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Losenická J, Gajdoš O, Kamenský V. Cost-utility analysis of an implant treatment in dentistry. BMC Oral Health 2021; 21:433. [PMID: 34488727 PMCID: PMC8422643 DOI: 10.1186/s12903-021-01790-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background When dealing with the replacement of one missing tooth, the patient has the option of choosing between different types of treatment interventions. Several important factors play a role in his decision-making process, including his limited financial means and his efforts to solve the problem of missing teeth as effectively as possible. The main goal of the study is the economic-clinical evaluation of implant treatment, as a surgical-prosthetic method in dentistry, in case of replacement of one missing tooth of the molar area. Methods Cost-utility analysis from the patient's perspective is used for evaluation. The selected comparator is a purely prosthetic solution with the help of a three-unit fixed dental prosthesis. Cost-utility analysis is modelled using Markov models, which consider a 30-year time horizon. Results Based on the results of modelling, the intervention evaluated by the patient, i.e. treatment with the help of implant-supported single crown, brings exactly 15.31 quality-adjusted prosthesis years (QAPY) after 30 years. The value of incremental cost-utility ratio amounted to USD − 1434. Conclusion The results of the cost-utility analysis suggest that implant treatment with an implant-supported single crown is more cost-effective than treatment with the three-unit fixed dental prosthesis.
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Affiliation(s)
- Johana Losenická
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, nám. Sítná 3105, 272 01, Kladno, Czech Republic
| | - Ondřej Gajdoš
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, nám. Sítná 3105, 272 01, Kladno, Czech Republic.
| | - Vojtěch Kamenský
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, nám. Sítná 3105, 272 01, Kladno, Czech Republic
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Martins SM, Ferreira FA, Ferreira JJM, Marques CS. An artificial-intelligence-based method for assessing service quality: insights from the prosthodontics sector. JOURNAL OF SERVICE MANAGEMENT 2020. [DOI: 10.1108/josm-03-2019-0084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe prosthodontics sector is facing major challenges because of scientific and technological advances that imply a clearer definition of lines of action and decision making processes. Measuring quality of service in this sector is a complex decision problem since the perceptions of three main players need to be considered: patients, dentists and dental technicians. This study sought to develop an artificial-intelligence-based (AI-based) method for assessing service quality in the dental prosthesis sector.Design/methodology/approachUsing strategic options development and analysis (SODA), which is grounded on cognitive mapping, and the measuring attractiveness by a categorical based evaluation technique (MACBETH), a constructivist decision support system was designed to facilitate the assessment of service quality in the dental prosthesis sector. The system was tested, and the results were validated both by the members of an expert panel and by the vice-president of the Portuguese association of dental prosthesis technicians.FindingsThe methodological process developed in this study is extremely versatile and its practical application facilitated the development of an empirically robust evaluation model in this study context. Specifically, the profile analyses carried out in actual clinics allowed the cases in which improvements are needed to be identified.Originality/valueAlthough already applied in the fields of AI and decision making, no prior work reporting the use of SODA and MACBETH for assessing service quality in the prosthodontics sector has been found.
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Joda T, Ferrari M, Gallucci GO, Wittneben JG, Brägger U. Digital technology in fixed implant prosthodontics. Periodontol 2000 2018; 73:178-192. [PMID: 28000274 DOI: 10.1111/prd.12164] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Digital protocols are increasingly influencing prosthodontic treatment concepts. Implant-supported single-unit and short-span reconstructions will benefit mostly from the present digital trends. In these protocols, monolithic implant crowns connected to prefabricated titanium abutments, which are created based on data obtained from an intraoral scan followed by virtual design and production, without the need of a physical master cast, have to be considered in lieu of conventional manufacturing techniques for posterior implant restorations. No space for storage is needed in the complete digital workflow, and if a remake is required a replica of the original reconstruction can be produced quickly and inexpensively using rapid prototyping. The technological process is split into subtractive methods, such as milling or laser ablation, and additive processing, such as three-dimensional printing and selective laser melting. The dimensions of the supra-implant soft-tissue architecture can be calculated in advance of implant placement, according to the morphologic copy, and consequently are individualized for each patient. All these technologies have to be considered before implementing new digital dental workflows in daily routine. The correct indication and application are prerequisite and crucial for the success of the overall therapy, and, finally, for a satisfied patient. This includes a teamwork approach and equally affects the clinician, the dental assistant and the technician as well. The digitization process has the potential to change the entire dental profession. The major benefits will be reduced production costs, improvement in time efficiency and fulfilment of patients' perceptions of a modernized treatment concept.
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Cost-effectiveness analysis of the single-implant mandibular overdenture versus conventional complete denture: study protocol for a randomized controlled trial. Trials 2016; 17:533. [PMID: 27814749 PMCID: PMC5097429 DOI: 10.1186/s13063-016-1646-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 10/05/2016] [Indexed: 12/03/2022] Open
Abstract
Background Preliminary clinical studies on the single-implant mandibular overdenture (SIMO) have reported favorable results as an alternative to the conventional complete dentures for rehabilitation of the edentulous mandible. Clinical and patient-reported outcomes were assessed but no evidence is available with respect to the cost-effectiveness of this treatment, which is particularly important to test whether the incremental cost associated with the implant treatment is justified facing the benefits from the intervention. Thus, the aim of this study is to assess the cost-effectiveness of single-implant mandibular overdentures. Methods/design This randomized clinical trial will include edentulous individuals who meet eligibility criteria. Participants will be randomized into one of the treatment groups: a conventional complete denture group or a single-implant mandibular overdenture group. Direct costs related to therapies in both groups will be identified, measured and valuated for 1 year after treatment. Oral health-related quality of life and satisfaction with the dentures will be the primary outcome variables. Incremental cost-effectiveness ratios will be estimated and graphically presented on cost-effectiveness planes. A Markov decision tree will be constructed to set out the consequences of the competing alternatives. Sensitivity analysis on the most important assumptions will be performed in order to assess the robustness of the model. Discussion This is the first trial-based cost-effectiveness study on single-implant mandibular overdentures. Specific challenges in designing the protocol are considered. The expected results are of high clinical relevance and may contribute to the decision-making process when choosing between different alternatives for the rehabilitation of the edentulous mandible. Trial registration ClinicalTrials.gov Identifier: NCT02710357, registered on 11 March 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1646-0) contains supplementary material, which is available to authorized users.
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Bartold PM, Ivanovski S, Darby I. Implants for the aged patient: biological, clinical and sociological considerations. Periodontol 2000 2016; 72:120-34. [DOI: 10.1111/prd.12133] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2015] [Indexed: 02/06/2023]
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Jensen C, Ross J, Feenstra TL, Raghoebar GM, Speksnijder C, Meijer HJA, Cune MS. Cost-effectiveness of implant-supported mandibular removable partial dentures. Clin Oral Implants Res 2016; 28:594-601. [PMID: 27080041 DOI: 10.1111/clr.12840] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. MATERIAL AND METHODS Thirty subjects were included. A new RPD was made and implant support was provided 3 months later. Treatment costs (opportunity costs and costs based on tariffs) were calculated. Treatment effect was expressed by means of the Dutch Oral Health Impact Profile questionnaire (OHIP-NL49), a chewing ability test (Mixing Ability Index, MAI) and a short-form health survey measuring perceived general health (SF-36), which was subsequently converted into quality-adjusted-life-years (QALYs). The incremental cost-effectiveness ratio (ICER) was the primary outcome measure of cost-effectiveness, comparing both treatment strategies. RESULTS The mean total opportunity costs were €981 (95% CI €971-€991) for the RPD treatment and €2.480 (95% CI €2.461-€2.500) for the ISRPD treatment. The total costs derived from the national tariff structure were €850 for the RPD treatment and €2.610 for the ISRPD treatment. The ICER for OHIP-NL49 and MAI using the opportunity costs was €80 and €786, respectively. When using the tariff structure, corresponding ICERs were €94 and €921. The effect of supporting an RPD with implants when expressed in QALYs was negligible; hence an ICER was not determined. CONCLUSIONS It is concluded that depending on the choice of outcome measure and monetary threshold, supporting an RPD with implants is cost-effective when payers are willing to pay more than €80 per OHIP point gained. Per MAI point gained, an additional €786 has to be invested.
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Affiliation(s)
- Charlotte Jensen
- Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jamila Ross
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University of Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Talitha L Feenstra
- Department of Epidemiology, Health Technology Assessment Unit, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Caroline Speksnijder
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University of Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Henny J A Meijer
- Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Marco S Cune
- Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius Hospital Nieuwegein, Nieuwegein, the Netherlands
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Joda T, Brägger U. Time-efficiency analysis of the treatment with monolithic implant crowns in a digital workflow: a randomized controlled trial. Clin Oral Implants Res 2016; 27:1401-1406. [PMID: 27796072 DOI: 10.1111/clr.12753] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of the randomized controlled trial was to analyze time-efficiency of a treatment with implant crowns made of monolithic lithium disilicate (LS2) plus titanium base vs. porcelain fuse to zirconium dioxide (ZrO2 ) in a digital workflow. MATERIALS AND METHODS Twenty study participants were included for single-tooth replacement in premolar and molar sites. Baseline was the start of the prosthetic treatment. All patients received transocclusal screw-retained implant reconstructions on a soft tissue level-type implant. The 3D implant position was captured with intraoral optical scanning (IOS). After randomization, ten patients were restored with CAD-/CAM-produced monolithic LS2-crowns bonded to prefabricated titanium abutments without any physical models (test), and ten patients with CAD-/CAM-fabricated ZrO2 -suprastructures and hand-layered ceramic veneering with milled master models (control). Every single clinical and laboratory work step was timed in minutes and then analyzed for time-efficiency with Wilcoxon Rank Sum Tests. Direct costs were assessed for laboratory fees for first line production in Swiss Francs (CHF). RESULTS Two clinical appointments were necessary for IOS and seating of all implant crowns. The mean total production time, as the sum of clinical plus laboratory work steps, was significantly different, resulting in 75.3 min (SD ± 2.1) for test and 156.6 min (SD ± 4.6) for control [P = 0.0001]. Analysis for clinical treatment sessions showed a significantly shorter mean chair time for the complete digital workflow of 20.8 min (SD ± 0.3) compared to 24.1 min (SD ± 1.1) [P = 0.001]. Even more obvious were the results for the mean laboratory work time with a significant reduction of 54.5 min (SD ± 4.9) vs. 132.5 min (SD ± 8.7), respectively [P = 0.0001]. CONCLUSION The test workflow was more time-efficient than the controls for implant-supported crowns; notably, laboratory fabrication steps could be effectively shortened with the digital process of monolithic LS2 plus titanium base resulting in more than 30% reduced overall treatment costs.
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Affiliation(s)
- Tim Joda
- Section for Digital Reconstructive Technology & Implant Dentistry [DiRecT+ID], School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Urs Brägger
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Tysome J, Hill-Feltham P, Hodgetts W, McKinnon B, Monksfield P, Sockalingham R, Johansson M, Snik A. The Auditory Rehabilitation Outcomes Network: an international initiative to develop core sets of patient-centred outcome measures to assess interventions for hearing loss. Clin Otolaryngol 2015; 40:512-5. [DOI: 10.1111/coa.12559] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 01/13/2023]
Affiliation(s)
- J.R. Tysome
- Cambridge University Hospitals; Cambridge UK
| | | | - W.E. Hodgetts
- University of Alberta and Institute for Reconstructive Sciences in Medicine; Edmonton AB Canada
| | | | | | | | - M.L. Johansson
- Oticon Medical; Askim Sweden
- Department of Biomaterials; Sahlgrenska Academy at University of Gothenburg; Gothenburg Sweden
| | - A.F. Snik
- Radboud University; Nijmegen The Netherlands
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Mo A, Hjortsjö C, Olsen-Bergem H, Jokstad A. Maxillary 3-implant removable prostheses without palatal coverage on Locator abutments - a case series. Clin Oral Implants Res 2015; 27:1193-1199. [DOI: 10.1111/clr.12724] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Arild Mo
- Department of Clinical Dentistry; Faculty of Health Sciences; UiT The Arctic University of Norway; Tromsø Norway
| | - Carl Hjortsjö
- Department of Prosthetic Dentistry and Oral Function; Institute of Clinical Dentistry; University of Oslo; Oslo Norway
| | - Heming Olsen-Bergem
- Department of Oral and Maxillofacial Surgery; Institute of Clinical Dentistry; University of Oslo; Oslo Norway
| | - Asbjørn Jokstad
- Department of Clinical Dentistry; Faculty of Health Sciences; UiT The Arctic University of Norway; Tromsø Norway
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Joda T, Brägger U. Digital vs. conventional implant prosthetic workflows: a cost/time analysis. Clin Oral Implants Res 2014; 26:1430-5. [PMID: 25179680 DOI: 10.1111/clr.12476] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this prospective cohort trial was to perform a cost/time analysis for implant-supported single-unit reconstructions in the digital workflow compared to the conventional pathway. MATERIALS AND METHODS A total of 20 patients were included for rehabilitation with 2 × 20 implant crowns in a crossover study design and treated consecutively each with customized titanium abutments plus CAD/CAM-zirconia-suprastructures (test: digital) and with standardized titanium abutments plus PFM-crowns (control conventional). Starting with prosthetic treatment, analysis was estimated for clinical and laboratory work steps including measure of costs in Swiss Francs (CHF), productivity rates and cost minimization for first-line therapy. Statistical calculations were performed with Wilcoxon signed-rank test. RESULTS Both protocols worked successfully for all test and control reconstructions. Direct treatment costs were significantly lower for the digital workflow 1815.35 CHF compared to the conventional pathway 2119.65 CHF [P = 0.0004]. For subprocess evaluation, total laboratory costs were calculated as 941.95 CHF for the test group and 1245.65 CHF for the control group, respectively [P = 0.003]. The clinical dental productivity rate amounted to 29.64 CHF/min (digital) and 24.37 CHF/min (conventional) [P = 0.002]. Overall, cost minimization analysis exhibited an 18% cost reduction within the digital process. CONCLUSION The digital workflow was more efficient than the established conventional pathway for implant-supported crowns in this investigation.
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Affiliation(s)
- Tim Joda
- Division of Fixed Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Urs Brägger
- Division of Fixed Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland
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Dierens M, Vandeweghe S, Kisch J, Nilner K, Cosyn J, De Bruyn H. Cost estimation of single-implant treatment in the periodontally healthy patient after 16-22 years of follow-up. Clin Oral Implants Res 2014; 26:1288-96. [DOI: 10.1111/clr.12453] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2014] [Indexed: 11/27/2022]
Affiliation(s)
- M. Dierens
- Department of Periodontology and Oral Implantology; Dental School; Faculty of Medicine and Health Sciences; University of Ghent; Ghent Belgium
| | - S. Vandeweghe
- Department of Periodontology and Oral Implantology; Dental School; Faculty of Medicine and Health Sciences; University of Ghent; Ghent Belgium
- Department of Prosthetic Dentistry; Malmö University; Malmö Sweden
| | - J. Kisch
- Clinic for Prosthodontics; Centre of Dental Specialist Care; Malmö Sweden
| | - K. Nilner
- Clinic for Prosthodontics; Centre of Dental Specialist Care; Malmö Sweden
| | - J. Cosyn
- Department of Periodontology and Oral Implantology; Dental School; Faculty of Medicine and Health Sciences; University of Ghent; Ghent Belgium
- Free University of Brussels (VUB); Faculty of Medicine and Pharmacy; Dental Medicine; Brussels Belgium
| | - H. De Bruyn
- Department of Periodontology and Oral Implantology; Dental School; Faculty of Medicine and Health Sciences; University of Ghent; Ghent Belgium
- Department of Prosthetic Dentistry; Malmö University; Malmö Sweden
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Foster Page LA, Thomson WM, Marshman Z, Stevens KJ. The potential of the Child Health Utility 9D Index as an outcome measure for child dental health. BMC Oral Health 2014; 14:90. [PMID: 25027722 PMCID: PMC4118790 DOI: 10.1186/1472-6831-14-90] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 07/02/2014] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The Child Health Utility 9D (CHU9D) is a relatively new generic child health-related quality of life measure (HRQoL)-designed to be completed by children-which enables the calculation of utility values.The aim is to investigate the use of the CHU9D Index as an outcome measure for child dental health in New Zealand. METHOD A survey was conducted of children aged between 6 and 9 years attending for routine dental examinations in community clinics in Dunedin (New Zealand) in 2012. The CHU9D, a HRQoL, was used, along with the Child Perceptions Questionnaire (CPQ), a validated oral health-related quality of life (OHRQoL) measure. Socio-demographic characteristics (sex, age, ethnicity and household deprivation) were recorded. Dental therapists undertook routine clinical examinations, with charting recorded for each child for decayed, missing and filled deciduous teeth (dmft) at the d3 level. RESULTS One hundred and forty 6-to-9-year-olds (50.7% female) took part in the study (93.3% participation rate). The mean d3mft was 2.4 (SD = 2.6; range 0 to 9). Both CHU9D and CPQ detected differences in the impact of dental caries, with scores in the expected direction: children who presented with caries had higher scores (indicating poorer OHRQoL) than those who were free of apparent caries. Children with no apparent caries had a higher mean CHU9D score than those with caries (indicating better HRQoL). The difference for the CPQ was statistically significant, but for CHU9D the difference was not significant. When the two indices were compared, there was a significant difference in mean CHU9D scores by the prevalence of CPQ and subscale impacts with children experiencing no impacts having mean CHU9D scores closer to 1.0 (representing perfect health). CONCLUSION The CHU9D may be useful in dental research. Further exploration in samples with different caries experience is required. The use of the CHU9D in child oral health studies will enable the calculation of quality-adjusted life years (QALYs) for use in economic evaluation.
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Affiliation(s)
| | | | - Zoe Marshman
- Academic Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Katherine J Stevens
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
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Vieira AH, Leles CR. Exploring motivations to seek and undergo prosthodontic care: an empirical approach using the Theory of Planned Behavior construct. Patient Prefer Adherence 2014; 8:1215-21. [PMID: 25246777 PMCID: PMC4168850 DOI: 10.2147/ppa.s69619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Motivations for seeking and undergoing prosthodontic care are poorly understood and are not often explored for clinical purposes when determining treatment need and understanding the factors related to the demand for health care and effective use. This article uses the Theory of Planned Behavior construct to identify factors related to the motivations of edentulous subjects to seek and undergo prosthodontic treatment. The conceptual framework of the Theory of Planned Behavior includes attitude toward behavior, an individual's positive or negative evaluation of self-performance of the particular behavior; the subjective norm, an individual's perception of social normative pressures or relevant others' beliefs that he or she should or should not perform such behavior; and perceived behavioral control, or an individual's perceived ease or difficulty in performing the particular behavior, determined by the total set of accessible control beliefs. These components mediate a subject's intention and behavior toward an object and may also explain health-related behaviors, providing strong predictions across a range of health behaviors. This study suggests categories for each component of the Theory of Planned Behavior, based on clinical evidence and practical reasoning. Attitudes toward behavior include perceived consequences of no treatment, perceived potential benefits and risks of treatment, dental anxiety, previous experiences, and interpersonal abilities of the health care providers. The subjective norm includes the opinions of relevant others, advertisement, professionally defined normative need, perceived professional skills, and technical quality of care. Perceived behavioral control includes subject's time, availability and opportunity, treatment costs, subject's perceived need, and accessibility to dental care. This conceptual model represents a theoretical multidimensional model that may help clinicians better understand the patient's treatment behaviors and provide additional information for clinical research on patient's adherence to interventions in prosthodontics.
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Affiliation(s)
- Antonio Hélio Vieira
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil
| | - Cláudio Rodrigues Leles
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil
- Correspondence: Cláudio Rodrigues Leles, Faculdade de Odontologia, Universidade Federal de Goiás, Praça Universitária, s/n, Setor Universitário, Goiânia, Goiás CEP 74.605-220, Brasil, Tel +55 062 32096052, Fax +55 062 32096051, Email
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