Structural equation modeling for factors influencing patients' willingness to replace removable dentures

Purpose: To investigate the factors influencing patients' willingness to replace removable dentures using structural equation modeling (SEM). Methods: A total of 153 patients who sought consultations for removable dentures self-evaluated denture quality using a visual analog scale (VAS); health-related quality of life using the 36-item Short-Form Health Survey; and oral health-related quality of life using the Oral Health Impact Profile. Dental clinicians evaluated denture quality using a VAS and by assessing the presence of defects. After being informed of various treatments, patients were asked whether they would prefer denture replacement. SEM was applied to analyze the relationships and interactive effects among the variables. Results: The final model showed high goodness-of-fit indices (chi-square/degree of freedom = 1.009, comparative fit index = 1.000, Tucker-Lewis index = 0.999, standardized root mean square residual = 0.421, and root mean square error of approximation = 0.008). SEM demonstrated that two latent constructs indirectly predicted patients' willingness to replace dentures; the standardized total effects of good oral health and poor denture quality were -0.154 and 0.503, respectively. Conclusion: These findings provide a unified understanding of the shared decision-making process for denture replacement and highlight the pretreatment assessments that play a relevant role in patient treatment preferences.