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KENNEDY'S CLASSIFICATION - A STUDY DONE AT DOW INTERNATIONAL DENTAL HOSPITAL.

Byline: ZIAULLAH CHOUDHARY, PARDEEP KUMAR, MUHAMMAD AMIN and SOFIA MALIK

ABSTRACT

Partially edentulous arch classification helps to identify possible combination of teeth to edentulous ridges. Kennedy's classification provides immediate visualization, prosthesis support and design features for removable partial denture. Dietary intake and nutritional status is affected by poor oral hygiene and loss of teeth.

The aim of this study was to assess the incidence of different Kennedy's classification of partially edentulous to find the relationship with gender, arches, age, and profession. This study was carried out at the Department of Prosthodontics, Dow International Dental Hospital. The study was conducted randomly among 400 patients who were partially edentulous. A structured proforma was used to find out the edentulousness based on Kennedy's classification.

Kennedys class III was the most common class where as class IV the least found in patients with missing teeth.

Key Words: Kennedy's classification, Partially edentulousness, Tooth loss.

INTRODUCTION

Teeth are main functional component of oral cavity.1 Missing teeth cause difficulty in chewing foods, alteration of speech and unpleasant esthetics which greatly affect the quality of life.2 Tooth loss can occur due to periodontal problems, dental caries, poor oral hygiene, trauma, pulpal, peri radicular disease, orthodontics and prosthodontics indications and some systemic factors.3,13,14,19 Good oral hygiene and prevention of tooth loss improve the dietary, nutritional intake status and improves the living condition.4 Partially edentulous patients require the replacement of missing teeth to restore the function.5 Kennedy method of classification was originally proposed by Edward Kennedy in 1925.6

There are different classifications for classifying the partially edentulous arches. Cummer's Kennedy's, Applegate's, Neurohr, Bailyn, Wild, Skinner,7 Kennedy's classification are most commonly used and widely accepted because they provide immediate visualization. They allow the differentiation between tooth born and tooth tissue born partial dentures.9,10 There are several classification models being proposed for identifying the different types of dental arches in relation to prosthetic space, topography, mechanics and function, some of which includes the teeth and saddle area.11 The concept of this classification of partially dentate arches provides communication between dental students, dental technician for good treatment planning and design of the partial denture.12-15

METHODOLOGY

This study was carried out at the Department of Prosthodontics, Dow International Dental Hospital. The sample size was calculated by open-epi software. Study was conducted randomly among 400 patients from July to September 2015. Only partially edentulous patients of age group 25-75 years were included in this study. Data were collected through oral examination of both the upper and lower jaw of each patient and it was done after obtaining consent. Patients were examined, interviewed and data collected was filled in the structured proforma. The oral examination was performed using the Kennedy's classification and Applegate rules. Collected data were analysed by SPSS 16 version software by Chi-square test.

RESULT

Details of results can be seen in Table 1-4 and in Fig 1-2.

TABLE1: KENNEDY CLASSIFICATION

Kennedy's classification:

Class I###Bilateral edentulous area located

###posterior to remaining natural teeth

Class II###Unilateral edentulous area located

###posterior to remaining natural teeth.

Class III###A unilateral edentulous area with

###natural teeth both anterior and pos-

###terior to it

Class IV###Class-IV: Single but bilateral edentu-

###lous area located anterior to remaining

###natural teeth.

TABLE 2: APPLEGATE'S RULES FOR KENNEDY CLASSIFICATION

Applegate's Rules

Rule 1: Classification should follow rather than

###precede any extraction of teeth that might

###alter the original classification.

Rule 2: If the 3rd molar is missing and not to be

###replaced, it is not considered in the classi-

###fication.

Rule 3: If the 3rd molar is present and to be used

###as an abutment, it is considered in the

###classification.

Rule 4: If the second molar is missing and not be

###replaced, it is not considered in the classi-

###fication.

Rule 5: The most posterior edentulous area always

###determines the classification.

Rule 6: Edentulous areas other than those deter-

###mining classification are called modification

###spaces.

Rule 7: The extent of the modification is not con-

###sidered, only the number of additional

###edentulous area

Rule 8: There is no modification space in Class IV.

TABLE 3: GENDER AND KENNEDYS CLASSIFICATION

Upper Arch###Male###Female

Class-I###26###10

Class-II###42###40

Class-III###88###72

Class-IV###8###4

Total###164###126

TABLE 4: GENDER and KENNEDYS CLASSIFICATION

Lower Arch###Male###Female

Class-I###24###22

Class-II###40###54

Class-III###72###72

Class-IV###12###10

Total###148###158

TABLE 5: GENDER DISTRIBUTION AMONG DENTURE WEARER AND NON-WEARER

Type###Male###Female###Total

Denture wearer###82###66###148

Non denture wearer###126###126###252

DISCUSSION

Tooth loss is associated with various factors such as trauma, carries, periodontal disease, diabetes, and smoking.2 For this study Kennedys classification was used as it provides immediate visualization of partially edentulous space and easy description of potential combination between ridge and teeth.7

Results of this study indicate that the mandibular arch show more partially edentulous than maxillary arch. Kennedy's class-III was most common pattern of partially edentulism and was common in both arches maxilla (55%) and mandible (45%). This result was in agreement with the study of Bharathi M et al.15,16

Another study carried out by Butt et al showed results similar to the present study. Frequency of partially edentulous was higher in mandible arch (76.5%) as compared to maxilla (72.5%).17 In the current study males showed higher proportion of partially edentulous than females. The results were similar to the study carried out by Patel et al.1 Also similar result was found in the study done among the people aged above 65 years in Turkey which also showed low literacy level and female gender to be high-risk groups for tooth loss. Further, it was also observed that more unemployed people were partially edentulous than employed.9,17

CONCLUSION

The incidence of various classes of partially edentulous showed that Kennedys class-III more in males. Mandibular arch was seen partially edentulous was more than maxillary arch. Kennedys Class-III was seen more in age group 46-75 years. Unemployed females were found more edentulous. Aesthetics and mastication problems were the main reasons for seeking replacement of missing teeths.

REFERENCES

1 Patel Javid Yunus, Vohra Mohyuddin Y, Husain Junani Mohammed. Assessment of Partial Edentulous Patients Based on Kennedy's Classification. International Journal of Scientific Study September 2014;2:32-36.

2 Naveed H, Aziz MZ, Hassan A, Khan W, Azad AA. Patterns of partial edentulism among armed forces personnel reporting at Armed Forces Institute of Dentistry Pakistan. Pak Oral Dent J 2011; 31:217-21.

3 Jiang Y, Okoro CA, Oh J, Fuller DL. Sociodemographic and health-related risk factors associated with tooth loss among adults in Rhode Island. Prev Chronic Dis 2013; 10:E45.

4 Sapkota B, Adhikari B, Upadhaya C. A Study of Assessment of Partial Edentulous Patients Based on Kennedy's Classification at Dhulikhel Hospital, Kathmandu University Hospital. Kathmandu Uni Med J 2013; 44(4)325-27.

5 Abdel-Rahman HK, Tahir CD, Saleh MM. Incidence of partial edentulism and its relation with age and gender. Zanco J Med Sci 2013; 17:463-70.

6 McGarry TJ, Nimmo A, Skiba JF, et al: Classification system for partial edentulism, J Prosthodont 2002; 11(3):181-93.

7 Kennedy E. Classification. In: Essentials of Removable Partial Denture Prosthesis. 2nd ed. Philadelphia: WB Saunders Company; 1960. p. 9-25.

8 Henderson D, McGivney GP, Castleberry DJ. McCracken's Removable Partial Prosthodontics. 7th ed. St. Louis, Toronto, Princeton: CV Mosby; 1985. p. 21-26.

9 Rasoul A, Ahmedian L, Sharifi E. A simplified classification system for partial edentulism: A theoretical explanation. J Indian Prosthodontics Soc 2007; 7:85-87.

10 Cummer WE. Possible combinations of teeth present and missing in partial restorations. Dent Summary 1921, 41(2):156-66.

11 Pereira JR. Literature Review: Partially Denture Arches Main Classifications. J J Dent Res. 2014, 1(2): 011.

12 E. E. Ehikhamenor, H. O. Oboro, O. I. Onuora, A. U. Umanah, N. M. Chukwumah and I. A. Aivboraye. Types of removable prostheses requested by patients who were presented to the University of Benin Teaching Hospital Dental Clinic. Journal of Dentistry and Oral Hygiene; August 2010; 2(2),15-18.

13 Khalaf F. Al-Shammari, Jassem M. Al-Ansari, Manal Abu Al- Melh, Areej K. Al- Khabbaz. Reasons for Tooth Extraction in Kuwait. Med Prince Pract; 2006; 15:417-22.

14 E. E. Ehikhamenor. Types of removable prostheses requested by patients who were presented to the University of Benin Teaching Hospital Dental Clinic Journal of Dentistry and Oral Hygiene 2010; 2(2): 15-18.

15 Olga O. Charyeva, Kubeysin D. AltynbekovandBakhyt Z. Nysa- nova, Kennedy Classification and Treatment Options: A Study of Partially Edentulous Patients Being Treated in a Specialized Prosthetic Clinic, Journal of Prosthodontics 2012;21:177-80.

16 Bharathi m, Babu KRM, Reddy G, Guptta M, Misuria A, Vinod A. Partial edentulism based on Kennedys classification: An Epidemological Study. J Contemp dent pract2014 ;(15)2:229-31.

17 Butt AM, Rahijho A, Punjabi SK, Lal R.Incidence of various Kennedy's classes in partially edentulous patients visiting of dental opd Hyderabad/jamshoro.Pakistan Oral and Dental Journal 2015;35(2):329-31.
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Author:Choudhary, Ziaullah; Kumar, Pardeep; Amin, Muhammad; Malik, Sofia
Publication:Pakistan Oral and Dental Journal
Article Type:Report
Date:Dec 31, 2016
Words:1742
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