Cost-effectiveness of implant-supported dental prosthesis compared to conventional dental prosthesis.

OBJECTIVE: To conduct a cost-effectiveness analysis of alternatives for rehabilitation treatment of mandibular edentulism in the context of the Brazilian Unified Health System (implant-supported total dental prosthesis versus conventional total dental prosthesis). METHODS: A Markov model was developed to capture long-term clinical and economic outcomes. The model's population was comprised of a hypothetical cohort of 1,000,000 patients, aged 55 years, with total mandibular edentulism and without medical contraindications for performing surgical procedures. The adopted analysis perspective was that of the Brazilian Unified Health System. Based on the proposed model, we calculated cost - in BRL, and effectiveness - measured by quality-adjusted prosthesis year (QAPY). The time horizon of the analysis was 20 years. RESULTS: Considering a 5% discount in costs and effects, the incremental cost-effectiveness ratio of implant-supported total dental prostheses compared to conventional total dental prosthesis (BRL 464.22/QAPY) was lower than the willingness to pay threshold adopted in the model (BRL 3,050.00/QAPY). CONCLUSIONS: The results of this economic analysis showed that the rehabilitation of mandibular edentulous patients by implant-supported total prosthesis is very cost-effective when compared to conventional complete prosthesis, considering the cost-effectiveness limits employed.

Cost-effectiveness of implant-supported dental prosthesis compared to conventional dental prosthesis / Custo-efetividade da prótese implanto-suportada comparada à prótese total convencional

ABSTRACT OBJECTIVE To conduct a cost-effectiveness analysis of alternatives for rehabilitation treatment of mandibular edentulism in the context of the Brazilian Unified Health System (implant-supported total dental prosthesis versus conventional total dental prosthesis). METHODS A Markov model was developed to capture long-term clinical and economic outcomes. The model's population was comprised of a hypothetical cohort of 1,000,000 patients, aged 55 years, with total mandibular edentulism and without medical contraindications for performing surgical procedures. The adopted analysis perspective was that of the Brazilian Unified Health System. Based on the proposed model, we calculated cost - in BRL, and effectiveness - measured by quality-adjusted prosthesis year (QAPY). The time horizon of the analysis was 20 years. RESULTS Considering a 5% discount in costs and effects, the incremental cost-effectiveness ratio of implant-supported total dental prostheses compared to conventional total dental prosthesis (BRL 464.22/QAPY) was lower than the willingness to pay threshold adopted in the model (BRL 3,050.00/QAPY). CONCLUSIONS The results of this economic analysis showed that the rehabilitation of mandibular edentulous patients by implant-supported total prosthesis is very cost-effective when compared to conventional complete prosthesis, considering the cost-effectiveness limits employed.

RESUMO OBJETIVO Conduzir uma análise de custo-efetividade das alternativas para tratamento reabilitador do edentulismo mandibular no contexto do Sistema Único de Saúde (prótese total implanto-suportada e prótese total convencional). MÉTODOS Foi desenvolvido um modelo de Markov para captar os resultados clínicos e econômicos de longo prazo. A população do modelo consistiu em uma coorte hipotética de 1.000.000 pacientes, com 55 anos, desdentados totais mandibulares e sem contraindicações médicas para a realização de procedimentos cirúrgicos. A perspectiva de análise adotada foi a do Sistema Único de Saúde. Com base no modelo proposto, calculamos o custo (em reais) e a efetividade, medida pelo ano de prótese ajustado à qualidade (QAPY). O horizonte temporal da análise foi de 20 anos. RESULTADOS Considerando o desconto de 5% nos custos e efeitos, a razão de custo-efetividade incremental da prótese total implanto-suportada em relação à prótese total convencional (R$ 464,22/QAPY) foi menor que o limiar de disposição a pagar adotado no modelo (R$ 3.050,00/QAPY). CONCLUSÕES Os resultados desta análise econômica mostraram que a reabilitação de edêntulos mandibulares por meio da prótese total implanto-suportada é muito custo-efetiva em comparação à prótese total convencional, de acordo com os limites de custo-efetividade empregados.

Cost-effectiveness of molar single-implant versus fixed dental prosthesis.

BACKGROUND: This study evaluates the cost-effectiveness of implants (Implant), insurance fixed dental prosthesis (IFDP) and private fixed dental prosthesis (PFDP) for a single intermediate missing tooth in the molar region to calculate the Incremental Cost Effectiveness Ratio (ICER). METHODS: The Markov model for cost-effectiveness analysis of the Implant, IFDP and PFDP was carried over maximum 30 years. The starting age for prosthetic treatment was decided to be 50 years. The General Oral Health Assessment Index (GOHAI) was used for the indicator of effectiveness as an oral health QOL value. The GOHAI value was collected from patients who visited the Department of Oral Implantology of Osaka Dental University between September 2014 and March 2016. In addition, the Tornado diagram was drawn and Monte-Carlo simulations made for sensitivity analysis. RESULTS: From the analysis of survey of QOL of each stage and treatment, the selection of an Implant led to a higher QOL value than FDP. However, the estimated 30-year cost for IFDP was lower than Implant. It also became evident that PFDP had an extended dominated condition compared with IFDP and Implants. The ICER on the Implant versus IFDP was €1423.00. CONCLUSIONS: These results suggest that a better of QOL value can be obtained from an Implant than from IFDP or PFDP. An evaluation form using an indexed scale for oral health-related aspects needs to be developed that is also consistent as an indicator of effect.

Full Coverage Crowns and Resin-bonded Bridge Combination for Missing Mandibular Anterior Teeth.

Most often the anterior teeth and those that are visible when a patient speaks or smiles are chosen for esthetic restorations. The mandibular anterior fixed bridge often presents problems to the dentist due to the size of the natural teeth and their visibility. In addition, due to high cost factor, many patients are not able to afford fixed partial denture for missing anterior teeth. This article describes a cost effective technique for the restoration of missing mandibular anterior teeth by fabrication of full coverage crowns and resin-bonded fixed bridge combination.

Single implant and crown versus fixed partial denture: A cost-benefit, patient-centred analysis.

Single implants and their crowns have high survival rates that exceed the survival rates for fixed partial dentures on teeth and most but not all publications have determined single implants are more cost-effective than 3-unit fixed partial dentures. Both initial root canal treatment and retreatment are more cost-effective than tooth extraction and rehabilitation with a single implant and crown.

Clinical Teaching of Prosthodontics in Undergraduate Courses in a German Dental School: Patients, Visits, Efforts, and Incentives.

It is unknown what disadvantages are faced by patients deciding for a prosthodontic treatment by inexperienced students. Commonly, the related extra effort and time are compensated by cost reduction of treatment fees. Thereby, the dental schools subsidize treatments to teach clinical prosthodontics. The aim of this study was to clarify the benefits to patients as well as the efforts of the dental school. Data collected from three courses in a dental school in Germany were patient gender, age, occupation, zip code, number of visits, scope of treatment including costs, financial discount, and remaining copayment. Travel costs were calculated based on zip code. Balance of travel costs and treatment discount was defined as financial benefit. The results showed that 185 patients (95 male) aged 32 to 82 years (median=58) were treated with fixed restorations (FR, n=110), telescopic dentures (TD, n=87), complete dentures (CD, n=17), or other (RD, n=3). The mean number of visits was 11 for FR, 12 for TD, and 9 for CD. Single distance to the clinic ranged from 0.6 to 65 miles (median=12). Total costs of prosthodontics were reduced by 19% on average. The mean financial benefit was 429 USD (median=298, min=-482, max=4025). The financial benefits were found to differ widely, including additional expenditures of patients. Participation, travel burden, and copayment did not depend on age, gender, or occupation. The financial benefit was relativized because students needed at least twice the sessions of a dentist. As a result, the financial efforts of dental schools are significant and compromise a cost-covering education.

An Up-to-15-Year Comparison of the Survival and Complication Burden of Three-Unit Tooth-Supported Fixed Dental Prostheses and Implant-Supported Single Crowns.

PURPOSE: To assess and compare the outcomes and economic complication burden of three-unit tooth-supported fixed dental prostheses (TFDPs) and implant-supported single crowns (ISCs) provided to a sequential cohort in a specialist prosthodontic practice over a 15-year period. MATERIALS AND METHODS: Sequential patients requiring replacement of a single missing tooth between 1996 and 2010 with a metal-ceramic three-unit TFDP (n = 145 patients, n = 174 prostheses) or ISC (n = 174 patients, n = 220 prostheses) were included. Prostheses subjectively judged at insertion to have an unfavorable 10-year prognosis (17 TFDPs, 0 ISCs) were removed from statistical analyses. The estimated cumulative survival (ECS) was calculated with the life table actuarial method and standard errors calculated with the Greenwood formula. Differences in outcomes between all prostheses and those replacing only anterior or only posterior teeth were assessed with the log rank test. Complication incidence, severity, and economic burden, measured in time/cost accounting units (TAUs), were tallied and compared descriptively. RESULTS: The 15-year ECS did not differ for 112 TFDPs (92.75% ± 3.28%) and 81 ISCs (95.95% ± 2.92%) replacing posterior teeth. However, the 15-year ECS was significantly greater for 139 ISCs (93.33% ± 6.44%) than for 45 TFDPs (82.82% ± 6.50%) replacing anterior teeth. The economic burden of nonterminal complications for both prostheses was low (mean = 0.3 and 0.2 TAUs per prosthesis for TFDPs and ISCs, respectively). This equated to 3 TAUs/100 years in clinical service and 4 TAUs/100 years in clinical service for the TFDPs and ISCs, respectively. CONCLUSION: The survival of three-unit TFDPs and ISCs over 15 years was not statistically different when replacing posterior teeth, but ISCs survived significantly better when replacing anterior teeth. The complication rates of the TFDPs and ISCs were similar, but the economic burden for the TFDPs was greater.

EAO consensus conference: economic evaluation of implant-supported prostheses.

OBJECTIVE: There are various alternatives for the management of oral conditions that may lead to or already have lead to partial or full edentulism. Economic evaluations measure the efficiency of alternative healthcare interventions and provide useful information for decision-making and the allocation of scarce resources. MATERIAL AND METHODS: The current English literature dealing with "cost-effectiveness" of dental implant therapy versus different alternative treatment modalities, that is, complete and fixed partial dentures, root canal, and periodontal treatment, has been included in this narrative review. Due to the high heterogeneity within the literature, a meta-analysis could not be conducted. RESULTS: The available evidence from economic evaluations indicated that for the treatment of central incisors with irreversible pulpitis and coronal lesions, root canal treatments were most cost-effective initial treatment options. When initial root canal treatments failed, orthograde retreatments were most cost-effective. When root canal retreatments failed, extractions and replacement with single implant-supported crowns were more cost-effective compared to fixed or removable partial dentures. In the treatment of periodontitis in molars with Class I furcation invasion, non-surgical periodontal therapy was more effective and costed less than implant-supported single crowns. For the replacement of single missing teeth, two evaluations indicated that implant-supported single crowns provided better outcomes in terms of greater quality-adjusted tooth years or survival rates at lower costs compared to fixed partial prostheses. Another economic evaluation found that implant-supported crowns costed more, but provided greater survival rates compared to fixed partial dentures. For the restoration of edentulous mandibles, two evaluations indicated that overdentures retained by two or four implants improved oral health-related quality of life outcomes, but costed more than complete dentures. CONCLUSIONS: To better assess the efficiency of implant-supported prostheses in various clinical conditions, more economic evaluations are needed that follow well-established methodologies in health economics.

Shortened dental arch concept shown to be cost effective.

DESIGN: Randomised controlled trial. INTERVENTION: All patients received treatment to render them dentally fit. Patients were randomly allocated to either the removable dental prostheses (RPD) or the shortened dental arch (SDA) group. Patients in the RDP group were restored to complete arches with RDP using cobalt-chromium frameworks according to a standardised protocol. For the SDA group, patients were restored to a shortened arch of ten occluding pairs of natural and replacement teeth using resin-bonded bridgework (RBB). OUTCOME MEASURE: Treatment effect was measured using the change in oral health-related quality of life (OHrQOL). For each patient the costs of delivering treatment were recorded by a research nurse during the intervention period. Laboratory costs were recorded as part of normal hospital policy for all patients. All of the dental materials used were recorded and given a unit price. The cost of professional time per patient was estimated using the highest point of the salary scale for the Community Dental Service in Ireland. RESULTS: One hundred and thirty-two patients were randomised; 65 to the RPD group and 67 to the SDA group. Ninety-two patients (69.7%) completed the study (46 in RPD group; 46in SDA group). There was no difference in the success rates of the two treatments over the period. Five pieces of resin-bonded bridgework (RBB) debonded and were recemented over the 12-month period giving a success rate of 95.5% for the RBB. Four patients discontinued wearing their RPDs; all four RPDS were fitted in the lower arch and included bilateral free end saddles, a success rate of 95.9%. Both RPD and SDA groups demonstrated statistically significant improvements in OHrQoL scores after 12 months.The total cost of achieving the minimally important clinical difference (MID) in OHrQOL for an average patient in the RDP group was [euro ]464.64. For the SDA group, the cost of achieving the MID for an average patient was [euro ]252.00. The cost-effectiveness ratio was therefore 1:1.84 in favour of SDA treatment. CONCLUSIONS: With an increasingly ageing population, many patients will continue to benefit from removable prostheses to replace their missing natural teeth. From a purely economic standpoint, the results from this analysis suggest that the treatment of partially dentate older adults should be focused on functionally orientated treatment because it is simply more cost-effective.

Reimbursement systems influence prosthodontic treatment of adult patients.

OBJECTIVE: To evaluate the influence of reimbursement system and organizational structure on oral rehabilitation of adult patients with tooth loss. MATERIALS AND METHODS: Patient data were retrieved from the databases of the Swedish Social Insurance Agency. The data consisted of treatment records of patients aged 19 years and above claiming reimbursement for dental care from July 1, 2007 until June 30, 2009. Before July 1, 2008, a proportionately higher level of subsidy was available for dental care in patients 65 years and above, but thereafter the system was changed, so that the subsidy was the same, regardless of the patient's age. Prosthodontic treatment in patients 65 years and above was compared with that in younger patients before and after the change of the reimbursement system. Prosthodontic treatment carried out in the Public Dental Health Service and the private sector was also analyzed. RESULTS: Data were retrieved for 722,842 adult patients, covering a total of 1,339,915 reimbursed treatment items. After the change of the reimbursement system, there was a decrease in the proportion of items in patients 65 years and above in relation to those under 65. Overall, there was a minimal change in the proportion of treatment items provided by the private sector compared to the public sector following the change of the reimbursement system. CONCLUSIONS: Irrespective of service provider, private or public, financial incentive such as the reimbursement system may influence the provision of prosthodontic treatment, in terms of volume of treatment.

Agenesis of maxillary lateral incisor and tooth replacement: cost-effectiveness of different treatment alternatives.

PURPOSE: To evaluate the long-term cost-effectiveness of five treatment alternatives for maxillary lateral incisor agenesis where space maintenance and tooth replacement are indicated. MATERIALS AND METHODS: The following treatment modalities were considered: single-tooth implant-supported crown, resin-bonded fixed partial denture (FPD), cantilever FPD, full-coverage FPD, and autotransplantation. The cost-effectiveness for each treatment modality was determined as the ratio of the outcome of each modality divided by the cost. Direct costs, clinical and laboratory, were calculated based on national fee schedules and converted to international dollars using purchasing power parity exchange rates. Outcomes were based on the most recently published long-term (10-year) survival rates. Sensitivity analyses were carried out, testing the robustness of the cost-effectiveness analysis. RESULTS: The five treatment modalities ranked in the following order from most to least cost-effective: autotransplantation, cantilever FPDs, resin-bonded FPDs, single-tooth implants and implant-supported crowns, and full-coverage FPDs. Sensitivity analysis illustrated that the cost-effectiveness analysis was reliable in identifying autotransplantation as the most and full-coverage FPDs as the least cost-effective treatment modalities. CONCLUSIONS: When replacing a missing maxillary lateral incisor, the most costeffective, long-term treatment modality is autotransplantation, whereas the least cost-effective is full-coverage FPDs. However, factors such as patient age, the state of the dentition, occlusion, and tooth conservation should also influence the choice of restoration.

Economic evaluation of single-tooth replacement: dental implant versus fixed partial denture.

PURPOSE: This study assessed the cost-effectiveness from a societal perspective of a dental implant compared with a three-unit tooth-supported fixed partial denture (FPD) for the replacement of a single tooth in 2010. MATERIALS AND METHODS: A decision tree was developed to estimate cost-effectiveness over a 10-year period. The survival rates of single-tooth implants and FPDs were extracted from a meta-analysis of single-arm studies. Medical costs included initial treatment costs, maintenance costs, and costs to treat complications. Patient surveys were used to obtain the costs of the initial single-tooth implant or FPD. Maintenance costs and costs to treat complications were based on surveys of seven clinical experts at dental clinics or hospitals. Transportation costs were calculated based on the number of visits for implant or FPD treatment. Patient time costs were estimated using the number of visits and time required, hourly wage, and employment rate. Future costs were discounted by 5% to convert to present values. RESULTS: The results of a 10-year period model showed that a single dental implant cost US $261 (clinic) to $342 (hospital) more than an FPD and had an average survival rate that was 10.4% higher. The incremental cost-effectiveness ratio was $2,514 in a clinic and $3,290 in a hospital for a prosthesis in situ for 10 years. The sensitivity analysis showed that initial treatment costs and survival rate influenced the cost-effectiveness. If the cost of an implant were reduced to 80% of the current cost, the implant would become the dominant intervention. CONCLUSION: Although the level of evidence for effectiveness is low, and some aspects of single-tooth implants or FPDs, such as satisfaction, were not considered, this study will help patients requiring single-tooth replacement to choose the best treatment option.

Making sense of complication reporting associated with fixed dental prostheses.

The current reporting of complications associated with FDPs is inadequate and misleading. Complications,which incur significant monetary costs, will particularly impact the perceived value (worth or importance)that patients derive from their prostheses.Effective documentation of complications should include type (biologic and technical), incidence, and severity. The fiscal burden of treatment should be quantified. Comparisons of different restorative materials,techniques, and procedures should be meaningful.Data collated prospectively or retrospectively and pooled over time should allow for comparisons within and between different practice settings. The proposed classification, based on the fiscal consequences of complications, achieves these objectives.Effective documentation of complications in conjunction with actual or projected survival data and personal clinical experience will enable clinicians to provide realistic information of the expected clinical service of dental prostheses.

Cost-effectiveness of tooth replacement strategies for partially dentate elderly: a randomized controlled clinical trial.

OBJECTIVE: To conduct a cost-effectiveness analysis comparing two different tooth replacement strategies for partially dentate older patients, namely partial removable dental prostheses (RDP) and functionally orientated treatment based on the shortened dental arch concept (SDA). METHODS: Ninety-two partially dentate older patients completed a randomized controlled clinical trial. Patients were randomly allocated to two treatment groups: the RDP group and the SDA group. Treatment effect was measured using impact on oral health-related quality of life (OHrQOL), and the costs involved in providing and maintaining care were recorded for all patients. Patients were followed for 12 months after treatment intervention. All treatment was provided by a single operator. RESULTS: The total cost of achieving the minimally important clinical difference (MID) in OHrQOL for an average patient in the RDP group was €464.64. For the SDA group, the cost of achieving the MID for an average patient was €252.00. The cost-effectiveness ratio was therefore 1:1.84 in favour of SDA treatment. CONCLUSION: With an increasingly ageing population, many patients will continue to benefit from removable prostheses to replace their missing natural teeth. From a purely economic standpoint, the results from this analysis suggest that the treatment of partially dentate older adults should be focused on functionally orientated treatment because it is simply more cost-effective.

Incorporating severity and risk as factors to the Fardal cost-effectiveness model to create a cost-benefit model for periodontal treatment.

BACKGROUND: A previously described economic model was based on average values for patients diagnosed with chronic periodontitis (CP). However, tooth loss varies among treated patients and factors for tooth loss include CP severity and risk. The model was refined to incorporate CP severity and risk to determine the cost of treating a specific level of CP severity and risk that is associated with the benefit of tooth preservation. METHODS: A population that received and another that did not receive periodontal treatment were used to determine treatment costs and tooth loss. The number of teeth preserved was the difference of the number of teeth lost between the two populations. The cost of periodontal treatment was divided by the number of teeth preserved for combinations of CP severity and risk. RESULTS: The cost of periodontal treatment divided by the number of teeth preserved ranged from (US) $1,405 to $4,895 for high or moderate risk combined with any severity of CP and was more than $8,639 for low risk combined with mild CP. The cost of a three-unit bridge was $3,416, and the cost of a single-tooth replacement was $4,787. CONCLUSION: Periodontal treatment could be justified on the sole basis of tooth preservation when CP risk is moderate or high regardless of disease severity.

Cost-effectiveness of anterior implants versus fixed dental prostheses.

For the restoration of an anterior missing tooth, implant-supported single crowns (ISCs) or fixed dental prostheses (FDPs) are indicated, but it is not clear which type of restoration is more cost-effective. A self-selected trial was performed with 15 patients with ISCs and 11 with FDPs. Patient preferences were recorded with visual analog scales before treatment, 1 month following restoration, and then annually. Quality-adjusted tooth years (QATYs) were estimated by considering the type of reconstruction for replacing the missing tooth and its effect on the adjacent teeth. A stochastic cost-effectiveness model was developed using Monte Carlo simulation. The expected costs and QATYs were summarized in cost-effectiveness acceptability curves. ISC was the dominant strategy, with a QATY increase of 0.01 over 3 years and 0.04 over 10 years with a higher probability of being cost-effective. While both treatment options provided satisfactory long-term results from the patient's perspective, the lower initial costs, particularly laboratory fees, were responsible for the dominance of ISCs over FDPs.

[Aftercare for durability and profitability of single-unit and multi-unit fixed dental prostheses]. / Nazorg voor dutrzaamheid en profijtelijkheid van kronen en bruggen.

An important aim ofa treatment with single-unit and multi-unit fixed dental prostheses is a durable and profitable treatment outcome. That requires aftercare, too. First, the frequency of routine oral examinations should be assessed, using an individual risk profile. The objectives of the routine oral examinations are the prevention and, when necessary, the treatment of pathological conditions and complications. With regard to prevention, attention should be paid to information and instruction, oral biofilm and calculus, non-functional activities, hard tooth tissues, periodontal and peri-implant tissues, and saliva. Subsequently, it can be determined whether the intended durability and profitability have been achieved or can still be achieved, whether or not through indicated adjustments. Special attention should be paid to endodontically treated teeth. Restorative, repair or replacement treatments may be indicated in case ofcomplications, such as loose single- or multi-unitfixed dental prosthesis, fracture of a fixed dental prosthesis unit, lost tooth pulp vitality, tooth root fracture, and implant or implant abutment problems.

Evaluating the health economic implications and cost-effectiveness of dental implants: a literature review.

PURPOSE: To review the available literature on the costs and cost-effectiveness of dental implant-supported or -retained prostheses versus tooth-supported fixed partial denture restorations or mucosa-borne conventional complete or partial dentures. MATERIALS AND METHODS: A systematic literature review of the PubMed, EMBASE, and Cochrane Library databases was conducted, restricted to studies published in English between November 2000 and November 2010. The searches returned a total of 381 unique hits, and a total of 14 studies on the long-term costs or cost-effectiveness of dental implants were included in the final review. A true systemic review was complicated by the heterogeneity of the conducted studies. RESULTS: For single-tooth replacement, dental implants were generally either cost saving or cost-effective in comparison with tooth replacement using traditional fixed dental prostheses. For patients with mandibular edentulism, dental implants were associated with higher initial costs in comparison with conventional mucosa-borne dentures. However, the consensus among most studies was that, over the long term, dental implants represent a cost-effective treatment option. Additionally, patient acceptance, satisfaction, and willingness to pay for dental implants were high, particularly in elderly edentulous patients. A trend toward improved overall health and decreased health care costs was also reported. CONCLUSIONS: For single-tooth replacement, a single implant was a cost-effective treatment option in comparison with a traditional three-unit fixed dental prosthesis. For the replacement of multiple teeth, dental implants (fixed or removable prostheses) were associated with higher initial costs but better improvements in oral health-related quality of life compared with other treatment options.

Implants versus short-span fixed bridges: survival, complications, patients' benefits. A systematic review on economic aspects.

AIM: To systematically evaluate the existing evidence to answer the focused question: For a patient with a single tooth to be replaced, is the implant crown, based on economic considerations, preferred to a conventional fixed partial denture? MATERIAL AND METHODS: PubMed MEDLINE, Cochrane-Central and Embase databases were searched using an extended list of search terms related to economics, which were then combined with the terms "prosthodontics" and "dental implant." RESULTS: The combined search for the "economic terms" and "prosthodontics" revealed 904 titles. The combination with "dental implants" revealed 2039 titles. Based on the abstracts, 73 full text publications were evaluated and data comparing outcomes with FDPs and implant crowns were retrieved from 26 publications. Initial costs for single implant crowns and FDPs on teeth were similar, but varied between tariff systems. The conditions of neighboring teeth and of the alveolar ridge defined the complexity (costs) of the treatment. Failure rates reported with single implant crowns and FDPs on teeth were similar. The long-term financial economic comparison showed a similar outcome for single implant crowns and FDPs. CONCLUSION: Other factors than costs and survival rates such as patient or provider reported factors may be more decisive when choosing between implant crowns and FDPs on teeth. The utility for the patient to keep healthy adjacent teeth unprepared makes the implant crown more economic.

Implant survival and complications. The Third EAO consensus conference 2012.

OBJECTIVES: The task of this working group was to analyze biological, technical and aesthetic complications of single crowns on implants and fixed dental prostheses with or without cantilevers on implants over 5 years or more. In addition, the group analyzed economic aspects on such implant treatment. MATERIALS AND METHODS: A systematic search of the relevant literature was conducted and critically reviewed. Four manuscripts were presented to cover the topics. RESULTS: The consensus statements prepared by the group and later accepted at the plenary session as well as suggestions for future research are presented in this article. The four reviews by Jung et al., Pjetursson et al., Romeo & Storelli and Scheuber et al. are printed separately and present detailed analyses of the research topics.