este estudo explorou variveis tcnicas , biolgicas e de satisfao no funcionamento de prteses parciais removveis ( pprs ) aps cinco anos de uso , comparando a avaliao do paciente e do cirurgio - dentista . cinqenta adultos ( 39 mulheres , 11 homens ) foram reexaminados aps cinco anos da instalao de ppr . atravs de exame clnico e questionrio estruturado , foram coletados os dados relativos s condies dos tecidos de suporte , aceitao e caractersticas tcnicas da ppr , mastigao , esttica , conforto , higiene e necessidade de interveno profissional . mais de 50% dos pacientes classificaram suas prteses como excelente quanto  reteno , mastigao , esttica , conforto e higiene . na avaliao do profissional , reteno e estabilidade foram consideradas excelentes em mais de 66% dos pacientes , e a higiene dos dentes e da prtese foi considerada boa em 52% e 46% dos casos , respectivamente . as armaes metlicas e bases acrlicas foram consideradas adaptadas em 92% dos casos . aceitao da prtese foi associada com reteno , mastigao , esttica , higiene e conforto avaliados pelo paciente , e com reteno , estabilidade e condio da armao metlica avaliadas pelo profissional . reteno e mastigao / conforto , avaliados pelo paciente , mostraram correlao positiva moderada com reteno e estabilidade medidas pelo profissional . aps cinco anos , a reabilitao oral com ppr estava satisfatria na maioria dos casos . oral rehabilitation with fixed or removable partial dentures ( rpds ) plays an important role in restoring oral and systemic health of edentulous patients . compared to fixed partial dentures , the advantages of rpds include lower cost and easier oral hygiene procedures4 . biological , mechanical , esthetic , and psychological factors are related to acceptance of prosthesis and , consequently , to the success of treatment . however , many controversies still exist about the determinants of rpd prognosis . success is judged differently by the patient and by the professional : the first judges personal satisfaction ; the second judges biological and technical aspects26 . comfort , masticatory ability , esthetics , and retention seem to be the most important factors for prosthesis acceptance26 . personality , attitude towards rpd , previous experience , and motivation are dependent on the patient and may influence general satisfaction12,28 . approximately sixty percent of rpds wearers have technical problems such as loss of integrity , excessive tooth wear , and loss of retention and stability19 . plaque accumulation and changes in the remaining teeth , such as caries , periodontal disease , and lesions of the mucosa , have been associated to rpd use8,16,23,24,27 . these deleterious effects on dental and supporting tissues may be mitigated if a maintenance program is undertaken , including oral hygiene instruction and motivation2,3,18as well as regular check - up by the dentist . thus , many questions arise in the clinics : which are the most important variables for the functional evaluation of rpds after placement ? the answers to these questions might help to determine which factors influence satisfaction and acceptance over time . therefore , the aim of this cross - sectional study was to carry out an exploratory analysis to determine technical , biological , and satisfaction variables for the evaluation of rpds after five years of delivery , comparing patient and professional assessments . one hundred twenty - nine partially edentulous patients from the removable partial denture clinic , dental school of the lutheran university of brazil , canoas / rs , were contacted by phone and invited to participate in this study , from june to december 2002 . the rpds were constructed by fourth - year undergraduate students , following the principles and methods of rpd fabrication adopted by the institution ( kratchovil , 1963)17 , during the second semester of 1997 . a convenience sample was selected within the five - year timespan and the patient 's agreement to participate . the sample was composed of 50 patients , 11 males and 39 females , between 36 and 76 years old . the level of rpd acceptance was classified as " excellent " , " good " or " bad " . retention , mastication , esthetics , hygiene and comfort variables were classified as " excellent " , " good " , " regular " or " bad " . one examiner ( egr ) , a certified prosthodontist , carried out the clinical and prosthesis examination . the following variables were collected : 
 oral and prosthesis hygiene : using a plaque disclosing solution , the patient 's oral hygiene status were classified as " excellent " ( visible plaque in up to 25% of the dental surfaces ) ; " good " ( 25 to 75% of visible plaque ) ; or " bad " ( more than 75% of plaque ) ( adapted from benson and spolsky , 1979)1 . prosthesis hygiene status was classified in the same categories , evaluating the internal surface of acrylic bases ( adapted from tarbet , 1982)21.prosthesis retention : the level of retention was classified as " excellent " ( resistance to vertical displacement ) ; " good " ( moderate resistance to vertical displacement ) ; or " bad " ( no resistance to vertical displacement)1.prosthesis stability : the stability of rpds was classified as " excellent " ( stable to rocking movement and the occlusal rests were seated ) ; " good " ( stable , but some rests were not seated ) ; or " bad " ( displaced by rocking movement)1.metallic framework and acrylic base : the framework was classified as " well - fitting " ; " with misfit in rests and clasps " ; or " fractured " . the adaptation of the base to the bearing mucosa was classified as " well - fitting " ; " moderate misfit " ; or " total misfit " 1.prosthetic needs : the rpd was evaluated in relation to the need of relining , repair or new confection , being classified as " need of intervention " or " no intervention needed " . oral and prosthesis hygiene : using a plaque disclosing solution , the patient 's oral hygiene status were classified as " excellent " ( visible plaque in up to 25% of the dental surfaces ) ; " good " ( 25 to 75% of visible plaque ) ; or " bad " ( more than 75% of plaque ) ( adapted from benson and spolsky , 1979)1 . prosthesis hygiene status was classified in the same categories , evaluating the internal surface of acrylic bases ( adapted from tarbet , 1982)21 . prosthesis retention : the level of retention was classified as " excellent " ( resistance to vertical displacement ) ; " good " ( moderate resistance to vertical displacement ) ; or " bad " ( no resistance to vertical displacement)1 . prosthesis stability : the stability of rpds was classified as " excellent " ( stable to rocking movement and the occlusal rests were seated ) ; " good " ( stable , but some rests were not seated ) ; or " bad " ( displaced by rocking movement)1 . metallic framework and acrylic base : the framework was classified as " well - fitting " ; " with misfit in rests and clasps " ; or " fractured " . the adaptation of the base to the bearing mucosa was classified as " well - fitting " ; " moderate misfit " ; or " total misfit " 1 . prosthetic needs : the rpd was evaluated in relation to the need of relining , repair or new confection , being classified as " need of intervention " or " no intervention needed " . data were analyzed by descriptive statistics and by spearman 's correlation tests at the 0.05% level of significance . spearman 's correlation coefficients ( rs ) tested the association between acceptance of rpd and variables evaluated by the patient and by the professional . one hundred twenty - nine partially edentulous patients from the removable partial denture clinic , dental school of the lutheran university of brazil , canoas / rs , were contacted by phone and invited to participate in this study , from june to december 2002 . the rpds were constructed by fourth - year undergraduate students , following the principles and methods of rpd fabrication adopted by the institution ( kratchovil , 1963)17 , during the second semester of 1997 . a convenience sample was selected within the five - year timespan and the patient 's agreement to participate . the sample was composed of 50 patients , 11 males and 39 females , between 36 and 76 years old . the level of rpd acceptance was classified as " excellent " , " good " or " bad " . retention , mastication , esthetics , hygiene and comfort variables were classified as " excellent " , " good " , " regular " or " bad " . one examiner ( egr ) , a certified prosthodontist , carried out the clinical and prosthesis examination . the following variables were collected : 
 oral and prosthesis hygiene : using a plaque disclosing solution , the patient 's oral hygiene status were classified as " excellent " ( visible plaque in up to 25% of the dental surfaces ) ; " good " ( 25 to 75% of visible plaque ) ; or " bad " ( more than 75% of plaque ) ( adapted from benson and spolsky , 1979)1 . prosthesis hygiene status was classified in the same categories , evaluating the internal surface of acrylic bases ( adapted from tarbet , 1982)21.prosthesis retention : the level of retention was classified as " excellent " ( resistance to vertical displacement ) ; " good " ( moderate resistance to vertical displacement ) ; or " bad " ( no resistance to vertical displacement)1.prosthesis stability : the stability of rpds was classified as " excellent " ( stable to rocking movement and the occlusal rests were seated ) ; " good " ( stable , but some rests were not seated ) ; or " bad " ( displaced by rocking movement)1.metallic framework and acrylic base : the framework was classified as " well - fitting " ; " with misfit in rests and clasps " ; or " fractured " . the adaptation of the base to the bearing mucosa was classified as " well - fitting " ; " moderate misfit " ; or " total misfit " 1.prosthetic needs : the rpd was evaluated in relation to the need of relining , repair or new confection , being classified as " need of intervention " or " no intervention needed " . oral and prosthesis hygiene : using a plaque disclosing solution , the patient 's oral hygiene status were classified as " excellent " ( visible plaque in up to 25% of the dental surfaces ) ; " good " ( 25 to 75% of visible plaque ) ; or " bad " ( more than 75% of plaque ) ( adapted from benson and spolsky , 1979)1 . prosthesis hygiene status was classified in the same categories , evaluating the internal surface of acrylic bases ( adapted from tarbet , 1982)21 . prosthesis retention : the level of retention was classified as " excellent " ( resistance to vertical displacement ) ; " good " ( moderate resistance to vertical displacement ) ; or " bad " ( no resistance to vertical displacement)1 . prosthesis stability : the stability of rpds was classified as " excellent " ( stable to rocking movement and the occlusal rests were seated ) ; " good " ( stable , but some rests were not seated ) ; or " bad " ( displaced by rocking movement)1 . metallic framework and acrylic base : the framework was classified as " well - fitting " ; " with misfit in rests and clasps " ; or " fractured " . the adaptation of the base to the bearing mucosa was classified as " well - fitting " ; " moderate misfit " ; or " total misfit " 1 . prosthetic needs : the rpd was evaluated in relation to the need of relining , repair or new confection , being classified as " need of intervention " or " no intervention needed " . data were analyzed by descriptive statistics and by spearman 's correlation tests at the 0.05% level of significance . spearman 's correlation coefficients ( rs ) tested the association between acceptance of rpd and variables evaluated by the patient and by the professional . table 2shows the results of the evaluation of rpd related variables by the patient . more than 70% of patients classified their prostheses as " excellent " for retention , mastication , and comfort . retention and stability had 98 and 96% of approval , respectively ( " excellent " and " good " categories ) . oral and prosthesis hygiene evaluations were " bad " for 34 and 20% of cases , respectively . the framework was " well - fitting " in 92% , " misfit in rests and clasps " in 4% and " fractured " in 4% of subjects ; acrylic base was " well - fitting " in 92% , " moderate misfit " in 6% and " totally misfit " in 2% ( data not shown ) . spearman 's coefficients of correlation between patient 's rpd acceptance and other variables are shown in table 4 . regarding patient evaluation , retention , mastication , esthetics , hygiene , and comfort were significantly associated with acceptance . for the professional evaluation , retention , the responses by the patient and by the professional were compared using spearman 's coefficients of correlation ( table 5 ) . mastication and comfort ( patient evaluation ) correlated positively with stability ( professional evaluation ) . hygiene evaluated by the patient had no association with oral hygiene evaluated by the professional , as well as prosthesis hygiene . regarding the relationship between rpd acceptance by the patient and the professional evaluation for need of intervention , 74% of subjects rated their satisfaction level as " excellent " even when intervention was considered needed . in this exploratory study , technical and biological variables evaluated by the patient and by the professional were related to the success of treatment with rpds after five years of placement , considering the association of those variables with the level of general acceptance . retention , chewing and comfort evaluated by the patient had an approval rate greater than 70% . comfort , esthetics , prosthesis biomechanics and abutment prognosis must be considered by the clinician for the framework design6 . simplicity of rpd framework influences mechanical ( retention and stability ) and biological ( health of oral tissues ) factors and , consequently , general satisfaction15 . most patients who rated the comfort with their rpds as " excellent " had prostheses supported by teeth and mucosa , which contradicts previous studies that reported a relationship between kennedy class i and class ii rpds and discomfort7,22 . however , in relation to masticatory evaluation , the results are in accordance with gunne and wall13(1985 ) , who found that rpds with distal extension do not negatively influence the subjective experience of mastication . excellence rates for retention ( 66% ) and stability ( 70% ) by the clinician were in accordance with the technical conditions of the framework and base ( adequate adaptation in 92% of patients ) . the major complications related to rpds are mechanical failures such as fracture of connectors and occlusal rests and distortion of retentive clasps , besides misfit of bases and occlusal problems , which influences denture retention and stability5 . excessive force transmission to periodontal tissues and poor oral hygiene may increase the incidence of caries and periodontal disease in rpd users6but a cause - effect relationship has not been proved yet . seventy - four percent of patients rated their acceptance level as " excellent " even if an intervention was indicated by the professional evaluation . van waas , et al.22(1994 ) reported that masticatory performance increases with the addition of occlusal units to the rpd . about two thirds of subjects had distal extension rpds ( kennedy class i and ii ) and the large number of occlusal units may be responsible for this high level of acceptance . we found association between rpd acceptance and retention , chewing , comfort , esthetics , and hygiene ( patient evaluation ) , and retention , stability , and metallic framework status ( professional evaluation ) . those variables are dependent on the rpd design showing the importance of adequate planning and rpd fabrication as predictors of patient satisfaction12 . comparing the patient and the professional evaluations , other studies have compared patient and professional evaluations of fixed partial , complete , and implant - supported prostheses9,10,14,20but few are related to rpds . zlataric and celebic26(2001 ) reported that the patient evaluation of rpd was opposite to the prosthodontist assessment : the more satisfied patients had lower rates in the professional evaluation , while the less satisfied patients showed higher professional rates . this may indicate that different dimensions are considered by the patient and by the professional to rate rpd clinical success . the limitations of our study are the sample size and the fact that the study subjects can not be considered representative of the entire population of rpd wearers ' . further epidemiological studies on rpd acceptance and professional - patient evaluation of long term functioning should include more subjects from different settings to increase external validity . longitudinal studies would allow the analysis of the evolution of technical , biological , psychological , and social aspects , assessed both by the professional and by the patient . in this study , oral rehabilitation with rpd was considered satisfactory after five years of use by most patients . even in the absence of regular recalls , patients classified their prosthesis as " excellent " in relation to technical and biological variables , which were associated with the level of general acceptance . the correspondence of ratings for technical aspects between patient and professional evaluations can be explained by the patients ' receptive attitude towards rpds , which must be assessed by the clinician during all phases of the dental treatment to optimize the long term clinical success .
most removable partial denture ( rpd ) wearers are satisfied with their prostheses , but the factors that influence satisfaction and acceptance are still not determined.objective:this study explored technical , biological , and satisfaction variables for the functioning of rpds after five years , and compared the evaluation by the patient and by the clinician.materials and methods : fifty adults ( 39 females , 11 males ) were reexamined after five years of rpd service . 
 data were collected through clinical examination and a structured questionnaire to record the conditions of supporting soft tissues , prosthesis acceptance and technical characteristics , mastication , esthetics , comfort , hygiene , and need for professional intervention . 
 data were analyzed by descriptive statistics and spearman correlation.results:more than 50% of patients classified their rpds as excellent regarding retention , mastication , esthetics , comfort , and hygiene . in the professional evaluation , retention and stability 
 were considered excellent in more than 66% of cases , and hygiene of teeth and prostheses was considered good in 52% and 46% , respectively . 
 the metallic framework and acrylic base were considered adapted in 92% of cases . 
 prosthesis acceptance was associated with retention , mastication , esthetics , hygiene , and comfort evaluated by the patient , and with retention , stability , and condition of the framework evaluated by the clinician . 
 retention and mastication / comfort evaluated by the patient had moderate positive correlation with retention and stability measured by the clinician . 
 there was no association of hygiene evaluation by the patient and by the clinician.conclusions:after five years , the oral rehabilitation with rpds was satisfactory for most cases 
 . there was correspondence between retention / retention and mastication - comfort / stability variables evaluated by the patient and by the clinician . 
 oral and prosthesis hygiene were not related .