An economic evaluation of maxillary implant overdentures based on six vs. four implants
Identifieur interne : 001C98 ( Main/Exploration ); précédent : 001C97; suivant : 001C99An 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.
Descripteurs français
- KwdFr :
- Analyse coût-bénéfice, Arbres de décision, Chaines de Markov, Humains, Implants dentaires (psychologie), Implants dentaires (économie), Maxillaire (), Modèles économiques, Mâchoire édentée (), Méthode de Monte-Carlo, Overdenture (psychologie), Overdenture (économie), Planification des soins du patient (économie), Probabilité, Prothèse dentaire complète supérieure (psychologie), Prothèse dentaire complète supérieure (économie), Prothèse dentaire implanto-portée (psychologie), Prothèse dentaire implanto-portée (économie), Préférence du patient (économie), Résultat thérapeutique, Rétention d'appareil de prothèse dentaire (instrumentation), Rétention d'appareil de prothèse dentaire (économie), Satisfaction du patient (économie), Échec de restauration dentaire (économie).
- MESH :
- psychologie : Implants dentaires, Overdenture, Prothèse dentaire complète supérieure, Prothèse dentaire implanto-portée, Rétention d'appareil de prothèse dentaire.
- économie : Implants dentaires, Overdenture, Planification des soins du patient, Prothèse dentaire complète supérieure, Prothèse dentaire implanto-portée, Préférence du patient, Rétention d'appareil de prothèse dentaire, Satisfaction du patient, Échec de restauration dentaire.
- Analyse coût-bénéfice, Arbres de décision, Chaines de Markov, Humains, Maxillaire, Modèles économiques, Mâchoire édentée, Méthode de Monte-Carlo, Probabilité, Résultat thérapeutique.
English descriptors
- KwdEn :
- Cost-Benefit Analysis, Decision Trees, Dental Implants (economics), Dental Implants (psychology), Dental Prosthesis, Implant-Supported (economics), Dental Prosthesis, Implant-Supported (psychology), Dental Restoration Failure (economics), Denture Retention (economics), Denture Retention (instrumentation), Denture, Complete, Upper (economics), Denture, Complete, Upper (psychology), Denture, Overlay (economics), Denture, Overlay (psychology), Humans, Jaw, Edentulous (surgery), Markov Chains, Maxilla (surgery), Models, Economic, Monte Carlo Method, Patient Care Planning (economics), Patient Preference (economics), Patient Satisfaction (economics), Probability, Treatment Outcome.
- MESH :
- chemical , economics : Dental Implants.
- chemical , psychology : Dental Implants.
- economics : Dental Prosthesis, Implant-Supported, Dental Restoration Failure, Denture Retention, Denture, Complete, Upper, Denture, Overlay, Patient Care Planning, Patient Preference, Patient Satisfaction.
- instrumentation : Denture Retention.
- psychology : Dental Prosthesis, Implant-Supported, Denture, Complete, Upper, Denture, Overlay.
- surgery : Jaw, Edentulous, Maxilla.
- Cost-Benefit Analysis, Decision Trees, Humans, Markov Chains, Models, Economic, Monte Carlo Method, Probability, Treatment Outcome.
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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Le document en format XML
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(surgery)</term><term>Markov Chains</term><term>Maxilla (surgery)</term><term>Models, Economic</term><term>Monte Carlo Method</term><term>Patient Care Planning (economics)</term><term>Patient Preference (economics)</term><term>Patient Satisfaction (economics)</term><term>Probability</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Analyse coût-bénéfice</term><term>Arbres de décision</term><term>Chaines de Markov</term><term>Humains</term><term>Implants dentaires (psychologie)</term><term>Implants dentaires (économie)</term><term>Maxillaire ()</term><term>Modèles économiques</term><term>Mâchoire édentée ()</term><term>Méthode de Monte-Carlo</term><term>Overdenture (psychologie)</term><term>Overdenture (économie)</term><term>Planification des soins du patient (économie)</term><term>Probabilité</term><term>Prothèse dentaire complète supérieure (psychologie)</term><term>Prothèse dentaire complète supérieure (économie)</term><term>Prothèse dentaire implanto-portée (psychologie)</term><term>Prothèse dentaire implanto-portée (économie)</term><term>Préférence du patient (économie)</term><term>Résultat thérapeutique</term><term>Rétention d'appareil de prothèse dentaire (instrumentation)</term><term>Rétention d'appareil de prothèse dentaire (économie)</term><term>Satisfaction du patient (économie)</term><term>Échec de restauration dentaire (économie)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="economics" xml:lang="en"><term>Dental Implants</term></keywords><keywords scheme="MESH" type="chemical" qualifier="psychology" xml:lang="en"><term>Dental Implants</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Dental Prosthesis, Implant-Supported</term><term>Dental Restoration Failure</term><term>Denture Retention</term><term>Denture, Complete, Upper</term><term>Denture, Overlay</term><term>Patient Care Planning</term><term>Patient Preference</term><term>Patient Satisfaction</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Denture Retention</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Implants dentaires</term><term>Overdenture</term><term>Prothèse dentaire complète supérieure</term><term>Prothèse dentaire implanto-portée</term><term>Rétention d'appareil de prothèse dentaire</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Dental Prosthesis, Implant-Supported</term><term>Denture, Complete, Upper</term><term>Denture, Overlay</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Jaw, Edentulous</term><term>Maxilla</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Implants dentaires</term><term>Overdenture</term><term>Planification des soins du patient</term><term>Prothèse dentaire complète supérieure</term><term>Prothèse dentaire implanto-portée</term><term>Préférence du patient</term><term>Rétention d'appareil de prothèse dentaire</term><term>Satisfaction du patient</term><term>Échec de restauration dentaire</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Cost-Benefit Analysis</term><term>Decision Trees</term><term>Humans</term><term>Markov Chains</term><term>Models, Economic</term><term>Monte Carlo Method</term><term>Probability</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Analyse coût-bénéfice</term><term>Arbres de décision</term><term>Chaines de Markov</term><term>Humains</term><term>Maxillaire</term><term>Modèles économiques</term><term>Mâchoire édentée</term><term>Méthode de Monte-Carlo</term><term>Probabilité</term><term>Résultat thérapeutique</term></keywords></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" uniqKey="Sendi P">P Sendi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Visser, A" uniqKey="Visser A">A Visser</name></author><author><name sortKey="Raghoebar, Gm" uniqKey="Raghoebar G">GM Raghoebar</name></author><author><name sortKey="Meijer, Hj" uniqKey="Meijer H">HJ Meijer</name></author><author><name sortKey="Batenburg, Rh" uniqKey="Batenburg R">RH Batenburg</name></author><author><name sortKey="Vissink, A" uniqKey="Vissink A">A Vissink</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sadowsky, Sj" uniqKey="Sadowsky S">SJ Sadowsky</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Slot, W" uniqKey="Slot W">W Slot</name></author><author><name sortKey="Raghoebar, Gm" uniqKey="Raghoebar G">GM Raghoebar</name></author><author><name sortKey="Vissink, A" uniqKey="Vissink A">A Vissink</name></author><author><name sortKey="Huddleston Slater, Jj" uniqKey="Huddleston Slater J">JJ 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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><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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