title: Agenesis of maxillary lateral incisor and tooth replacement: cost-effectiveness of different treatment alternatives.
abstract: OBJECTIVE
  To evaluate the long-term cost-effectiveness of five treatment alternatives for maxillary lateral incisor agenesis where space maintenance and tooth replacement are indicated.
  
  
  METHODS
  The following treatment modalities were considered: single-tooth implant-supported crown, resin-bonded fixed partial denture (FPD), cantilever FPD, full-coverage FPD, and autotransplantation. The cost-effectiveness for each treatment modality was determined as the ratio of the outcome of each modality divided by the cost. Direct costs, clinical and laboratory, were calculated based on national fee schedules and converted to international dollars using purchasing power parity exchange rates. Outcomes were based on the most recently published long-term (10-year) survival rates. Sensitivity analyses were carried out, testing the robustness of the cost-effectiveness analysis.
  
  
  RESULTS
  The five treatment modalities ranked in the following order from most to least cost-effective: autotransplantation, cantilever FPDs, resin-bonded FPDs, single-tooth implants and implant-supported crowns, and full-coverage FPDs. Sensitivity analysis illustrated that the cost-effectiveness analysis was reliable in identifying autotransplantation as the most and full-coverage FPDs as the least cost-effective treatment modalities.
  
  
  CONCLUSIONS
  When replacing a missing maxillary lateral incisor, the most costeffective, long-term treatment modality is autotransplantation, whereas the least cost-effective is full-coverage FPDs. However, factors such as patient age, the state of the dentition, occlusion, and tooth conservation should also influence the choice of restoration.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Antonarakis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Prevezanos
authors.forename: Jelena
authors.initials: J
authors.lastname: Gavric
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Christou
mesh_terms: D000848:Anodontia / Q000191:economics / Q000534:rehabilitation*; D064592:Autografts / Q000191:economics / Q000637:transplantation; D003362:Cost-Benefit Analysis; D003442:Crowns / Q000191:economics; D019250:Dental Implants, Single-Tooth / Q000191:economics; D017266:Dental Prosthesis / Q000191:economics*; D019094:Dental Prosthesis, Implant-Supported / Q000191:economics; D003830:Denture, Partial, Fixed / Q000191:economics; D016379:Denture, Partial, Fixed, Resin-Bonded / Q000191:economics; D004180:Direct Service Costs; D005245:Fee Schedules; D006801:Humans; D007180:Incisor / Q000002:abnormalities*; D007754:Laboratories, Dental / Q000191:economics; D008137:Longitudinal Studies; D008437:Maxilla; D012680:Sensitivity and Specificity; D013027:Space Maintenance, Orthodontic / Q000191:economics; D016019:Survival Analysis; D014070:Tooth / Q000637:transplantation; D016896:Treatment Outcome