title: Cumulative costs for the prosthetic reconstructions and maintenance in young adult patients with birth defects affecting the formation of teeth.
abstract: OBJECTIVE
  To assess retrospectively the cumulative costs for the long-term oral rehabilitation of patients with birth defects affecting the development of teeth.
  
  
  METHODS
  Patients with birth defects who had received fixed reconstructions on teeth and/or implants > or =5 years ago were asked to participate in a comprehensive clinical, radiographic and economic evaluation.
  
  
  RESULTS
  From the 45 patients included, 18 were cases with a cleft lip and palate, five had amelogenesis/dentinogenesis imperfecta and 22 were cases with hypodontia/oligodontia. The initial costs for the first oral rehabilitation (before the age of 20) had been covered by the Swiss Insurance for Disability. The costs for the initial rehabilitation of the 45 cases amounted to 407,584 CHF (39% for laboratory fees). Linear regression analyses for the initial treatment costs per replaced tooth revealed the formula 731 CHF+(811 CHF x units) on teeth and 3369 CHF+(1183 CHF x units) for reconstructions on implants (P<.001). Fifty-eight percent of the patients with tooth-supported reconstructions remained free from failures/complications (median observation 15.7 years). Forty-seven percent of the patients with implant-supported reconstructions remained free from failures/complications (median observation 8 years). The long-term cumulative treatment costs for implant cases, however, were not statistically significantly different compared with cases reconstructed with tooth-supported fixed reconstructions. Twenty-seven percent of the initial treatment costs were needed to cover supportive periodontal therapy as well as the treatment of technical/biological complications and failures.
  
  
  CONCLUSIONS
  Insurance companies should accept to cover implant-supported reconstructions because there is no need to prepare healthy teeth, fewer tooth units need to be replaced and the cumulative long-term costs seem to be similar compared with cases restored on teeth.
authors.affiliation: School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Erol
authors.initials: E
authors.lastname: Incici
authors.forename: Giedre
authors.initials: G
authors.lastname: Matuliene
authors.forename: Jürg
authors.initials: J
authors.lastname: Hüsler
authors.forename: Giovanni E
authors.initials: GE
authors.lastname: Salvi
authors.forename: Bjarni
authors.initials: B
authors.lastname: Pjetursson
authors.forename: Urs
authors.initials: U
authors.lastname: Brägger
mesh_terms: D000567:Amelogenesis Imperfecta / Q000191:economics; D000848:Anodontia / Q000191:economics; D002971:Cleft Lip / Q000191:economics; D002972:Cleft Palate / Q000191:economics; D003442:Crowns / Q000191:economics; D003731:Dental Caries / Q000191:economics; D015921:Dental Implants / Q000191:economics; D017266:Dental Prosthesis / Q000191:economics*; D019094:Dental Prosthesis, Implant-Supported / Q000191:economics; D003788:Dental Pulp Diseases / Q000191:economics; D019232:Dental Restoration Failure; D003811:Dentinogenesis Imperfecta / Q000191:economics; D003830:Denture, Partial, Fixed / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D018868:Insurance, Disability / Q000191:economics; D007754:Laboratories, Dental / Q000191:economics; D008297:Male; D009065:Mouth Rehabilitation / Q000191:economics*; D010510:Periodontal Diseases / Q000191:economics; D012189:Retrospective Studies; D017213:Root Caries / Q000191:economics; D012391:Root Resorption / Q000191:economics; D013557:Switzerland; D014071:Tooth Abnormalities / Q000191:economics*; D055815:Young Adult
chemical_list: D015921:Dental Implants