title: Costs and clinical outcomes of implant placement during ablative surgery and postponed implant placement in curative oral oncology: a five-year retrospective cohort study.
abstract: OBJECTIVE
  The aim of this study was to compare costs and clinical outcomes of two protocols for implant placement in edentulous oral cancer patients: implant placement during ablative surgery and postponed implant placement.
  
  
  METHODS
  All edentulous patients who underwent curative tumor surgery between 2007 and 2009 at the Radboud university medical center (Radboudumc) and UMC Utrecht, both in the Netherlands, were included retrospectively. At the Radboudumc, 79 of 98 patients received implants during ablative surgery. At the UMC Utrecht, 18 of 95 patients received implants after a disease-free period of at least 6 months, because satisfying conventional dentures could not be made. Costs, implant details and clinical outcomes were recorded retrospectively up to 5 years after tumor surgery.
  
  
  RESULTS
  Individual costs of implant placement were lower in the during-ablative-surgery protocol (€2235 vs. €4152), while implant failure and loading were comparable to the postponed-placement protocol. In the during-ablative-surgery protocol, more patients received implant-retained overdentures (62% vs. 17%) and more patients had functioning dentures (65% vs. 47%), which were placed at an earlier stage (291 vs. 389 days after surgery). Overall costs of the during-ablative-surgery protocol were higher, as more patients received implants and functioning implant-retained dentures, which were more expensive than conventional dentures.
  
  
  CONCLUSIONS
  Placing implants during ablative surgery lowered the individual costs of implant placement and led to more patients with functioning dentures, while implant failure and loading were comparable to postponed placement.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.|Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Jan-Willem G H
authors.identifier: http://orcid.org/0000-0002-1599-6731
authors.initials: JGH
authors.lastname: Wetzels
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Gert J
authors.initials: GJ
authors.lastname: Meijer
authors.affiliation: Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Ron
authors.initials: R
authors.lastname: Koole
authors.affiliation: Section Biostatistics, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Eddy M
authors.initials: EM
authors.lastname: Adang
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Matthias A W
authors.initials: MAW
authors.lastname: Merkx
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.|Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands.|Julius Center Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Speksnijder
mesh_terms: D055011:Ablation Techniques; D000368:Aged; D003758:Dental Implantation, Endosseous / Q000191:economics*; D015921:Dental Implants / Q000191:economics*; D019094:Dental Prosthesis, Implant-Supported / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D009062:Mouth Neoplasms / Q000191:economics / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants
keywords: costs and cost analysis; dental implants; health expenditures; implant-supported dental prosthesis; mouth neoplasms