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- Title
Retaining or replacing molars with furcation involvement: a cost-effectiveness comparison of different strategies.
- Authors
Schwendicke, Falk; Graetz, Christian; Stolpe, Michael; Dörfer, Christof Edmund
- Abstract
Aim The comparative cost-effectiveness of retaining or replacing molars with furcation involvement ( FI) remains unclear. We assessed the cost-effectiveness of retaining FI molars via periodontal treatments versus replacing them via implant-supported crowns ( ISCs). Methods Using tooth-level Markov models, we followed a molar with FI degree I or II/ III in a 50-year-old patient over his lifetime. Tooth-retaining periodontal treatments (scaling and root planing, flap debridement, root resection, guided-tissue regeneration, tunnelling) were compared with tooth replacement using ISCs. We analysed costs, time until first re-treatment and total time of tooth or implant retention. The model adopted a private payer perspective within German health care. Transition probabilities were calculated based on current evidence. Monte-Carlo microsimulations were performed, and robustness of the model and effects of heterogeneity assessed using sensitivity analyses. Results Despite requiring re-treatment later than other strategies, ISCs were the most costly therapy. Compared with most periodontal treatments, ISCs were retained for shorter time than natural teeth regardless of the degree of FI, the patients' age or risk profile (smoker/non-smoker). Conclusions Based on available data and within its limitations, our study indicates that retaining FI molars via periodontal treatments might be more cost-effective than replacing them via ISCs. Changes in the underlying evidence or the setting might alter these results.
- Subjects
GERMANY; PERIODONTAL disease treatment; ACADEMIC medical centers; COST effectiveness; DENTAL implants; MOLARS; SEVERITY of illness index
- Publication
Journal of Clinical Periodontology, 2014, Vol 41, Issue 11, p1090
- ISSN
0303-6979
- Publication type
Article
- DOI
10.1111/jcpe.12315