The cost-effectiveness of supportive periodontal care for patients with chronic periodontitis.
OBJECTIVE
To systematically evaluate the evidence for effectiveness of supportive periodontal care (SPC) provided in specialist care and general practice for patients with chronic periodontitis; to construct a model for the cost effectiveness of SPC.


METHODS
Electronic database searches of MEDLINE, EMBASE and SCOPUS were performed with hand searching of relevant journals and Workshops of Periodontology.


METHODS
SPC for patients with chronic periodontitis, at least 12 months follow-up and clinical attachment level as a primary outcome.


RESULTS
Three articles addressed the question (Nyman et al. 1975, Axelsson & Lindhe 1981, Cortellini et al. 1994): Deltas CAL for patients undergoing "specialist" SPC were 0.1 mm (2 years), 0.2 mm (6 years) and -0.01 mm (3 years) respectively. In generalist care the Deltas CAL during SPC were -2.2, -1.8 and -2.8 mm. Differences between specialist and generalist SPC were an extra 20.59 tooth years and 3.95 mm attachment loss for generalist SPC. Incremental cost-effectiveness ratios were an extra 288 euros for one tooth year or an extra 1503 euros/1 mm reduction in loss of attachment for SPC delivered in specialist care.


CONCLUSIONS
SPC delivered in specialist as compared with general practice will result in greater stability of clinical attachment but this will be achieved at relatively greater cost.
Gaunt
Francesca
F
Faculty of Medical Sciences, School of Dental Sciences, Newcastle University, Framlington Place Newcastle upon Tyne, UK.
Devine
Maria
M
Pennington
Mark
M
Vernazza
Chris
C
Gwynnett
Erika
E
Steen
Nick
N
Heasman
Peter
P
D055113:Chronic Periodontitis / Q000191:economics / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003756:Dental Hygienists / Q000191:economics; D012534:Dental Scaling / Q000191:economics; D018450:Disease Progression; D005792:General Practice, Dental / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D010517:Periodontics / Q000191:economics; D012008:Recurrence; D016745:Root Planing / Q000191:economics; D016896:Treatment Outcome