New research on cost-effectiveness of implants
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- Published: Friday, 27 December 2013 10:36
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A new study by Swiss researchers looked at the cost-effectiveness of implant-supported single crowns (ISCs) compared to fixed dental prostheses (FDPs) when restoring a single missing tooth (Journal of Dental Research, December 2013, Vol. 92:12, pp. 183S-188S). The information can help clinicians guide patient decision-making they believe.
The researchers observed greater costs (amounting about plus 10%) in a group with fixed dental prostheses as compared to implant single crowns. This difference was mainly related to higher laboratory fees. In both groups, costs varied slightly among patients due to individual needs for bone augmentation during implant placement or soft-tissue grafting in the pontic area.
Both options have similar survival rates after five and 10 years: 94% and 90% for FDPs and 95% and 90% for ISCs, respectively. Costs differed in the areas of maintenance and initial treatment, but the researchers' main goal for the prospective preference trial was to compare long-term cost-effectiveness for each option for restoring a single missing tooth.
The treatments were all performed in dental postgraduate programs at the University of Basel. The study included 26 patients who agreed to the three-year recall period and were only excluded for general contraindications for implant surgery. The researchers tallied initial treatment costs and maintenance costs during scheduled or emergency recall visits. Patient perceptions were evaluated one month and one year after treatment.
During statistical analysis, the researchers calculated quality-adjusted tooth years (QATYs) and assigned values to the treatments. The average observation time for the ISC and the FDP groups were 51 and 49 months, respectively. The ISC group also had two unscheduled recalls to address a biological complication, palatal soft-tissue swelling in the fourth year, and a technical complication, an issue with a screw in the sixth year.
Based on their analysis, the researchers found that ISCs were more likely to be cost-effective than FDPs at the three- and 10-year time horizons. The former also had "slightly higher QATYs," although both provided satisfactory long-term results in the view of the patients.
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