Attard Nikolai, Wei Xiaolin, Laporte Audrey, Zarb George A, Ungar Wendy J
Faculty of Dentistry, University of Toronto, Ontario, Canada.
Int J Prosthodont. 2003 May-Jun;16(3):271-6.
This study aimed to determine if implant-supported overdentures are a long-term economically efficacious therapy for edentulous patients when compared to fixed osseointegrated prostheses.
Clinical records of 25 patients from two long-term studies (fixed and overdenture) were included in this analysis. A cost minimization analysis from the patient perspective was employed. Direct clinical and time costs incurred over the 9-year period were deflated to 1995 Canadian dollars using the Consumer Price Index. National salary rates by occupation and gender were used to value patients' time, and a sensitivity analysis was carried out to assess the robustness of the results when an equal mean salary rate across treatment groups was assumed.
The mean total, clinical, and time costs were significantly higher (Ps .05) for the fixed restoration group (dollars CAD10,748, dollars CAD10,094, and dollars CAD654, respectively) when compared to the overdenture group (dollars CAD3,665, dollars CAD3,343, and dollars CAD322, respectively). The initial, maintenance, and clinical visit costs were also significantly higher (P < or = .05) in the fixed restoration group (dollars CAD7,567, dollars CAD2,527, dollars CAD542, respectively) than in the overdenture group (dollars CAD2,505, dollars CAD830, dollars CAD292, respectively). The sensitivity analysis demonstrated that the time cost for the fixed prosthodontic group (dollars CAD488 vs dollars CAD322) was still significantly higher (P = .002), even after an equal mean salary rate was assumed.
Overdenture therapy for edentulous patients is a more cost-effective treatment compared to fixed prosthodontic treatment.
本研究旨在确定与固定种植义齿相比,种植体支持的覆盖义齿对无牙患者而言是否为一种长期经济有效的治疗方法。
本分析纳入了两项长期研究(固定义齿和覆盖义齿)中25例患者的临床记录。采用了从患者角度进行的成本最小化分析。使用消费者价格指数将9年期间产生的直接临床成本和时间成本折算为1995年加拿大元。利用按职业和性别划分的全国工资率对患者的时间进行估值,并进行敏感性分析,以评估在假设各治疗组平均工资率相等时结果的稳健性。
与覆盖义齿组(分别为3665加元、3343加元和322加元)相比,固定修复组的平均总成本、临床成本和时间成本显著更高(P<0.05)(分别为10748加元、10094加元和654加元)。固定修复组的初始成本、维护成本和临床就诊成本(分别为7567加元、2527加元和542加元)也显著高于覆盖义齿组(分别为2505加元、830加元和292加元)(P≤0.05)。敏感性分析表明,即使假设平均工资率相等,固定修复组的时间成本(488加元对322加元)仍显著更高(P = 0.002)。
与固定修复治疗相比,无牙患者的覆盖义齿治疗是一种更具成本效益的治疗方法。