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ePaper created 2014-11-23, 21:56:20 | version 1.30.01
I economy _Nowadays, dental implants are well estab- lished in daily practice and are well known and ac- cepted by the public. They allow anchorage of re- movable and fixed dental prostheses in a pre- dictable way. The efforts of scientists in collabora- tion with the implant industry have led to continuousimprovementinclinicaloutcomesow- ing to the modification of implant surfaces, im- plant design and prosthetic connections. Together with a better understanding of biology, these de- velopments yield fewer implant failures despite the usage of implants in compromised or at-risk patients. In their consensus reports, the European Associ- ation for Osseointegration (EAO) stressed the need for additional research in the field of patient-cen- tred treatment outcomes, including the economic impact of implant restorative treatments.1 Patient- centredoutcomesconsideranumberofparameters that are not always objectively measurable, in con- trast to implant survival, bone loss, peri-implant health and incidence of complication, for example. Patient-centred outcome variables include patient satisfactionwithagiventreatment,improvedmas- ticatoryabilityandaesthetics,theabsenceofspeech problems and the subjective evaluation of oral health-related quality of life. _Greater attention to cost–benefit In light of a growing interest in health econom- ics, greater attention is also being given to the cost–benefit of tooth replacements. In economics, cost–benefit analysis compares the cost of making a product or delivering a service to the direct bene- fittotheindividualorthesociety,includingtherev- enue, the product or service will generate in the long term. Applied to dental or medical care, this analysis would have to consider resource expendi- ture relative to potential medical benefits, such as longer survival, reduced pain or morbidity, and greatercomfort.Suchananalysiswouldseektode- termine the best choice considering limited re- sources,anditwouldweighthepossibilityofunde- sirable outcomes and side-effects against the po- tential of a positive treatment outcome. A cost–benefit analysis would consider these aspectstogetherwiththecostsinvolvedintermsof chair time, patient-related time, handling compli- cations, and satisfying patients’ expectations and preferences. It has become a part of the process of determining necessity in delivery of qualitative care and it brings the patient to the centre of deci- sion-making. In dental science, these aspects are largely uncovered. Cost–benefit and affordability of dental implant restorations Author_Prof. Hugo de Bruyn, Belgium 28 I implants4_2014 [PICTURES: ©CREATIONS, ©PATHDOC]