The cost-effectiveness of supportive periodontal care for patients with chronic periodontitis


Gaunt, F; Devine, M; Pennington, M; Vernazza, C; Gwynnett, E; Steen, N; Heasman, P; (2008) The cost-effectiveness of supportive periodontal care for patients with chronic periodontitis. Journal of clinical periodontology, 35 (8 Suppl). pp. 67-82. ISSN 0303-6979 DOI: https://doi.org/10.1111/j.1600-051X.2008.01261.x

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Abstract

OBJECTIVE: To systematically evaluate the evidence for effectiveness of supportive periodontal care (SPC) provided in specialist care and general practice for patients with chronic periodontitis; to construct a model for the cost effectiveness of SPC. SEARCH STRATEGY: Electronic database searches of MEDLINE, EMBASE and SCOPUS were performed with hand searching of relevant journals and Workshops of Periodontology. Selection Criteria: SPC for patients with chronic periodontitis, at least 12 months follow-up and clinical attachment level as a primary outcome. RESULTS: Three articles addressed the question (Nyman et al. 1975, Axelsson & Lindhe 1981, Cortellini et al. 1994): Deltas CAL for patients undergoing "specialist" SPC were 0.1 mm (2 years), 0.2 mm (6 years) and -0.01 mm (3 years) respectively. In generalist care the Deltas CAL during SPC were -2.2, -1.8 and -2.8 mm. Differences between specialist and generalist SPC were an extra 20.59 tooth years and 3.95 mm attachment loss for generalist SPC. Incremental cost-effectiveness ratios were an extra 288 euros for one tooth year or an extra 1503 euros/1 mm reduction in loss of attachment for SPC delivered in specialist care. CONCLUSION: SPC delivered in specialist as compared with general practice will result in greater stability of clinical attachment but this will be achieved at relatively greater cost.

Item Type: Article
Keywords: Chronic Periodontitis, economics, prevention & control, Cost-Benefit Analysis, Dental Hygienists, economics, Dental Scaling, economics, Disease Progression, General Practice, Dental, economics, Health Care Costs, Humans, Periodontics, economics, Recurrence, Root Planing, economics, Treatment Outcome
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 18724842
Web of Science ID: 258734000007
URI: http://researchonline.lshtm.ac.uk/id/eprint/2561

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