[Evaluation of clinical application of ACP classification for edentulous patients].

Objective: To evaluate clinical application of American College of Prosthodontics classification system for complete edentulism; and to analyze the relationship between clinician's rating of general degree of difficulty of each case and patients' rating of denture satisfaction.

Methods: One hundred and seven edentulous patients were examined clinically using American College of Prosthodontics (ACP) classification for complete edentulism. The least heights of patients' mandible were measured on panoramic radiographs. Clinician rated general degree of difficulty of each case on visual analogue scale. Six month following denture delivery, patients rated their denture using Mcgill satisfaction Visual Analog Scale (VAS). Multivariate linear regression analysis were conducted to analyze the relationship between clinician's rating of general degree of difficulty and mandibular bone height adjusting for confounding factors such as mandibular ridge form, soft tissue quality etc. Pearson correlation analysis was conducted to analyze the correlation between clinician's rating of case difficulty and patients' rating of denture satisfaction.

Results: Advanced residual ridge resorption were found in around 80% (83/105) of all the cases. When the least mandibular bone height were measured on panoramic radiographs, intra-examiner reliability was 0.96, inter-examiner reliability was 0.90. Cases were rated as more difficult when patients showed lower mandibular bone height, unfavorate ridge form (knife ridge and irregular ridge), mobile soft tissue and longer period of wearing time of their previous dentures. No significant correlation (r<0.1) was found between clinician's rating of degree of difficulty of each case and patients' rating of denture satisfaction 6 month following delivery of prostheses. Clinician rated cases in which patient's mandibular bone height was lower than 11 mm as 8.8%-16.1% more difficult than those in which patient's mandibular bone height was higher than 11 mm (P<0.05).

Conclusion: ACP classification for complete edentulism showed good intra- and inter-examiner reliability, and is an useful tool for clinical evaluation of edentulous patients' oral condition. However, there was no significant correlation between clinicians' rating of difficulty of cases and patients' rating of denture satisfaction.