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A cost-effectiveness evaluation of enamel matrix derivatives alone or in conjunction with regenerative devices in the treatment of periodontal intra-osseous defects.
- Source :
-
Journal of clinical periodontology [J Clin Periodontol] 2010 Oct; Vol. 37 (10), pp. 920-7. - Publication Year :
- 2010
-
Abstract
- Purpose: To identify the most cost-effective approach to treatment of infrabony lesions with enamel matrix derivatives (EMD).<br />Methods: We incorporated costs and clinical outcomes of 12 different treatment techniques (including flap operation, EMD alone, and EMD in association with other reconstructive devices) within a decision tree model in which costs were based on insurance regulations in Germany and health outcomes followed a recent meta-analysis. The most cost-effective treatment option was identified on the basis of the maximum net benefit criterion.<br />Results: Treatment techniques using EMD were cost-efficient if the decision maker's willingness-to-pay (WTP) was at least €150-175 per incremental mm of pocket probing depth reduction and clinical attachment level gain, respectively (1-year perspective). When EMD was affordable, the maximum net benefit was achieved by treatment with EMD in conjunction with bioactive glass or bovine bone substitutes. Additional application of platelet-rich plasma (PRP) or a resorbable membrane came at relatively high costs.<br />Conclusions: If EMD use is indicated, EMD in conjunction with either bioactive glass or bovine bone substitutes is more cost-effective than EMD alone. The additional use of PRP or a resorbable membrane may only be justifiable when monetary resources for treatment are very generous.<br /> (© 2010 John Wiley & Sons A/S.)
- Subjects :
- Bone Substitutes economics
Decision Trees
Germany
Guided Tissue Regeneration, Periodontal economics
Humans
Insurance, Dental
Membranes, Artificial
Meta-Analysis as Topic
Monte Carlo Method
Platelet-Rich Plasma
Treatment Outcome
Alveolar Bone Loss economics
Alveolar Bone Loss surgery
Cost-Benefit Analysis
Dental Enamel Proteins economics
Dental Enamel Proteins therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1600-051X
- Volume :
- 37
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of clinical periodontology
- Publication Type :
- Academic Journal
- Accession number :
- 20727057
- Full Text :
- https://doi.org/10.1111/j.1600-051X.2010.01611.x