School of Dentistry, Federal University of Goias, Goiânia, Goiás, Brazil.
Clinic of General, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
J Dent. 2021 Dec;115:103846. doi: 10.1016/j.jdent.2021.103846. Epub 2021 Oct 9.
In recent years, the single-implant mandibular overdenture (SIMO) has been proposed as an alternative to more complex overdenture designs as a simplified implant intervention for edentulous patients.
The aim of this study was to run a cost-effectiveness analysis alongside a randomized clinical trial comparing the SIMO and the conventional complete denture (CCD) treatment. Imediately loaded external hexagon implant and ball attachment were used for the overdenture goup. Direct costs related to therapies were identified and valuated throughout a 1-year period after delivery, in Brazilian currency (R$) and converted into international dollars (I$) using purchase power parity exchange rates. Treatment effectiveness was measured using the OHIP-Edent and satisfaction scores for calculation of incremental cost-effectiveness ratios (ICER).
Outcomes were assessed at the 1-year follow-up for 65 patients (CCD=34; SIMO=31). Overall OHIP-Edent and satisfaction scores improved significantly in the SIMO group, while remained unchanged in the CCD group. The mean overall costs were R$1,179.04 (I$590.99) for the CCD group and R$2,127.91 (I$1,068.20) for the SIMO group - 80.7% incremental cost for SIMO. The ICER calculation for SIMO treatment showed a mean cost of I$48.20 for 1-point reduction in OHIP-Edent scores, and I$12.56 for 1-point increase in satisfaction score.
Findings support the effectiveness of this simplified and low-cost implant intervention for edentulous patients. SIMO also seems a cost-effective alternative to the CCD and the relatively low incremental cost may potentially increase the utilization of dental implants among older subjects, especially those with limited financial resources.
The immediately loaded single-implant mandibular overdenture was superior to the conventional complete denture in terms of patient-reported outcome measures at a low incremental cost.
近年来，单种植体下颌覆盖义齿（SIMO）作为一种简化的种植体干预措施，被提议作为更复杂覆盖义齿设计的替代方案，用于无牙患者。
本研究旨在对 SIMO 与传统全口义齿（CCD）治疗进行随机临床试验的同时进行成本效益分析。覆盖义齿组使用即刻负载外六角种植体和球附体。在交付后 1 年内确定并评估与治疗相关的直接成本，以巴西雷亚尔（R$）计价，并使用购买力平价汇率转换为国际元（I$）。使用 OHIP-Edent 和满意度评分来衡量治疗效果，以计算增量成本效益比（ICER）。
65 名患者（CCD=34；SIMO=31）在 1 年随访时评估了结果。SIMO 组的总体 OHIP-Edent 和满意度评分显著提高，而 CCD 组则保持不变。CCD 组的平均总费用为 R$1,179.04（I$590.99），SIMO 组为 R$2,127.91（I$1,068.20） - SIMO 的增量成本为 80.7%。SIMO 治疗的 ICER 计算显示，OHIP-Edent 评分每降低 1 分的平均成本为 I$48.20，满意度评分每增加 1 分的平均成本为 I$12.56。
研究结果支持对无牙患者进行这种简化和低成本的种植体干预的有效性。SIMO 似乎也是 CCD 的一种具有成本效益的替代方案，而且相对较低的增量成本可能会增加老年患者，尤其是那些经济资源有限的患者对牙科植入物的利用。
在低增量成本的情况下，即刻负载的单种植体下颌覆盖义齿在患者报告的结果测量方面优于传统全口义齿。
