Cost-effectiveness of molar single-implant versus fixed dental prosthesis

Abstract

BackgroundThis study evaluates the cost-effectiveness of implants (Implant), insurance fixed dental prosthesis (IFDP) and private fixed dental prosthesis (PFDP) for a single intermediate missing tooth in the molar region to calculate the Incremental Cost Effectiveness Ratio (ICER).MethodsThe Markov model for cost-effectiveness analysis of the Implant, IFDP and PFDP was carried over maximum 30 years. The starting age for prosthetic treatment was decided to be 50 years. The General Oral Health Assessment Index (GOHAI) was used for the indicator of effectiveness as an oral health QOL value. The GOHAI value was collected from patients who visited the Department of Oral Implantology of Osaka Dental University between September 2014 and March 2016. In addition, the Tornado diagram was drawn and Monte-Carlo simulations made for sensitivity analysis.ResultsFrom the analysis of survey of QOL of each stage and treatment, the selection of an Implant led to a higher QOL value than FDP. However, the estimated 30-year cost for IFDP was lower than Implant. It also became evident that PFDP had an extended dominated condition compared with IFDP and Implants. The ICER on the Implant versus IFDP was €1423.00.ConclusionsThese results suggest that a better of QOL value can be obtained from an Implant than from IFDP or PFDP. An evaluation form using an indexed scale for oral health-related aspects needs to be developed that is also consistent as an indicator of effect.

Cost-utility analysis of an implant treatment in dentistry

“…The study by Mack et al [ 28 ] proves that the first molar is the most frequently missing tooth in the population between 20 and 74 years of age. Most published foreign cost-effectiveness studies [ 1 , 5 , 7 – 13 , 15 ] used FDP for comparison with implant treatment. Endodontic treatment [ 8 , 12 , 29 ] or treatment with a removable prosthesis [ 13 ] was also often chosen as a comparator.…”

“…There is no cost study in the Czech Republic that would accurately assess the costs and benefits of this treatment. Most published foreign studies [ 5 – 8 ] comparing implant treatment and FDP as part of the solution to the replacement of one missing tooth agree that implant treatment entails higher initial costs. However, success, longevity and patient satisfaction are considered more favourable.…”

“…However, success, longevity and patient satisfaction are considered more favourable. Foreign studies [ 1 , 5 , 7 – 13 ] focused on economic-clinical evaluation of dental implants very often use models with long time horizon which proves that after a longer period of time, implant treatment becomes more cost-effective compared to FDP.…”

Smoking Cessation Therapy is a Cost-Effective Intervention to Avoid Tooth Loss in Subjects With Periodontitis – An Economic Evaluation 

“…In the absence of a suitable measure in Dentistry, and considering the low sensitivity of medical questionnaires, we assumed that the utility was proportional to quality of life. This methodology was proposed by previous studies that converted scores from quality of life questionnaires to utilities scores between 0 and 1 and reflected changes related to periodontal conditions/treatment [53,54]. Even though this is not the ideal approach, the use of this interim tool allowed the incorporation of a patient-centered approach into the analysis.…”

Custo-efetividade da terapia de cessação do tabagismo para pacientes com periodontite

“…Na ausência de uma forma definida para mensurar o QALY na Odontologia e considerando a baixa sensibilidade dos questionários médicos para os desfechos bucais, nós assumimos que os valores de utilidade eram proporcionais aos valores de questionários de qualidade de vida utilizados na Odontologia. Essa metodologia foi proposta por estudos prévios que converteram escores de questionários de qualidade de vida em valores de utilidade entre 0 e 1 (Mohd-Dom et al,Korenori et al, 2018).Nossos resultados da análise de custo-efetividade necessitam ser interpretados com cautela, uma vez que não é possível afirmar se há uma relação linear entre qualidade de vida e utilidade. Ademais, os escores de utilidade podem ter sido subestimados quando comparados aos escores derivados de questionários gerais de qualidade de vida.…”