A cost minimization analysis of implant treatment in mandibular edentulous patients.
OBJECTIVE
This study aimed to determine if implant-supported overdentures are a long-term economically efficacious therapy for edentulous patients when compared to fixed osseointegrated prostheses.


METHODS
Clinical records of 25 patients from two long-term studies (fixed and overdenture) were included in this analysis. A cost minimization analysis from the patient perspective was employed. Direct clinical and time costs incurred over the 9-year period were deflated to 1995 Canadian dollars using the Consumer Price Index. National salary rates by occupation and gender were used to value patients' time, and a sensitivity analysis was carried out to assess the robustness of the results when an equal mean salary rate across treatment groups was assumed.


RESULTS
The mean total, clinical, and time costs were significantly higher (Ps .05) for the fixed restoration group (dollars CAD10,748, dollars CAD10,094, and dollars CAD654, respectively) when compared to the overdenture group (dollars CAD3,665, dollars CAD3,343, and dollars CAD322, respectively). The initial, maintenance, and clinical visit costs were also significantly higher (P < or = .05) in the fixed restoration group (dollars CAD7,567, dollars CAD2,527, dollars CAD542, respectively) than in the overdenture group (dollars CAD2,505, dollars CAD830, dollars CAD292, respectively). The sensitivity analysis demonstrated that the time cost for the fixed prosthodontic group (dollars CAD488 vs dollars CAD322) was still significantly higher (P = .002), even after an equal mean salary rate was assumed.


CONCLUSIONS
Overdenture therapy for edentulous patients is a more cost-effective treatment compared to fixed prosthodontic treatment.
Attard
Nikolai
N
Faculty of Dentistry, University of Toronto, Ontario, Canada. nik.attard@utoronto.ca
Wei
Xiaolin
X
Laporte
Audrey
A
Zarb
George A
GA
Ungar
Wendy J
WJ
D000704:Analysis of Variance; D003362:Cost-Benefit Analysis / Q000379:methods; D019094:Dental Prosthesis, Implant-Supported / Q000191:economics*; D003780:Denture Repair / Q000191:economics; D003781:Denture Retention / Q000191:economics / Q000295:instrumentation; D003828:Denture, Overlay / Q000191:economics*; D003830:Denture, Partial, Fixed / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D007182:Income; D008297:Male; D008334:Mandible; D012189:Retrospective Studies