An economic evaluation of maxillary implant overdentures based on six vs. four implants

BMC Oral Health

Nikolaos Nikitas Giannakopoulos³  Leonhard Fischer²  Stefan Listl¹ 

[1] Max Planck Institute for Social Law and Social Policy, Munich Center for the Economics of Aging, Munich, Germany;Department of Conservative Dentistry, Heidelberg University, Heidelberg, Germany;Department of Prosthodontics, Heidelberg University, Heidelberg, Germany

关键词: Maxilla;    Dentures;    Implants;    Cost-effectiveness analysis;   

Others  :  1109573
DOI  :  10.1186/1472-6831-14-105

 received in 2014-06-27, accepted in 2014-08-13,  发布年份 2014

【 摘 要 】

Background

The purpose of the present study was to assess the value for money achieved by bar-retained implant overdentures based on six implants compared with four implants as treatment alternatives for the edentulous maxilla.

Methods

A Markov decision tree model was constructed and populated with parameter estimates for implant and denture failure as well as patient-centred health outcomes as available from recent literature. The decision scenario was modelled within a ten year time horizon and relied on cost reimbursement regulations of the German health care system. The cost-effectiveness threshold was identified above which the six-implant solution is preferable over the four-implant solution. Uncertainties regarding input parameters were incorporated via one-way and probabilistic sensitivity analysis based on Monte-Carlo simulation.

Results

Within a base case scenario of average treatment complexity, the cost-effectiveness threshold was identified to be 17,564 € per year of denture satisfaction gained above of which the alternative with six implants is preferable over treatment including four implants. Sensitivity analysis yielded that, depending on the specification of model input parameters such as patients’ denture satisfaction, the respective cost-effectiveness threshold varies substantially.

Conclusions

The results of the present study suggest that bar-retained maxillary overdentures based on six implants provide better patient satisfaction than bar-retained overdentures based on four implants but are considerably more expensive. Final judgements about value for money require more comprehensive clinical evidence including patient-centred health outcomes.

【 授权许可】

   
2014 Listl et al.; licensee BioMed Central Ltd.

【 图 表 】

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