Journal of Clinical and Diagnostic Research. 2021 May, Vol-15(5): ZC15-ZC20 15 15 DOI: 10.7860/JCDR/2021/48343.14878 Original Article Dentistry Section Screening and Allotting Completely Edentulous Patients using Prosthodontic Diagnostic Index in a Dental School, Jeddah, Saudi Arabia INTRODUCTION The glossary of prosthodontic terms defines edentulism as ‘the state of being edentulous or without natural teeth [1].’ Since some sort of treatment is required for a completely edentulous individual, a more apt definition would be “the physical state of the jaw(s) following removal of all erupted teeth and the condition of the supporting structures available for reconstructive or replacement therapies [2].” Edentulism is a chronic irreversible state and a terminal consequence of a multifactorial process including biological (caries, periodontal disease, pulpal pathology, trauma, oral cancer) and patient-related factors (access to care, patient’s choices, treatment options, etc.,) [3]. It has an impact on chewing efficiency, nutrition, and general health, which lessens the oral health-related quality of life [4-10]. The complete loss of dentition affects numerous normal and vital human functions, including the ability to perform two of the most vital tasks of life that are eating and speaking; thus it can be considered a disability [11,12]. Complete loss of teeth is from the same group of known variable risk factors as other noncommunicable diseases like smoking, use of alcohol, and harmful carbohydrate-rich dietary behaviors [13]. Thus, edentulism satisfies the World Health Organisation (WHO) definition of physical impairment and can present challenges for those plagued with this ailment [14,15]. It remains a huge global health care liability, and will for the near future [16-18]. Thus, there is a growing demand for complete denture prostheses in the future, as it is a worldwide problem [5,19-22]. To frame a proper treatment plan for an edentulous patient, information obtained from various diagnostic aids needs to be classified according to their treatment based on complexity. The lack of a classification system and referral has forever been an obstacle for an accurate system of treatment planning among prosthodontists [23]. Consequently, the American College of Prosthodontists (ACP) formed a classification system to answer all these queries and help in treatment planning. McGarry TJ et al., proposed various classifications, including the PDI for completely edentulism (1999), partially edentulous patients (2002), and completely dentate patients (2004) [2,24,25]. These were implemented to diagnose patients in need of prosthetic treatment based on the complexity of the oral conditions seen at the first diagnostic appointment [26]. As very few studies [7,27] have been conducted on implementing the PDI on an edentulous population in a dental school, this study was carried out to screen completely edentulous patients using PDI and allot the cases to students based on the complexity of the prosthodontic treatment to be rendered, and to identify and refer patients with higher complexity to a specialist. MATERIALS AND METHODS The study was a cross-sectional survey conducted in the outpatient clinics of Ibn Sina National College, Jeddah, Saudi Arabia from April 2019 to December 2019. The study was conducted after obtaining approval from the Institutional Ethical Committee (IEC Ref No. H-24- 13022019). A total of 122 completely edentulous patients of Saudi MOHAMMED SHAMMAS 1 , NAGIHAN KURU MUHCU 2 , ELAF ABDULLAH ALZAHRANI 3 , RANA ALI ALSAADI 4 , ELAF MOHAMMED ALSHAQHA 5 , JOOD AHMED BALKHYOOR 6 , VT ABDURAHIMAN 7 , SHAIQ GAJDHAR 8 Keywords: Bone height, Bone resorption, Classification, Complete denture, Diagnosis, Rehabilitation ABSTRACT Introduction: To formulate an ideal treatment plan for edentulous patients, data collected from various diagnostic aids need to be structured and classified according to their treatment needs. The lack of structured diagnostic findings for edentulous patients has always been a barrier to effective care for patients. To address these issues, the American College of Prosthodontists (ACP) established the Prosthodontic Diagnostic Index (PDI) based on specific criteria. Aim: To screen and allot completely edentulous patients to students using PDI in a dental school, in Jeddah, Saudi Arabia. Materials and Methods: This cross-sectional study was conducted on 122 completely edentulous patients who visited the outpatient clinic of a dental school in Jeddah, Saudi Arabia. The edentulous patients based on PDI were classified into four classes (Class I-IV) according to the diagnostic findings based on the complexities. The parameters studied were: mandibular bone height measured on a panoramic radiograph, residual ridge morphology of the maxillary arch, muscle attachments in the mandibular arch, and maxillomandibular relationship. Statistical analysis were performed using counts and percentages. Results: In the overall classification of PDI, maximum 52 (42.6%) patients were classified as Class IV. Among the different criteria of PDI, 48 (39.4%) patients exhibited Class III mandibular bone height of 11-15 mm, whereas 40 (32.8%) patients exhibited Class IV mandibular bone height of 10 mm or less. In the maxillary residual ridge morphology, 62 patients (50.8%) were classified as Class I. A large number of patients 84 (70%) had Type A mandibular muscle attachment criteria and were classified as Class I or II. In the maxillomandibular relationship, the maximum number of patients 74 (60.7%) was of Class I. Conclusion: The majority of patients in the study were categorised as Class IV (severely compromised). Edentulous patients must be classified according to PDI during the initial screening phase so that less complex cases (Class I and II) can be allotted to undergraduate students and more complex cases (Class IV) can be handled by prosthodontists or can be referred to specialist centers so that costly and time-consuming remake of complete dentures can be avoided.