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Cost Consequence Analysis of Non-Surgical Treatment Approaches for Patients With Periodontitis
Anna Liss1,2, Max Petzold3, Cristiano Tomasi1
1Department of Periodontology, Institute of Odontology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Aim:
To analyse and compare cost consequences of two evidence-based non-surgical periodontal treatment protocols performed by dental hygienists (DHs) in general practice.
Materials And Methods:
Six-hundred and fifteen patients were included. Treatment approaches compared were (i) conventional non-surgical therapy (CNST), often performed at multiple sessions, and (ii) a 'full-mouth' concept called guided periodontal infection control (GPIC), with initial focus on patient education followed by one session of ultrasonic instrumentation. A cost consequence analysis was conducted regarding the two approaches, including treatment costs, travelling costs and productivity costs, as well as non-monetary consequences (closed pockets and bleeding on probing). In data analysis, the 95% confidence intervals were obtained using the percentile method based on 5000 bootstrap replications.
Results:
Treatment costs were higher for CNST compared to GPIC by €60 (€359.5 [95% CI: 345.5-374.2] vs. €299.4 [95% CI: 289.3-309.1]). Productivity costs related to treatment were also greater in CNST by +€15. Travel costs showed minor differences (+€1 for CNST). Non-monetary outcomes showed no significant differences between groups.
Conclusion:
CNST was more costly than GPIC while maintaining comparable clinical outcomes at 6 months. When designing policy and practice for non-surgical treatment approaches, both evidence-based practice and how shared resources are best used should be acknowledged.
