[The shortened dental arch - philosophy, examination and clinical application].

Abstract

In the evolution of the human race we can observe a drastic change in oral functions. The question can be raised whether there is still an optimal relation between form and function of the dentition of modern man. In our cultural pattern shortened dental arches are frequently seen, as molars are often and seriously afflicted by caries and periodontal disease. The necessary restorative treatment is often omitted because of lack of motivation and/or financial limitations. Treatment by fitting free-end removable partial dentures introduces unfavourable conditions for the remaining dentition. A cross-sectional clinical investigation was carried out among 118 subjects with different shortened arches. The preliminary conclusion is that there is sufficient adaptive capacity to maintain adequate oral function in shortened dental arches when at least four occlusal units are left, preferably in a symmetrical position. Longitudinal research is needed to verify this conclusion. The advantages and disadvantages of shortened dental arches are presented and guidelines are mentioned to shorten dental arches in restorative dentistry. Clinical examples are given of cases where the existing shortened arches are restored in that condition, and of cases where the dental arch is shortened intentionally as part of the treatment plan.