van der Wijk P, Bouma J, van Waas M A, van Oort R P, Rutten F F
Northern Centre for Healthcare Research, University of Groningen, The Netherlands.
Int J Oral Maxillofac Implants. 1998 Jul-Aug;13(4):546-53.
The effectiveness of dental implants is widely studied, especially in terms of their clinical outcomes. However, from the policymaker's point of view, variables other than safety and efficacy, such as the costs and effectiveness of dental implants as compared to other treatment alternatives, are vital in decision making. This paper compares the costs of different treatment strategies in a randomized clinical trial in patients with resorbed mandibles and persistent problems with their conventional dentures: treatment with a mandibular overdenture on permucosal dental implants, an overdenture on a transmandibular implant, new dentures after preprosthetic surgery, and new dentures only. Data were gathered on an individual patient level to gain insight into specific cost episodes. Direct costs were subdivided into labor, material, technique, and overhead. Data concerning these components were gathered during the consecutive treatment phases in the first year. Results show that the resources used to treat a patient with an overdenture supported by a transmandibular implant are seven times those of a complete new set of dentures. Comparison of the cost ratio of an implant-retained overdenture supported by permucosal implants and conventional new prostheses proves less unfavorable: 1:3. New dentures after preprosthetic surgery are almost as expensive as treatment with permucosal implants.
牙种植体的有效性已得到广泛研究，尤其是在临床疗效方面。然而，从政策制定者的角度来看，除安全性和有效性之外的其他变量，如与其他治疗方案相比牙种植体的成本和效益，在决策过程中至关重要。本文在一项针对下颌骨吸收且传统义齿存在持续性问题的患者的随机临床试验中，比较了不同治疗策略的成本：使用黏膜下牙种植体的下颌覆盖义齿治疗、经下颌种植体的覆盖义齿治疗、修复前手术后置入新义齿，以及仅置入新义齿。在个体患者层面收集数据，以深入了解具体的成本情况。直接成本细分为人工、材料、技术和间接费用。在第一年的连续治疗阶段收集了有关这些组成部分的数据。结果表明，使用经下颌种植体支持的覆盖义齿治疗患者所耗费的资源是全新一套义齿的七倍。黏膜下种植体支持的种植体固位覆盖义齿与传统新修复体的成本比相对更有利：1:3。修复前手术后置入新义齿几乎与黏膜下种植体治疗一样昂贵。
