title: Technology assessment in dentistry: a comparison of the longevity and cost-effectiveness of inlays.
abstract: OBJECTIVE
  An example of technology assessment in dental care by evaluating the (cost-)effectiveness of types of three-surface inlays (gold, laboratory-fabricated ceramic, and chairside CAD/CAM ceramic) is provided.
  
  
  METHODS
  MEDLINE, EMBASE, and the Cochrane Library were searched for studies published between 1966 and June 2003 that reported annual survival probabilities and annual observations. The longevity of different types of inlays was measured by the number of failure-free years. Annual survival rates from different studies were pooled by weighing the rates of each study by the inverse of the variance of the effect estimate. A cost-effectiveness analysis from the perspective of German private health insurers was performed using billing charges.
  
  
  RESULTS
  Three, five, and two case series on laboratory-fabricated ceramic, chairside CAD/CAM ceramic, and gold inlays, respectively, were included. Over a 9-year observation period, the number of undiscounted failure-free years was 8.62 (95 percent confidence interval, 8.40-8.85), 8.65 (8.58-8.73), and 8.76 (8.72-8.80) for laboratory-fabricated ceramic, chairside CAD/CAM ceramic, and gold inlays, respectively. Laboratory-fabricated ceramic inlays were the most expensive.
  
  
  CONCLUSIONS
  While laboratory-fabricated ceramic, chairside CAD/CAM ceramic, and gold inlays had a strikingly similar failure-free survival rate, laboratory-fabricated ceramic inlays had the highest costs and, thus, were less cost-effective than chairside CAD/CAM ceramic and gold inlays.
authors.affiliation: University of Cologne, 50935 Cologne, Germany. afschin.gandjour@medizin.uni-koeln.de
authors.forename: Afschin
authors.initials: A
authors.lastname: Gandjour
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerschbaum
authors.forename: Andreas
authors.initials: A
authors.lastname: Reis
authors.forename: Karl Wilhelm
authors.initials: KW
authors.lastname: Lauterbach
mesh_terms: D003362:Cost-Benefit Analysis; D019554:Dental Restoration Wear; D006801:Humans; D007284:Inlays / Q000191:economics*; D013673:Technology Assessment, Biomedical / Q000191:economics*