Attachment-Retained versus Clasp-Retained Removable Partial Dentures: Effects of Retention on Patient Satisfaction.

Abstract

Objectives:  To compare the retention and patient satisfaction of attachment-retained versus clasp-retained removable partial dentures (RPDs) over time and to evaluate the impact of retention force on patient satisfaction.

Materials and methods:  This study included 107 patients with 130 RPDs at the University Dentistry Clinical Center, Prishtina, Kosovo. Patients were divided into two groups: clasp-retained RPDs (n = 79) and attachment-retained RPDs (n = 51). RPD retention forces were measured using a dynamometer, and satisfaction was evaluated using a questionnaire covering retention, stability, chewing ability, aesthetics, oral hygiene maintenance, speech, and pain/discomfort on a Likert scale from 1 (complete dissatisfaction) to 5 (complete satisfaction). Reliability was assessed using Cronbach's α. Descriptive statistics and the independent-samples Kruskal-Wallis test were used for analysis, with pairwise comparisons and Spearman's rho correlation for additional insights.

Results:  Attachment-retained RPDs demonstrated superior retention, with mean scores decreasing from 5.43 to 4.40 over 3 months, compared with clasp-retained RPDs, which decreased from 4.02 to 3.23. Satisfaction scores also favored attachment-retained RPDs, dropping from 4.96 to 3.96, while clasp-retained RPDs decreased from 4.05 to 3.44. Cronbach's α indicated high reliability (α = 0.952). The Kruskal-Wallis test showed significant differences in retention and satisfaction between the two RPD types (p < 0.0001). Pairwise comparisons indicated significant declines over time for both types. Spearman's rho correlation analysis revealed strong positive relationships between retention force and satisfaction scores, with correlation coefficients of 0.574 for clasp-retained and 0.522 for attachment-retained RPDs (p < 0.0001).

Conclusion:  Attachment-retained RPDs offer higher and more stable retention and greater patient satisfaction compared with clasp-retained RPDs over the initial months of use. The significant positive correlation between retention force and patient satisfaction underscores the importance of optimizing retention in RPD design.