum number of 20 teeth are needed to fulfil this requirement2 and the Adult Dental Health Survey uses the presence of 21 teeth as an indicator of a functional dentition.4 Though many patients may possess a functional dentition according to the WHO, the number of teeth required to satisfy functional demands varies with each individual and the prosthetic replacement of missing teeth is commonly seen. Missing teeth are most likely to be replaced with a fixed or removable prosthesis in the 55–64 year age group.4 When considering the replacement of missing teeth, the distal extension saddle, particularly in the lower arch, presents a considerable challenge. This situation is encountered when there are no teeth at the distal end of an edentulous area, as seen in Kennedy Class I and II classifications.5 This lack of distal abutment teeth creates problems with support and retention should restorative treatment be sought.6 Though many management options are available, none appears to provide an ideal solution to this scenario. There are concerns regarding decreased oral function with a reduced occlusal table,6,7 and an increased prevalence of periodontal disease and caries when wearing both fixed and removable prostheses has been reported.8,9
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