Cost-Effectiveness Analysis of Single-Tooth Rehabilitation Options

Authors

  • Manuel Henrique de Medeiros Neto
  • Rênnis Oliveira da Silva
  • Leopoldina de Fátima Dantas de Almeida
  • Edson Hilan Gomes de Lucena
  • Denise de Fátima Barros Cavalcante
  • Antonio Carlos Pereira
  • Yuri Wanderley Cavalcanti

Keywords:

Economics, Dental Prosthesis, Implant-Supported, Denture, Partial, Fixed

Abstract

Objective: To evaluate the cost-effectiveness of single-tooth rehabilitation options with dental implants associated with a prosthetic crown (I+C) compared to a fixed partial denture (FPD). Material and Methods: A rapid review was carried out to identify the costs (expressed in US$) and effectiveness (expressed through success rate). Bibliographic searches retrieved 1,447 records, of which 19 studies of type randomized clinical trials were selected to collect cost and effectiveness data. Markov economic models were used to simulate hypothetical 15-year cohorts with 2000 patients using cost and effectiveness data from the rapid review under the perspective of private practice. Results: The average costs of I+C and FPD treatments were US$ 3,432.23 and US$ 3,322.52, respectively. The average effectiveness of I+C was 88.33%, with a mean follow-up time of 9.33 years, and FPD had an average yearly success rate of 82.14%, with a mean follow-up time of 11.89 years. The I+C treatment has an incremental cost-effectiveness ratio (RCEI) of US$ 170.88 compared to FPD. Conclusion: Both I+C and FPD rehabilitation options are cost-effective; I+C rehabilitation has a higher cost and greater effectiveness, being the recommended option if the patient with no contraindication.

References

López CS, Saka CH, Rada G. Impact of fixed implant supported prostheses in edentulous patients: Protocol for a systematic review. BMJ Open 2016; 6:e009288. https://doi.org/10.1136/bmjopen-2015-009288

Greenstein G, Greenstein B, Carpentieri J. The need to replace a missing second molar with a dental implant restoration: Analysis of a controversial issue. Compend Contin Educ Dent 2018; 39(1):686-693.

Al-Quran FA, Al-Ghalayini RF, Al-Zu'bi BN. Single-tooth replacement: Factors affecting different prosthetic treatment modalities. BMC Oral Health 2011; 11:34. https://doi.org/10.1186/1472-6831-11-34

Hemmings K, Harrington Z. Replacement of missing teeth with fixed prostheses. Dent Update 2004; 31(3):137-141. https://doi.org/10.12968/denu.2004.31.3.137

Brägger U, Krenander P, Lang NP. Economic aspects of single-tooth replacement. Clin Oral Implants Res 2005; 16(3):335-341. https://doi.org/10.1111/j.1600-0501.2005.01112.x

Brägger U, Hirt-Steiner S, Schnell N, Schmidlin K, Salvi GE, Pjetursson B, et al. Complication and failure rates of fixed dental prostheses in patients treated for periodontal disease. Clin Oral Implants Res 2011; 22(1):70-77. https://doi.org/10.1111/j.1600-0501.2010.02095.x

Styranivska O, Kliuchkovska N, Mykyyevych N. Comparison of using differentbridge prosthetic designs for partial defect restoration through mathematical modeling. Eur J Dent 2017; 11(3):345-351. https://doi.org/10.4103/ejd.ejd_72_17

Goodacre CJ, Naylor WP. Single implant and crown versus fixed partial denture: A cost-benefit, patient-centred analysis. Eur J Oral Implantol 2016; 9(Suppl 1):S59-68.

Lee CT, Huang YW, Zhu L, Weltman R. Prevalences of peri-implantitis and peri-implant mucositis: Systematic review and meta-analysis. J Dent 2017; 62:1-12. https://doi.org/10.1016/j.jdent.2017.04.011

Kim Y, Park JY, Park SY, Oh SH, Jung Y, Kim JM, et al. Economic evaluation of single-tooth replacement: Dental implant versus fixed partial denture. Int J Oral Maxillofac Implants 2014; 29(3):600-607. https://doi.org/10.11607/jomi.3413

Leles CR, Dias DR, Nogueira TE, McKenna G, Schimmel M, Jordão LMR. Impact of patient characteristics on edentulous subjects' preferences for prosthodontic rehabilitation with implants. Clin Oral Implants Res 2019; 30(3):285-292. https://doi.org/10.1111/clr.13414

De Angelis F, Papi P, Mencio F, Rosella D, Di Carlo S, Pompa G. Implant survival and success rates in patients with risk factors: Results from a long-term retrospective study with a 10 to 18 years follow-up. Eur Rev Med Pharmacol Sci 2017; 21(3):433-437.

Albrektsson T, Donos N, Working Group 1. Implant survival and complications. The Third EAO consensus conference 2012. Clin Oral Implants Res 2012; 23(Suppl 6):63-65. https://doi.org/10.1111/j.1600-0501.2012.02557.x

Schwarz S, Bernhart G, Eiffler C, Hassel AJ, Lehmann F, Rammelsberg P. Early loading of implants with fixed dental prostheses in edentulous mandibles: 7.2-year clinical results from a prospective study. Clin Implant Dent Relat Res 2014; 16(6):904-912. https://doi.org/10.1111/cid.12062

Pennington MW, Vernazza CR, Shackley P, Armstrong NT, Whitworth JM, Steele JG. Evaluation of the cost-effectiveness of root canal treatment using conventional approaches versus replacement with an implant. Int Endod J 2009; 42(10):874-883. https://doi.org/10.1111/j.1365-2591.2009.01582.x

Maia LC, Antonio AG. Systematic reviews in dental research. A guideline. J Clin Pediatr Dent 2012; 37(2):117-124. https://doi.org/10.17796/jcpd.37.2.h606137vj3826v61

Torabinejad M, Anderson P, Bader J, Brown LJ, Chen LH, Goodacre CJ. Outcomes of root canal treatment and restoration, implant-supported single crowns, fixed partial dentures, and extraction without replacement: A systematic review. J Prosthet Dent 2007; 98(4):285-311. https://doi.org/10.1016/S0022-3913(07)60102-4

Pereira AC, Bahia LR, Cavalcante DFB, Menehim MC, Cavalcanti YW, Ambrosano GMB, et al. Budgetary impact of oral rehabilitation with complete dentures: An economical evaluation from São Paulo State, Brazil. Value Health Reg Issues 2019; 20:73-78. https://doi.org/10.1016/j.vhri.2019.01.008

Probst LF, Vanni T, Cavalcante DFB, Silva ET, Cavalcanti YW, Passeri LA, et al. Cost-effectiveness of implant-supported dental prosthesis compared to conventional dental prosthesis. Rev Saude Publica 2019; 53:S0034-89102019000100257. https://doi.org/10.11606/s1518-8787.2019053001066

Christensen GJ. Three-unit fixed prostheses versus implant-supported single crowns. J Am Dent Assoc. 2008 Feb;139(2):191-4. doi: 10.14219/jada.archive.2008.0136. PMID: 18245688.

Bouchard P, Renouard F, Bourgeois D, Fromentin O, Jeanneret MH, Beresniak A. Cost-effectiveness modeling of dental implant vs. bridge. Clin Oral Implants Res 2009; 20(6):583-587. https://doi.org/10.1111/j.1600-0501.2008.01702.x

Kim SG, Solomon C. Cost-effectiveness of endodontic molar retreatment compared with fixed partial dentures and single-tooth implant alternatives. J Endod 2011; 37(3):321-325. https://doi.org/10.1016/j.joen.2010.11.035

Augusti D, Augusti G, Re D. Prosthetic restoration in the single-tooth gap: patient preferences and analysis of the WTP index. Clin Oral Implants Res 2014; 25(11):1257-1264. https://doi.org/10.1111/clr.12264

Zitzmann NU, Krastl G, Weiger R, Kühl S, Sendi P. Cost-effectiveness of anterior implants versus fixed dental prostheses. J Dent Res 2013; 92(12 Suppl):183S-188S. https://doi.org/10.1177/0022034513504927

Antonarakis GS, Prevezanos P, Gavric J, Christou P. Agenesis of maxillary lateral incisor and tooth replacement: Cost-effectiveness of different treatment alternatives. Int J Prosthodont 2014; 27(3):257-263. https://doi.org/10.11607/ijp.3851

Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res 2012; 23(Suppl 6):22-38. https://doi.org/10.1111/j.1600-0501.2012.02546.x

Salinas TJ, Eckert SE. In patients requiring single-tooth replacement, what are the outcomes of implant- as compared to tooth-supported restorations? Int J Oral Maxillofac Implants 2007; 22:71-95.

Fugazzotto PA. Evidence-based decision making: Replacement of the single missing tooth. Dent Clin North Am 2009; 53(1):97-129. https://doi.org/10.1016/j.cden.2008.10.001

Incici E, Matuliene G, Hüsler J, Salvi GE, Pjetursson B, Brägger U. Cumulative costs for the prosthetic reconstructions and maintenance in young adult patients with birth defects affecting the formation of teeth. Clin Oral Implants Res 2009; 20(7):715-721. https://doi.org/10.1111/j.1600-0501.2009.01711.x

Swelem AA, Gurevich KG, Fabrikant EG, Hassan MHA, Aqou S. Oral health-related quality of life in partially edentulous patients treated with removable, fixed, fixed-removable, and implant-supported prostheses. Int J Prosthodont 2014; 27(4):338-347. https://doi.org/10.11607/ijp.3692

Walton TR. An up-to-15-year comparison of the survival and complication burden of three-unit tooth-supported fixed dental prostheses and implant-supported single crowns. Int J Oral Maxillofac Implants 2015; 30(4):851-861. https://doi.org/10.11607/jomi.4220

Leung KC, McGrath CP. Willingness to pay for implant therapy: a study of patient preference. Clin Oral Implants Res 2010; 21(8):789-793. https://doi.org/10.1111/j.1600-0501.2009.01897.x

Chen H, Liu N, Xu X, Qu X, Lu E. Smoking, radiotherapy, diabetes and osteoporosis as risk factors for dental implant failure: a meta-analysis. PLoS One 2013; 8(8):e71955. https://doi.org/10.1371/journal.pone.0071955

Downloads

Published

2024-06-10

How to Cite

Medeiros Neto, M. H. de, Silva, R. O. da, Almeida, L. de F. D. de, Lucena, E. H. G. de, Cavalcante, D. de F. B., Pereira, A. C., & Cavalcanti, Y. W. (2024). Cost-Effectiveness Analysis of Single-Tooth Rehabilitation Options. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 24, e230174. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/3475

Issue

Vol. 24 (2024)

Section

Original Articles

License

Copyright (c) 2023 Pesquisa Brasileira em Odontopediatria e Clínica Integrada

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.