It was suggested that a number of four implants would be the minimum to support a maxillary overdenture and six implants would provide additional clinical advantages. Maxillary overden-tures have however been considered a relevant treatment alternative, particularly when retention and stability of conventional dentures is dissatisfactory. Yet comparably little evidence and consensus seem to exist with respect to implant-based overdentures for treatment of the edentulous maxilla. * Correspondence: department of Conservative Dentistry, Heidelberg University, Im Neuenheimer Feld 400, 69120 Heidelberg, GermanyĢMax Planck Institute for SocialLaw and SocialPolicy, Munich Center for the Economics of Aging, Munich, Germanyįulllist of author information is available at the end of the articleĪlready facilitated an assessment of the cost-effectiveness of implant-retained mandibular overdentures. For mandibular implant-based overdentures, current consensus is that patients' satisfaction and quality of life is significantly greater for implant-supported overdentures than for conventional dentures and that a two-implant mandibular overden-ture should be the minimum treatment standard for most patients. Such treatment presents the prospect of high levels of oral health related quality of life and is particularly important in times of population aging as edentulousness rates continue to be relevantly high.
Implant-retained overdentures have become an important treatment option of modern dentistry. Keywords: Cost-effectiveness analysis, Implants, Dentures, Maxilla
Final judgements about value for money require more comprehensive clinical evidence including patient-centred health outcomes. Sensitivity analysis yielded that, depending on the specification of model input parameters such as patients' denture satisfaction, the respective cost-effectiveness threshold varies substantially.Ĭonclusions: The results of the present study suggest that bar-retained maxillary overdentures based on six implants provide better patient satisfaction than bar-retained overdentures based on four implants but are considerably more expensive. Results: Within a base case scenario of average treatment complexity, the cost-effectiveness threshold was identified to be 17,564 € per year of denture satisfaction gained above of which the alternative with six implants is preferable over treatment including four implants. Uncertainties regarding input parameters were incorporated via one-way and probabilistic sensitivity analysis based on Monte-Carlo simulation. The cost-effectiveness threshold was identified above which the six-implant solution is preferable over the four-implant solution. The decision scenario was modelled within a ten year time horizon and relied on cost reimbursement regulations of the German health care system. Methods: A Markov decision tree model was constructed and populated with parameter estimates for implant and denture failure as well as patient-centred health outcomes as available from recent literature. Stefan List!1,2*, Leonhard Fischer3 and Nikolaos Nikitas Giannakopoulos4īackground: The purpose of the present study was to assess the value for money achieved by bar-retained implant overdentures based on six implants compared with four implants as treatment alternatives for the edentulous maxilla. An economic evaluation of maxillary implant overdentures based on six vs.
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