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Published on: December 11, 2017
An economic evaluation of different sinus lift techniques
Stefan Listl1, Clovis Mariano Faggion
1Department of Conservative Dentistry, University of Heidelberg, Heidelberg, Germany. stefan.listl@med.uni-heidelberg.de
Purpose:
To identify the most cost-effective approach to sinus lifting on the basis of currently available evidence.
Methods:
We incorporate the costs and clinical outcomes of nine different sinus lift techniques within a decision tree model in which costs are based on insurance regulations in Germany and health outcomes follow two recent meta-analyses. The most cost-effective treatment option is identified on the basis of the maximum net benefit criterion. Uncertainties regarding health outcomes are incorporated via probabilistic sensitivity analysis based on Monte-Carlo simulation.
Results:
When there are no financial restrictions, the optimum treatment strategy is the lateral approach with autogenous particulate bone and a resorbable membrane. When, however, monetary resources for sinus-floor elevation are scarce, the most cost-effective option is the transalveolar technique without bone grafting. Only if relatively high costs can be afforded or if initial bone height at implant site is below 5 mm is the maximum net benefit achieved by lateral approaches.
Conclusions:
On the basis of currently available evidence, the transalveolar technique is advisable when monetary resources for sinus-floor elevation are scarce and initial bone height is sufficiently high. Lateral approaches are primarily recommended for lower pre-operative bone heights.
