Abstract
Background: The economic burden for patients seeking treatment with implant-supported prostheses has not been given adequate attention.
Purpose: To document long-term costs from a prospective trial on edentulous patients treated with mandibular implant-supported overdentures and 2 loading protocols.
Materials and methods: The direct clinical and time costs for 35 patients receiving an immediate-loading protocol (ILP) and 40 patients with a conventional-loading protocol, over 14 years of observation, were analyzed in 2016 Canadian dollars as a base year. Quality of life (QoL) for the ILP was measured using the OHIP-20 questionnaire.
Results: The ILP was associated with higher complication costs ($870.77 +/- 692.24 vs $85.73 +/- 133.14) with resultant higher maintenance costs ($1746.37 +/- 892.68 vs $853.04 +/- 276.21) (P<.05). OHIP results showed a sustained improvement in QoL through the first 5 year of follow-up. A worsening of QoL, specifically the functional-related OHIP scores, was noted at 14 years. Incremental cost-effectiveness ratios indicated that the accrued maintenance costs for the ILP made the treatment less cost-effective over time.
Conclusions: This long-term study confirmed that ILP is associated with higher maintenance costs and varying subjective QoL measurements. Clinical treatment protocols should be evaluated over a long period and address different perspectives.