title: A preliminary report of the cost-effectiveness of tooth replacement strategies for partially dentate elders.
abstract: OBJECTIVE
  To compare the cost-effectiveness of conventional treatment using partial dentures with functionally orientated treatment to replace missing teeth for partially dentate elders using a randomised controlled clinical trial.
  
  
  BACKGROUND
  In many countries, including the Republic of Ireland, the only publically funded treatment option offered to partially dentate older patients is a removable partial denture. However, evidence suggests that these removable prostheses are unpopular with patients and can potentially increase the risk of further dental disease and subsequent tooth loss.
  
  
  METHODS
  Fourty-four partially dentate patients aged 65 years and older were recruited. Patients were randomly assigned to the two treatment arms of the study. The conventional treatment group received removable partial dentures to replace all missing natural teeth. The functionally orientated group was restored to a Shortened Dental Arch (SDA) of 10 occluding contacts using resin-bonded bridgework (RBB). The costs associated with each treatment were recorded. Effectiveness was measured in terms of the impact on oral health-related quality of life (OHRQoL) using OHIP-14.
  
  
  RESULTS
  Both groups reported improvements in OHRQoL 1 month after completion of treatment. The conventional treatment group required 8.3 clinic visits as compared to 4.4 visits for the functionally orientated group. The mean total treatment time was 183 min 19 s for the conventional group vs. 124 min 8 s for the functionally orientated group. The average cost of treatment for the conventional group was 487.74 Euros compared to 356.20 Euros for the functional group.
  
  
  CONCLUSIONS
  Functionally orientated treatment was more cost-effective than conventional treatment in terms of treatment effect and opportunity costs to the patients' time.
authors.affiliation: Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, Ireland. g.mckenna@ucc.ie
authors.forename: Gerald
authors.initials: G
authors.lastname: McKenna
authors.forename: P Finbarr
authors.initials: PF
authors.lastname: Allen
authors.forename: Noel
authors.initials: N
authors.lastname: Woods
authors.forename: Denis
authors.initials: D
authors.lastname: O'Mahony
authors.forename: Cristiane
authors.initials: C
authors.lastname: DaMata
authors.forename: Michael
authors.initials: M
authors.lastname: Cronin
authors.forename: Charles
authors.initials: C
authors.lastname: Normand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D003729:Dental Care / Q000191:economics; D003779:Denture Design; D016379:Denture, Partial, Fixed, Resin-Bonded / Q000191:economics* / Q000523:psychology; D003832:Denture, Partial, Removable / Q000191:economics* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007494:Ireland; D007576:Jaw, Edentulous, Partially / Q000523:psychology / Q000534:rehabilitation*; D007754:Laboratories, Dental / Q000191:economics; D008297:Male; D009909:Oral Health; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome