Cost-effectiveness analysis of two attachment systems for mandibular overdenture

Area of Science:

• Dental prosthetics
• Health economics
• Evidence-based dentistry

Background:

• Cost-effectiveness analysis is crucial for stakeholders in dental treatment decisions.
• Edentulous mandibles can be effectively restored with 2-implant overdentures (2IOD).
• Attachment systems significantly influence the overall cost and patient well-being of 2IODs.

Purpose of the Study:

• To compare the cost-effectiveness of two different attachment systems for mandibular 2-implant overdentures (2IOD).
• To evaluate patient well-being and treatment costs over a 5-year period.
• To provide data for informed decision-making for patients, clinicians, and payers.

Main Methods:

• A 5-year prospective study involving 116 patients with mandibular 2IODs using spherical (Group D) and cylindrical (Group L) attachments.
• Patient well-being assessed using OHIP-14-Total (OHIP-14-T).
• Cost-effectiveness analysis incorporating initial and maintenance costs, discounted at 4% and 1.5%, with sensitivity analysis via bootstrapping.

Main Results:

• The cylindrical attachment (Group L) demonstrated a higher health effect (8.54) compared to the spherical attachment (Group D) (6.36).
• The total discounted costs over 5 years were lower for Group L (EUR 3,840.62) than for Group D (EUR 4,210.98).
• Bootstrap analysis confirmed that the cylindrical attachment (Group L) dominates the spherical attachment (Group D) in cost-effectiveness.

Conclusions:

• The 2-implant overdenture (2IOD) with the cylindrical (L) abutment is the dominant, more cost-effective option compared to the spherical (D) abutment over a 5-year period.
• This finding supports the selection of cylindrical attachments for mandibular 2IODs to optimize patient outcomes and resource allocation.