An economic evaluation of maxillary implant overdentures based on six vs. four implants
Identifieur interne : 000479 ( Pmc/Checkpoint ); précédent : 000478; suivant : 000480An economic evaluation of maxillary implant overdentures based on six vs. four implants
Auteurs : Stefan Listl [Allemagne] ; Leonhard Fischer [Allemagne] ; Nikolaos Nikitas Giannakopoulos [Allemagne]Source :
- BMC Oral Health [ 1472-6831 ] ; 2014.
Abstract
The purpose of the present study was to assess the value for money achieved by bar-retained implant overdentures based on six implants compared with four implants as treatment alternatives for the edentulous maxilla.
A Markov decision tree model was constructed and populated with parameter estimates for implant and denture failure as well as patient-centred health outcomes as available from recent literature. The decision scenario was modelled within a ten year time horizon and relied on cost reimbursement regulations of the German health care system. The cost-effectiveness threshold was identified above which the six-implant solution is preferable over the four-implant solution. Uncertainties regarding input parameters were incorporated via one-way and probabilistic sensitivity analysis based on Monte-Carlo simulation.
Within a base case scenario of average treatment complexity, the cost-effectiveness threshold was identified to be 17,564 € per year of denture satisfaction gained above of which the alternative with six implants is preferable over treatment including four implants. Sensitivity analysis yielded that, depending on the specification of model input parameters such as patients’ denture satisfaction, the respective cost-effectiveness threshold varies substantially.
The results of the present study suggest that bar-retained maxillary overdentures based on six implants provide better patient satisfaction than bar-retained overdentures based on four implants but are considerably more expensive. Final judgements about value for money require more comprehensive clinical evidence including patient-centred health outcomes.
Url:
DOI: 10.1186/1472-6831-14-105
PubMed: 25135370
PubMed Central: 4147876
Affiliations:
- Allemagne
- Bade-Wurtemberg, Bavière, District de Haute-Bavière, District de Karlsruhe
- Heidelberg, Munich
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">An economic evaluation of maxillary implant overdentures based on six vs. four implants</title><author><name sortKey="Listl, Stefan" sort="Listl, Stefan" uniqKey="Listl S" first="Stefan" last="Listl">Stefan Listl</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Conservative Dentistry, Heidelberg University, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Conservative Dentistry, Heidelberg University, Im Neuenheimer Feld 400, 69120 Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I2">Max Planck Institute for Social Law and Social Policy, Munich Center for the Economics of Aging, Munich, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Max Planck Institute for Social Law and Social Policy, Munich Center for the Economics of Aging, Munich</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement></placeName></affiliation></author><author><name sortKey="Fischer, Leonhard" sort="Fischer, Leonhard" uniqKey="Fischer L" first="Leonhard" last="Fischer">Leonhard Fischer</name><affiliation wicri:level="3"><nlm:aff id="I3">Department of Conservative Dentistry, Heidelberg University, Heidelberg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Conservative Dentistry, Heidelberg University, Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author><author><name sortKey="Giannakopoulos, Nikolaos Nikitas" sort="Giannakopoulos, Nikolaos Nikitas" uniqKey="Giannakopoulos N" first="Nikolaos Nikitas" last="Giannakopoulos">Nikolaos Nikitas Giannakopoulos</name><affiliation wicri:level="3"><nlm:aff id="I4">Department of Prosthodontics, Heidelberg University, Heidelberg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Prosthodontics, Heidelberg University, Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25135370</idno><idno type="pmc">4147876</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147876</idno><idno type="RBID">PMC:4147876</idno><idno type="doi">10.1186/1472-6831-14-105</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000272</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000272</idno><idno type="wicri:Area/Pmc/Curation">000272</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000272</idno><idno type="wicri:Area/Pmc/Checkpoint">000479</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000479</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">An economic evaluation of maxillary implant overdentures based on six vs. four implants</title><author><name sortKey="Listl, Stefan" sort="Listl, Stefan" uniqKey="Listl S" first="Stefan" last="Listl">Stefan Listl</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Conservative Dentistry, Heidelberg University, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Conservative Dentistry, Heidelberg University, Im Neuenheimer Feld 400, 69120 Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I2">Max Planck Institute for Social Law and Social Policy, Munich Center for the Economics of Aging, Munich, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Max Planck Institute for Social Law and Social Policy, Munich Center for the Economics of Aging, Munich</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement></placeName></affiliation></author><author><name sortKey="Fischer, Leonhard" sort="Fischer, Leonhard" uniqKey="Fischer L" first="Leonhard" last="Fischer">Leonhard Fischer</name><affiliation wicri:level="3"><nlm:aff id="I3">Department of Conservative Dentistry, Heidelberg University, Heidelberg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Conservative Dentistry, Heidelberg University, Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author><author><name sortKey="Giannakopoulos, Nikolaos Nikitas" sort="Giannakopoulos, Nikolaos Nikitas" uniqKey="Giannakopoulos N" first="Nikolaos Nikitas" last="Giannakopoulos">Nikolaos Nikitas Giannakopoulos</name><affiliation wicri:level="3"><nlm:aff id="I4">Department of Prosthodontics, Heidelberg University, Heidelberg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Prosthodontics, Heidelberg University, Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author></analytic><series><title level="j">BMC Oral Health</title><idno type="eISSN">1472-6831</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The purpose of the present study was to assess the value for money achieved by bar-retained implant overdentures based on six implants compared with four implants as treatment alternatives for the edentulous maxilla.</p></sec><sec><title>Methods</title><p>A Markov decision tree model was constructed and populated with parameter estimates for implant and denture failure as well as patient-centred health outcomes as available from recent literature. The decision scenario was modelled within a ten year time horizon and relied on cost reimbursement regulations of the German health care system. The cost-effectiveness threshold was identified above which the six-implant solution is preferable over the four-implant solution. Uncertainties regarding input parameters were incorporated via one-way and probabilistic sensitivity analysis based on Monte-Carlo simulation.</p></sec><sec><title>Results</title><p>Within a base case scenario of average treatment complexity, the cost-effectiveness threshold was identified to be 17,564 € per year of denture satisfaction gained above of which the alternative with six implants is preferable over treatment including four implants. Sensitivity analysis yielded that, depending on the specification of model input parameters such as patients’ denture satisfaction, the respective cost-effectiveness threshold varies substantially.</p></sec><sec><title>Conclusions</title><p>The results of the present study suggest that bar-retained maxillary overdentures based on six implants provide better patient satisfaction than bar-retained overdentures based on four implants but are considerably more expensive. Final judgements about value for money require more comprehensive clinical evidence including patient-centred health outcomes.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Carlsson, Ge" uniqKey="Carlsson G">GE Carlsson</name></author><author><name sortKey="Omar, R" uniqKey="Omar R">R Omar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Thomason, Jm" uniqKey="Thomason J">JM Thomason</name></author><author><name sortKey="Kelly, Sa" uniqKey="Kelly S">SA Kelly</name></author><author><name sortKey="Bendkowski, A" uniqKey="Bendkowski A">A Bendkowski</name></author><author><name sortKey="Ellis, Js" uniqKey="Ellis J">JS Ellis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zitzmann, Nu" uniqKey="Zitzmann N">NU Zitzmann</name></author><author><name sortKey="Marinello, Cp" uniqKey="Marinello C">CP Marinello</name></author><author><name sortKey="Sendi, P" 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sortKey="Lepkowski, J" uniqKey="Lepkowski J">J Lepkowski</name></author><author><name sortKey="Belli, R" uniqKey="Belli R">R Belli</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mccabe, C" uniqKey="Mccabe C">C McCabe</name></author><author><name sortKey="Claxton, K" uniqKey="Claxton K">K Claxton</name></author><author><name sortKey="Culyer, Aj" uniqKey="Culyer A">AJ Culyer</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article" xml:lang="en"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Oral Health</journal-id><journal-id journal-id-type="iso-abbrev">BMC Oral Health</journal-id><journal-title-group><journal-title>BMC Oral Health</journal-title></journal-title-group><issn pub-type="epub">1472-6831</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25135370</article-id><article-id pub-id-type="pmc">4147876</article-id><article-id pub-id-type="publisher-id">1472-6831-14-105</article-id><article-id pub-id-type="doi">10.1186/1472-6831-14-105</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>An economic evaluation of maxillary implant overdentures based on six vs. four implants</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Listl</surname><given-names>Stefan</given-names></name><xref ref-type="aff" rid="I1">1</xref><xref ref-type="aff" rid="I2">2</xref><email>stefan.listl@med.uni-heidelberg.de</email></contrib><contrib contrib-type="author" id="A2"><name><surname>Fischer</surname><given-names>Leonhard</given-names></name><xref ref-type="aff" rid="I3">3</xref><email>fischerleo1@googlemail.com</email></contrib><contrib contrib-type="author" id="A3"><name><surname>Giannakopoulos</surname><given-names>Nikolaos Nikitas</given-names></name><xref ref-type="aff" rid="I4">4</xref><email>Nik.Giannakopoulos@med.uni-heidelberg.de</email></contrib></contrib-group><aff id="I1"><label>1</label>Department of Conservative Dentistry, Heidelberg University, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany</aff><aff id="I2"><label>2</label>Max Planck Institute for Social Law and Social Policy, Munich Center for the Economics of Aging, Munich, Germany</aff><aff id="I3"><label>3</label>Department of Conservative Dentistry, Heidelberg University, Heidelberg, Germany</aff><aff id="I4"><label>4</label>Department of Prosthodontics, Heidelberg University, Heidelberg, Germany</aff><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>18</day><month>8</month><year>2014</year></pub-date><volume>14</volume><fpage>105</fpage><lpage>105</lpage><history><date date-type="received"><day>27</day><month>6</month><year>2014</year></date><date date-type="accepted"><day>13</day><month>8</month><year>2014</year></date></history><permissions><copyright-statement>Copyright © 2014 Listl et al.; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2014</copyright-year><copyright-holder>Listl et al.; licensee BioMed Central Ltd.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><self-uri xlink:href="http://www.biomedcentral.com/1472-6831/14/105"></self-uri><abstract><sec><title>Background</title><p>The purpose of the present study was to assess the value for money achieved by bar-retained implant overdentures based on six implants compared with four implants as treatment alternatives for the edentulous maxilla.</p></sec><sec><title>Methods</title><p>A Markov decision tree model was constructed and populated with parameter estimates for implant and denture failure as well as patient-centred health outcomes as available from recent literature. The decision scenario was modelled within a ten year time horizon and relied on cost reimbursement regulations of the German health care system. The cost-effectiveness threshold was identified above which the six-implant solution is preferable over the four-implant solution. Uncertainties regarding input parameters were incorporated via one-way and probabilistic sensitivity analysis based on Monte-Carlo simulation.</p></sec><sec><title>Results</title><p>Within a base case scenario of average treatment complexity, the cost-effectiveness threshold was identified to be 17,564 € per year of denture satisfaction gained above of which the alternative with six implants is preferable over treatment including four implants. Sensitivity analysis yielded that, depending on the specification of model input parameters such as patients’ denture satisfaction, the respective cost-effectiveness threshold varies substantially.</p></sec><sec><title>Conclusions</title><p>The results of the present study suggest that bar-retained maxillary overdentures based on six implants provide better patient satisfaction than bar-retained overdentures based on four implants but are considerably more expensive. Final judgements about value for money require more comprehensive clinical evidence including patient-centred health outcomes.</p></sec></abstract><kwd-group><kwd>Cost-effectiveness analysis</kwd><kwd>Implants</kwd><kwd>Dentures</kwd><kwd>Maxilla</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Allemagne</li></country><region><li>Bade-Wurtemberg</li><li>Bavière</li><li>District de Haute-Bavière</li><li>District de Karlsruhe</li></region><settlement><li>Heidelberg</li><li>Munich</li></settlement></list><tree><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Listl, Stefan" sort="Listl, Stefan" uniqKey="Listl S" first="Stefan" last="Listl">Stefan Listl</name></region><name sortKey="Fischer, Leonhard" sort="Fischer, Leonhard" uniqKey="Fischer L" first="Leonhard" last="Fischer">Leonhard Fischer</name><name sortKey="Giannakopoulos, Nikolaos Nikitas" sort="Giannakopoulos, Nikolaos Nikitas" uniqKey="Giannakopoulos N" first="Nikolaos Nikitas" last="Giannakopoulos">Nikolaos Nikitas Giannakopoulos</name><name sortKey="Listl, Stefan" sort="Listl, Stefan" uniqKey="Listl S" first="Stefan" last="Listl">Stefan Listl</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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