Cost -effective non-surgical alternative for the peri- implantitis treatment
Why is it interesting? There are several alternative nonsurgical treatments for peri- implantitis, however, still does not seem clear which treatment is the best cost-effectiveness. A comparison of non- surgical treatments with other alternatives may be relevant not only to identify the most effective therapeutic approach, but also to investigate the effectiveness of various treatments against the expenses associated with these in order to understand what therapy can be considered which provides the most favorable cost. Moreover, it is the first study investigating the cost-effectiveness of non-surgical treatment of peri -implant. The objective of the authors was to evaluate the cost-effectiveness of various non- surgical alternatives for the treatment of peri -implant.
Experimental design: the analytical decision model was constructed with estimated parameters in literature for reduction in probing depth and responding to eight different alternatives of treatment: debridement + chlorhexidine gel, debridement + Periochip, debridement + local antibiotics, debridement with ultrasound (Vector System), AirFlow , Er: YAG laser, photodynamic therapy or just debridement. A combination of lower cost approach to a specialized online survey was applied to simulate decision-making, with scenery in Germany. The treatment cost alternative offering the combinations / the most advantageous results were identified according to the criteria of net benefit. Uncertainties as to the form of input parameters were incorporated via simple probabilistic sensitivity analysis based on Monte Carlo simulation.
Findings: Based on the scenario in question, debridement alone, AirFlow, debridement + Periochip and debridement + local antibiotics were identified as treatment strategies more cost -effective compared to other proposed treatments. Sensory analyzes revealed considerable uncertain decisions corresponding to the limited evidence on the different alternatives for the treatment of peri -implant.
Comments: the study suggested that debridement alone, AirFlow + local debridement and antibiotic promoted better cost-effectiveness results in treating peri -implant compared to other treatment modalities. The authors recommend further that more clinical studies are conducted. However, the focus of the study is highly relevant for clinicians seeking recommendations based on evidence for the best non-surgical treatment of peri -implant, from the currently available knowledge.
Source: INPN, written by: Rafaela Videira
Image takes from: http://www.inpn.com.br/Materia/CasoClinico/21514