A prospective study on immediate loading of implants with mandibular overdentures: patient-mediated and economic outcomes.
OBJECTIVE
The aims of this report are to present the patient-based outcomes and associated clinical costs of an immediate loading protocol for mandibular overdentures in edentulous patients.


METHODS
Two groups of patients were selected. Thirty-five consecutively treated patients received an immediate protocol, while 42 patients treated with a conventional protocol served as a historical control. Patient-based concerns for patients in the immediate group were measured at various stages of treatment with 2 questionnaires: the Denture Satisfaction Scale and the Oral Health Impact Profile. Direct clinical and time costs over a 1-year period were estimated and deflated to 2002 Canadian dollars. Salary rates by occupation, age, and gender were used to evaluate the patients' time costs. Treatment costs were compared between the 2 groups. Additionally, incremental cost-effectiveness ratios for various stages with the immediate protocol were calculated.


RESULTS
Significant improvements posttreatment were observed with both the Denture Satisfaction Scale (Wilcoxon signed rank test, P < .05) and the Oral Health Impact Profile (Friedman test, P < .05). The immediate protocol was associated with higher maintenance costs, with resultant higher total costs (Mann-Whitney U test, P < .05). No difference was observed in the time costs associated with the 2 protocols. Within-group analysis of costs at various stages of the immediate protocol suggested that treatment with implant-supported overdentures was more cost-effective than treatment with conventional dentures.


CONCLUSIONS
This study suggests that implants in 1 jawbone lead to a substantial improvement in perceived oral health status. Furthermore, the immediate loading protocol was not cheaper than a conventional protocol.
Department of Prosthodontics, Faculty of Dental Surgery, University of Malta, The Medical School, G'Mangia, Malta. njattard@maltanet.net
Nikolai J
NJ
Attard
Audrey
A
Laporte
David
D
Locker
George A
GA
Zarb
D015331:Cohort Studies; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D000044:Dental Abutments / Q000191:economics / Q000523:psychology; D015921:Dental Implants / Q000191:economics / Q000523:psychology; D019094:Dental Prosthesis, Implant-Supported / Q000191:economics / Q000523:psychology; D003826:Denture, Complete, Lower / Q000191:economics / Q000523:psychology; D003828:Denture, Overlay / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome
D015921:Dental Implants