Cost-effectiveness of implant-supported dental prosthesis compared to conventional dental prosthesis

Abstract

OBJECTIVE: To conduct a cost-effectiveness analysis of alternatives for rehabilitation treatment of mandibular edentulism in the context of the Brazilian Unified Health System (implantsupported total dental prosthesis versus conventional total dental prosthesis). METHODS: A Markov model was developed to capture long-term clinical and economic outcomes. The model’s population was comprised of a hypothetical cohort of 1,000,000 patients, aged 55 years, with total mandibular edentulism and without medical contraindications for performing surgical procedures. The adopted analysis perspective was that of the Brazilian Unified Health System. Based on the proposed model, we calculated cost – in BRL, and effectiveness – measured by quality-adjusted prosthesis year (QAPY). The time horizon of the analysis was 20 years. RESULTS: Considering a 5% discount in costs and effects, the incremental cost-effectiveness ratio of implant-supported total dental prostheses compared to conventional total dental prosthesis (BRL 464.22/QAPY) was lower than the willingness to pay threshold adopted in the model (BRL 3,050.00/QAPY). CONCLUSIONS: The results of this economic analysis showed that the rehabilitation of mandibular edentulous patients by implant-supported total prosthesis is very cost-effective when compared to conventional complete prosthesis, considering the cost-effectiveness limits employed.

Cost‐effectiveness of three different concepts for the rehabilitation of edentulous mandibles: Overdentures with 1 or 2 implant attachments and hybrid prosthesis on four implants

“…A previous report on economic aspects of implant‐supported prosthesis in the Brazilian scenario suggested that the two‐implant overdenture has a low incremental cost and was more effective than the conventional complete dentures 13 . Similarly, our study demonstrated that there were small incremental costs for Group II compared to group I, and a high incremental cost from the overdenture groups (Groups I and II) compared to the hybrid 4‐implant prosthesis (Group III).…”

A comparison of cost and cost-effectiveness analysis of two- implant-retained overdentures versus other removable prosthodontic treatment options for edentulous mandible: A systematic review

“…[ 25 ] Untreated edentulism is a serious public health problem, and in a socioeconomically backward population, treatment cost is one important determinant of individual oral health status. [ 9 ] Any treatment modality should be evidence-based and should not be just on the basis of personal beliefs and popular schools of thought. [ 26 ]…”

“…Oral rehabilitation by a prosthesis certainly restores masticatory function and appearance of an individual, which leads to improvements in social interaction and quality of life of that person. [ 8 9 ] When it comes to the rehabilitation of patients with complete edentulism, rehabilitation with implant-supported total prosthesis offers greater quality of life benefits than conventional complete dentures. [ 10 ] Although conventional dentures provide less functional efficiency and comfort, their use still remains a valid treatment option in dental clinics, partly because of the higher treatment costs required for dental implants and associated materials, equipment, and surgery.…”

Oral rehabilitation with complete implant-supported dental prosthesis: a budget impact analysis from the unified health system perspective

“…Improvement in the ingestion of nutritive foods by rehabilitated patients may have effects outside of dental treatment, improving the recovery of general health of patients. CISP is the most cost-effective treatment for rehabilitation of patients with edentulous mandibles even when analyzed from the perspective of the public health manager [28] and its dissemination will lead to more benefits to the population.…”

“…This study used parameters of values arising from a cost-effectiveness study and has the same limitations, such as The precise estimate of costs of rehabilitation by means of CISP versus CCP [28]. Our data study comes from public databases and it was exempted from consideration by a research ethics committee.…”