Monday, July 28, 2014

Cost estimation of single-implant treatment in the periodontally healthy patient after 16–22 years of follow-up

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 Impl. Res. 00, 2014; 19.

Abstract

Background

Costs for single-implant treatment are mostly described for the initial treatment. Information on the additional cost related to aftercare is scarce.

Objective

To make an estimation of complication costs of single implants in periodontally healthy patients after 16–22 years and to compare costs for various prosthetic designs.

Materials and methods

Patients with a single implant were recalled for a clinical examination and file investigation. Prosthetic designs included single-tooth (ST) and CeraOne (CO) abutments supporting a porcelain-fused-to-metal (PFM), all-ceramic (CER), or gold-acrylic (ACR) crown. Costs related to failures or technical, biologic, and aesthetic complications were retrieved from patient's records. Total and yearly additional complication costs were calculated as a percentage relative to the initial cost. Chair time needed to solve the complication was recorded and prosthetic designs were compared by Kruskal–Wallis tests.

Results

Fifty patients with 59 surviving implants were clinically investigated. Additional complication costs after a mean follow-up of 18.5 years amounted to 23% (range 0–110%) of the initial treatment cost. In total, 39% of implants presented with no costs, whereas 22% and 8% encountered additional costs over 50% and 75%, respectively. In 2%, the complication costs exceeded the initial cost. The mean yearly additional cost was 1.2% (range 0–6%) and mean complication time per implant was 67 min (range 0–345 min). Differences between prosthetic designs (CO, ST-PFM, ST-ACR) were statistically significant for total cost (P = 0.011), yearly cost (P = 0.023), and time (P = 0.023). Pairwise comparison revealed significant lower costs for CO compared with ST-ACR reconstructions.

Conclusion

Patients should be informed about additional costs related to complications with single implants. The mean additional cost spent on complications was almost one-quarter of the initial treatment price. A majority of implants presented with lower additional costs, whereas the highest complication costs were related to a smaller group with 22% of the implants needing more than half of the initial cost for complication management. Expenses were significantly different for various prosthetic designs.

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