title: Cost-effectiveness of silicone and alginate impressions for complete dentures.
abstract: OBJECTIVE
  The aim of this study was to assess the cost effectiveness of silicone and alginate impressions for complete dentures.
  
  
  METHODS
  Cost effectiveness analyses were undertaken alongside a UK single centre, double blind, controlled, crossover clinical trial. Taking the perspective of the healthcare sector, effectiveness is measured using the EuroQol (EQ-5D-3L) which provides a single index value for health status that may be combined with time to produce quality adjusted life years (QALYs); and Oral Health Impact Profile (OHIP-EDENT). Incremental cost effectiveness ratios are presented representing the additional cost per one unit gained.
  
  
  RESULTS
  Mean cost was higher in the silicone impression group (£388.57 vs. £363.18). Negligible between-group differences were observed in QALY gains; the silicone group had greater mean OHIP-EDENT gains. The additional cost using silicone was £3.41 per change of one point in the OHIP-EDENT.
  
  
  CONCLUSIONS
  The silicone group was more costly, driven by the cost of materials. Changes in the EQ-5D and QALY gains over time and between arms were not statistically significant. Change in OHIP-EDENT score showed greater improvement in the silicone group and the difference between arms was statistically significant. Given negligible QALY gains and low level of resource use, results must be treated with caution. It is difficult to make robust claims about the comparative cost-effectiveness.
  
  
  CONCLUSIONS
  Silicone impressions for complete dentures improve patients' quality of life (OHIP-EDENT score). The extra cost of silicone impressions is £30 per patient. Dentists, patients and health care funders need to consider the clinical and financial value of silicone impressions. Different patients, different dentists, different health funders will have individual perceptions and judgements. ISRCTN01528038. NIHR-RfPB grant PB-PG-0408-16300. This article forms part of a project for which the author (TPH) won the Senior Clinical Unilever Hatton Award of the International Assocation for Dental Research, Capetown, South Africa, June 2014.
authors.affiliation: Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK.
authors.forename: C
authors.initials: C
authors.lastname: Hulme
authors.affiliation: Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK.
authors.forename: G
authors.initials: G
authors.lastname: Yu
authors.affiliation: Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK.
authors.forename: C
authors.initials: C
authors.lastname: Browne
authors.affiliation: Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK.
authors.forename: J
authors.initials: J
authors.lastname: O'Dwyer
authors.affiliation: University of Aberdeen Dental School, Cornhill Road, Aberdeen AB25 2ZR, UK.
authors.forename: H
authors.initials: H
authors.lastname: Craddock
authors.affiliation: Leeds Institute of Clinical Trials Research, University of Leeds, Leeds LS29JT, UK.
authors.forename: S
authors.initials: S
authors.lastname: Brown
authors.affiliation: Leeds Institute of Clinical Trials Research, University of Leeds, Leeds LS29JT, UK.
authors.forename: J
authors.initials: J
authors.lastname: Gray
authors.affiliation: Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK.
authors.forename: S
authors.initials: S
authors.lastname: Pavitt
authors.affiliation: Leeds Institute of Clinical Trials Research, University of Leeds, Leeds LS29JT, UK.
authors.forename: C
authors.initials: C
authors.lastname: Fernandez
authors.affiliation: Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK.
authors.forename: M
authors.initials: M
authors.lastname: Godfrey
authors.affiliation: Dental Translational Clinical Research Unit (DenTCRU), Leeds Dental Institute, University of Leeds, Leeds LS2 9LU, UK.
authors.forename: G
authors.initials: G
authors.lastname: Dukanovic
authors.affiliation: Leeds Dental Institute, University of Leeds, Leeds LS2 9LU, UK; Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
authors.forename: P
authors.initials: P
authors.lastname: Brunton
authors.affiliation: Leeds Dental Institute, University of Leeds, Leeds LS2 9LU, UK. Electronic address: t.p.hyde@leeds.ac.uk.
authors.forename: T P
authors.initials: TP
authors.lastname: Hyde
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000464:Alginates / Q000191:economics*; D003362:Cost-Benefit Analysis; D018592:Cross-Over Studies; D003729:Dental Care / Q000191:economics / Q000706:statistics & numerical data; D003760:Dental Impression Materials / Q000191:economics*; D003779:Denture Design / Q000191:economics*; D003824:Denture, Complete / Q000191:economics*; D004311:Double-Blind Method; D016527:Drug Costs; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012826:Silicone Elastomers / Q000191:economics*; D013218:State Dentistry / Q000191:economics; D013997:Time Factors; D006113:United Kingdom
chemical_list: D000464:Alginates; D003760:Dental Impression Materials; D012826:Silicone Elastomers
keywords: Cost; Cost effectiveness; Impression materials; Prosthodontics; Quality-of life; Resource