Economic evaluations in the treatment and evaluation of patients with periodontal disease: A critical review

Tay, John Rong Hao; Ng, Ethan; Nair, Rahul; Tan, Zhe Sheng; Tan, Sharon Hui Xuan

doi:10.1111/jcpe.13456

Cited by 14 publications

(9 citation statements)

References 36 publications

(144 reference statements)

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“…Our updated review noted there was a diversity of dental and generic health outcomes used in the studies included in this review and identified that there was sparse evidence for cost-effective interventions to prevent periodontitis [29,[114][115][116], which is a consistent finding from previous reviews [23][24][25][26][27][28][29]. Different outcome measures do not allow comparison between interventions or diseases to guide resource allocation.…”

Section: Discussionmentioning

confidence: 84%

Economic Evaluations of Preventive Interventions for Dental Caries and Periodontitis: A Systematic Review

Nguyen

Tonmukayakul

et al. 2022

Appl Health Econ Health Policy

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Objectives To critically examine the methods used for full economic evaluations of preventive interventions for dental caries and periodontitis. Methods Published literature post-2000 was searched to April 2021. Based on a developed intervention classification framework for dental caries and periodontitis, only universal, selective or indicated interventions were included in this review. The Drummond 10-point checklist was used for quality appraisal. Results Of 3,007 unique records screened for relevance, 73 studies were reviewed. Most model-based studies (61/73) used cost-effectiveness analysis (49%) or cost-benefit analysis (28%). Trial-based studies (16/73) commonly used cost-effectiveness analysis (59%). Four studies used both economic evaluation methods. Sixty-four papers (88%) were on dental caries, eight papers (11%) focused on periodontitis, and one paper (1%) included both oral diseases; 72% of model-based and 82% of trial-based studies were of good quality. The most frequently investigated dental caries preventive interventions were water fluoridation (universal intervention; cost-saving or cost-effective), fissure sealant and fluoride varnish (selective and indicated interventions; cost-effectiveness outcomes were inconsistent). Supportive periodontal therapy with oral health education (indicated intervention; cost-effective) was the most frequently evaluated preventive intervention for periodontitis. Thirty percent of studies with a time horizon > 1 year did not apply an appropriate discount rate and 26% did not comprehensively discuss other important considerations beyond the technical analysis. Conclusions Generic health outcome measures should be incorporated for economic evaluations on preventive interventions for dental caries and periodontitis, and an increased focus to prevent periodontitis using economic evaluation methods is needed to inform resource allocation and policy decision-making.

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Section: Discussionmentioning

confidence: 84%

Economic Evaluations of Preventive Interventions for Dental Caries and Periodontitis: A Systematic Review

Nguyen

Tonmukayakul

et al. 2022

Appl Health Econ Health Policy

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“…The societal aspects of treatment were measured in Caries Research, Journal of Clinical Periodontology and the Journal of Oral & Facial Pain and Headache by investigating the cost‐effectiveness of various treatment (McMahon et al., 2020; Shin et al., 2021; Tay et al., 2021; Vos et al., 2018). A detailed list of all included studies from the four journals is available in Appendix S2.…”

Section: Resultsmentioning

confidence: 99%

A critical look at outcome measures: Comparison between four dental research journals by use of a hierarchical model

Wrangstål,

Pigg,

Almutairi

et al. 2023

Int Endodontic J

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AimTo assess the status quo of outcome measures used in treatment studies in Endodontics, and potentially identify strategies for improvement, by (i) systematically assessing the outcome measures using a conceptual model and (ii) comparing these with measures used in corresponding studies in the adjacent fields.MethodologyThe International Endodontic Journal, Caries Research, The Journal of Clinical Periodontology and The Journal of Oral & Facial Pain and Headache were selected to cover four adjacent dental disciplines. In each journal, the 50 most recent consecutive publications fulfilling inclusion criteria were included. A hierarchical model for diagnostic imaging studies was modified to assess studies related to treatment. The model comprised six levels, with technical as the lowest level and societal as the highest. Extracted data included study origin, study type, and identified outcome measures. Fisher's Exact Tests with Bonferroni corrections compared studies. p < .05 was considered statistically significant.ResultsAmongst 756 publications, the 200 most recent studies matching the inclusion criteria were identified. Less than half (36.5%) assessed the clinical, patient, or societal aspects of treatment; 10.0% in International Endodontic Journal, 28.0% in Caries Research, 38.0% in Journal of Clinical Periodontology, and 70.0% in Journal of Oral & Facial Pain and Headache (p < .001).ConclusionsAccording to included publications, research on treatment within the endodontic field is mainly focusing on technical and biological outcomes. The benefits of patients and society were less frequently examined than in corresponding journals in adjacent disciplines. When designing studies, including higher‐level outcomes should be considered.

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“…Non-surgical periodontal treatment is associated with mechanical removal of the soft and hard deposits from an exposed root surface in a 'closed' manner in addition to oral hygiene instructions and patient motivation. Different strategies of non-surgical periodontal treatment have been designed to successfully arrest the progression of periodontitis and re-establish a healthy ecosystem [21], frequently having economic implications [22,23]. Treatment improves patient behaviour (i.e.…”

Section: Periodontal Wound Healing and Treatment Considerations Of Pe...mentioning

confidence: 99%

Microbial–stem cell interactions in periodontal disease

Iliopoulos

Layrolle

Apatzidou

2022

Journal of Medical Microbiology

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Periodontitis is initiated by hyper-inflammatory responses in the periodontal tissues that generate dysbiotic ecological changes within the microbial communities. As a result, supportive tissues of the tooth are damaged and periodontal attachment is lost. Gingival recession, formation of periodontal pockets with the presence of bleeding, and often suppuration and/or tooth mobility are evident upon clinical examination. These changes may ultimately lead to tooth loss. Mesenchymal stem cells (MSCs) are implicated in controlling periodontal disease progression and have been shown to play a key role in periodontal tissue homeostasis and regeneration. Evidence shows that MSCs interact with subgingival microorganisms and their by-products and modulate the activity of immune cells by either paracrine mechanisms or direct cell-to-cell contact. The aim of this review is to reveal the interactions that take place between microbes and in particular periodontal pathogens and MSCs in order to understand the factors and mechanisms that modulate the regenerative capacity of periodontal tissues and the ability of the host to defend against putative pathogens. The clinical implications of these interactions in terms of anti-inflammatory and paracrine responses of MSCs, anti-microbial properties and alterations in function including their regenerative potential are critically discussed based on literature findings. In addition, future directions to design periodontal research models and study ex vivo the microbial–stem cell interactions are introduced.

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Economic evaluations in the treatment and evaluation of patients with periodontal disease: A critical review

Cited by 14 publications

References 36 publications

Economic Evaluations of Preventive Interventions for Dental Caries and Periodontitis: A Systematic Review

Economic Evaluations of Preventive Interventions for Dental Caries and Periodontitis: A Systematic Review

A critical look at outcome measures: Comparison between four dental research journals by use of a hierarchical model

Microbial–stem cell interactions in periodontal disease

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