Cost-effectiveness analysis of two attachment systems for mandibular overdenture.
Clin Oral Implants Res 2020;
31:615-624. [PMID:
32212393 PMCID:
PMC7386928 DOI:
10.1111/clr.13599]
[Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/05/2020] [Accepted: 03/12/2020] [Indexed: 11/29/2022]
Abstract
Objectives
This study analysed the cost‐effectiveness of two different attachments for the 2‐implant overdenture (2IOD) in edentulous mandibles.
Materials and methods
When considering alternative treatments, cost‐effectiveness analysis is an important factor for stakeholders (patient, clinician, social security, insurance company, etc.). A general practice population (n = 116) was treated between 2003 and 2013 with a mandibular 2IOD with 2 different ball/stud attachment systems, one spherical (Group D) and one cylindrical (Group L). Patient well‐being was assessed with OHIP‐14‐Total (OHIP‐14‐T), at intake and annually up to 5 years, to calculate the health effect. Initial and maintenance costs of both treatments were inventoried. The cost‐effectiveness was compared. Annual discount rates of 4% and 1.5% were applied to future costs and health outcomes, following Dutch guidelines. Prices were adjusted to the year 2003. To offset the uncertainty in relevant input parameters, a sensitivity analysis was performed using bootstrap analysis. Significance was set at p < .05.
Results
The health effect was 6.36 (SD 5.32) for Group D and 8.54 (SD 5.63) for Group L. The sum of the discounted costs up to 5 years was EUR 4,210.98 (SD 634.75) for the D and EUR 3,840.62 (SD 302.63) for the Group L (p = .005). The bootstrapping reports that L abutment clearly dominates the D abutment in terms of cost‐effectiveness.
Conclusions
The 2IOD on the L abutment is dominant compared to the 2IOD on D abutment, in a 5‐year perspective.
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