A comparison of teeth and implants during maintenance therapy in terms of the number of disease‐free years and costs ‐ an in vivo internal control study

Abstract

A comparison of teeth and implants during maintenance therapy in terms of the number of disease-free years and costsan in vivo internal control study AbstractBackground: Little is known about the cost minimization and cost effectiveness involved in maintaining teeth and implants for patients treated for periodontal disease. Materials & Methods: A retrospective study was carried out encompassing all patients who had initial periodontal treatment followed by implant placement and maintenance therapy in a specialist practice in Norway. The neighbouring tooth and the contra-lateral tooth were used as controls. The number of diseasefree years and the extra cost over and above maintenance treatment for both teeth and implants were recorded. Results: The sample consisted of 43 patients with an average age of 67.4 years. The patients had 847 teeth at the initial examination and received 119 implants. Two implants were removed 13 and 22 years after insertion. The prevalence of peri-implantitis was 53.5% at the patient level and 31.1% at the implant level. The prevalence of periodontitis was 53.4% at the patient level and 7.6% at the tooth level. The mean number of disease-free years was: implants: 8.66; neighbouring tooth: 9.08; contra-lateral teeth: 9.93. These mean values were not statistically significantly different from each other. The extra cost of maintaining the implants was about five times higher for implants than for teeth. Conclusion: The number of disease-free years was the same for neighbouring teeth, contra-lateral teeth and implants. However, due to the high prevalence of peri-implantitis, the cost of maintaining implants was much higher than the cost of maintaining teeth.

Retaining or replacing molars with furcation involvement: a cost‐effectiveness comparison of different strategies

“…However, the used item‐based calculation reflects the efforts required per treatments, with our cost estimates concurring with those obtained in different settings (Flemmig & Beikler , Pretzl et al. , Fardal & Grytten ). Cost estimates calculated based on different assumptions of German health care (privately or publically insured, standard or average national multiplication factor) were similar as well.…”

“…Such replacement via implant‐supported crowns (ISCs), however, is increasingly common, but generates high initial costs (Pretzl et al. , Fardal & Grytten , Lang‐Hua et al. ), and might also be costly long term due to technical and biological complications (Jung et al.…”

Clinical practice guidelines for recall and maintenance of patients with tooth-borne and implant-borne dental restorations

“…Therefore, a set of CPGs was created for each type of restoration comprising (1) patient recall, (2) professional maintenance, and (3) at-home maintenance. The CPGs are presented in Table 3 for tooth-borne restorations [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] and Table 4 for implant-borne restorations. [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] For tooth-borne restorations, the professional maintenance and at-home maintenance CPGs were subdivided for removable and fixed restorations.…”

Implant Patient Compliance Varies by Periodontal Treatment History

“…Implant placement itself seems to improve compliance levels, 17 presumably because of influences related to treatment cost. In patients with periodontitis history, implant maintenance is more expensive than tooth maintenance due to the more frequent recurrence of peri‐implant inflammation compared with periodontitis 23 . Given the patient sensitivity toward treatment costs, patient motivation and education should include information on the potential increased treatment costs when maintenance therapy is not adequately followed.…”