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J Clin Periodontol ; 42(5): 470-7, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25867116

RESUMEN

AIM: The purpose of the present study was to assess the cost-effectiveness of various alternatives of non-surgical peri-implantitis treatment. MATERIALS AND METHODS: A decision analytical model was constructed and populated with parameter estimates from recent literature for reduction in pocket probing depth (PPD) in response to eight different treatment alternatives. A micro-costing approach combined with an online expert survey was applied to simulate a decision-making scenario taking place in Germany. The treatment alternatives providing the most advantageous cost/outcome combinations were identified according to the net benefit criterion. Uncertainties regarding model input parameters were incorporated via simple and probabilistic sensitivity analysis based on Monte Carlo simulation. RESULTS: In the base case scenario, debridement alone, Air-Flow, debridement combined with PerioChip, and debridement combined with local antibiotics were identified as treatment strategies with comparably better value for money than Er:YAG laser monotherapy, Vector System, debridement combined with CHX, and photodynamic therapy. Sensitivity analysis revealed considerable decision uncertainty corresponding to limited evidence about different treatment alternatives for peri-implantitis treatment. CONCLUSIONS: Derivation of robust treatment recommendations for peri-implantitis requires more comprehensive and patient-centred evidence on peri-implantitis treatments.


Asunto(s)
Periimplantitis/economía , Desbridamiento Periodontal/economía , Antibacterianos/economía , Antibacterianos/uso terapéutico , Antiinfecciosos Locales/economía , Antiinfecciosos Locales/uso terapéutico , Clorhexidina/análogos & derivados , Clorhexidina/economía , Clorhexidina/uso terapéutico , Terapia Combinada/economía , Análisis Costo-Beneficio , Técnicas de Apoyo para la Decisión , Pulido Dental/economía , Pulido Dental/instrumentación , Financiación Personal/economía , Costos de la Atención en Salud , Humanos , Láseres de Estado Sólido/uso terapéutico , Método de Montecarlo , Periimplantitis/terapia , Desbridamiento Periodontal/instrumentación , Bolsa Periodontal/economía , Bolsa Periodontal/terapia , Fotoquimioterapia/economía , Probabilidad , Sensibilidad y Especificidad , Irrigación Terapéutica/economía , Irrigación Terapéutica/instrumentación , Resultado del Tratamiento , Incertidumbre
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