title: Cost-effectiveness of anterior implants versus fixed dental prostheses.
abstract: For the restoration of an anterior missing tooth, implant-supported single crowns (ISCs) or fixed dental prostheses (FDPs) are indicated, but it is not clear which type of restoration is more cost-effective. A self-selected trial was performed with 15 patients with ISCs and 11 with FDPs. Patient preferences were recorded with visual analog scales before treatment, 1 month following restoration, and then annually. Quality-adjusted tooth years (QATYs) were estimated by considering the type of reconstruction for replacing the missing tooth and its effect on the adjacent teeth. A stochastic cost-effectiveness model was developed using Monte Carlo simulation. The expected costs and QATYs were summarized in cost-effectiveness acceptability curves. ISC was the dominant strategy, with a QATY increase of 0.01 over 3 years and 0.04 over 10 years with a higher probability of being cost-effective. While both treatment options provided satisfactory long-term results from the patient's perspective, the lower initial costs, particularly laboratory fees, were responsible for the dominance of ISCs over FDPs.
authors.affiliation: Department of Periodontology, Endodontology, and Cariology, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland.
authors.forename: N U
authors.initials: NU
authors.lastname: Zitzmann
authors.forename: G
authors.initials: G
authors.lastname: Krastl
authors.forename: R
authors.initials: R
authors.lastname: Weiger
authors.forename: S
authors.initials: S
authors.lastname: Kühl
authors.forename: P
authors.initials: P
authors.lastname: Sendi
mesh_terms: D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003442:Crowns / Q000191:economics; D019250:Dental Implants, Single-Tooth / Q000191:economics*; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported / Q000191:economics; D003779:Denture Design; D003830:Denture, Partial, Fixed / Q000191:economics*; D004955:Esthetics, Dental; D005500:Follow-Up Studies; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000191:economics / Q000534:rehabilitation; D008137:Longitudinal Studies; D057240:Patient Preference; D017060:Patient Satisfaction; D011336:Probability; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D013269:Stochastic Processes
keywords: cost effectiveness; dental economics; dental restoration; fixed partial denture; patient satisfaction; single-tooth implants