Mini-Implants for Mandibular Overdentures: Cost-Effectiveness Analysis alongside a Randomized Trial
| Autor: | Rubens Ferreira de Albuquerque, Tatiana Ramirez Cunha, Danilo Balero Sorgini, M. P. Della Vecchia, Andréa Cândido dos Reis, Valdir Antonio Muglia, R. F. B. de Souza, Cláudio Rodrigues Leles, Adriana Barbosa Ribeiro |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Cost-Benefit Analysis medicine.medical_treatment Denture Complete Lower Dentistry Mandible law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Jaw Edentulous In patient Patient Reported Outcome Measures 030212 general & internal medicine General Dentistry Average cost Dental Implants Edentulism business.industry 030206 dentistry Cost-effectiveness analysis Middle Aged Denture Overlay medicine.disease United States Confidence interval Dental Prosthesis Design Mini implants Patient Satisfaction Female CIRURGIA BUCAL Dentures business |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| ISSN: | 2380-0852 2380-0844 0141-1683 |
| DOI: | 10.1177/2380084417741446 |
| Popis: | Mandibular overdentures retained by 2 conventional implants have been considered the standard of care for complete edentulism, according to the McGill and York consensuses. However, many patients refuse this treatment modality due to the associated costs and postsurgical discomfort. Mini-implants have the chance to overcome these limitations due to their potentially lower costs and a relatively uncomplicated surgical technique. This study compared treatment costs and incremental cost-effectiveness following the insertion of mini-implants (2 or 4) or 2 standard-size implants for the retention of mandibular overdentures, by means of a randomized clinical trial. In total, 120 edentulous participants (mean age 59.5 ± 8.5 y) were randomly allocated into 3 groups according to treatment received: 4 mini-implants (group 1), 2 mini-implants (group 2), or 2 standard implants (group 3). Treatment costs and outcomes (Oral Health Impact Profile for Edentulous [OHIP-EDENT] and satisfaction with the dentures) were evaluated after 6 mo. Incremental cost-effectiveness ratios (ICERs) were calculated for each intervention in terms of cost per 1-point change in patient outcomes. A 1-way sensitivity analysis was performed considering a 95% confidence interval variation in cost and outcome parameters, represented in tornado diagrams. Overall treatment cost was the lowest for group 2 (average cost: US$318.08), followed by group 1 (US$510.75) and group 3 (US$566.13). Groups did not differ in terms of the length of unscheduled appointments and time spent by participants. In summary, our findings indicate that mandibular overdentures retained by 2 or 4 mini-implants are less costly compared to 2-implant overdentures. Despite the lower costs of overdentures retained by 2 mini-implants, those retained by 4 mini-implants showed further improvement in patient-reported outcomes and reduced costs compared to standard implants ( ClinicalTrials.gov NCT01411683). Knowledge Transfer Statement: This report shows that mini-implant retained overdentures are less costly than overdenture treatment on 2 standard-sized implants. Treatment with 2 mini-implants is an effective procedure to substantially save resources, whereas treatment with 4 mini-implants provides better results from a patient perspective combined with slightly reduced costs compared to the treatment with 2 standard implants. Therefore, mini-implant overdentures may be effective and more accessible than overdentures on 2 standard-size implants for those with limited incomes. |
| Databáze: | OpenAIRE |
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