A Cost Minimization Analysis of Implant Treatment in Mandibular Edentulous Patients

Purpose: This study aimed to determine if implant-supported overdentures are a long-term economically efficacious therapy for edentulous patients when compared to fixed osseointegrated prostheses. Materials and Methods: Clinical records of 25 patients from two longterm studies (fixed and overdenture) were included in this analysis. A cost minimization analysis from the patient perspective was employed. Direct clinical and time costs incurred over the 9-year period were deflated to 1995 Canadian dollars using the Consumer Price Index. National salary rates by occupation and gender were used to value patients' time, and a sensitivity analysis was carried out to assess the robustness of the results when an equal mean salary rate across treatment groups was assumed. Results: The mean total, clinical, and time costs were significantly higher (P = .05) for the fixed restoration group ($CAD10,748, $CAD10,094, and $CAD654, respectively) when compared to the overdenture group ($CAD3,665, $CAD3,343, and $CAD322, respectively). The initial, maintenance, and clinical visit costs were also significantly higher (P = .05) in the fixed restoration group ($CAD7,567, $CAD2,527, $CAD542, respectively) than in the overdenture group ($CAD2,505, $CAD830, $CAD292, respectively). The sensitivity analysis demonstrated that the time cost for the fixed prosthodontic group ($CAD488 vs $CAD322) was still significantly higher (P = .002), even after an equal mean salary rate was assumed. Conclusion: Overdenture therapy for edentulous patients is a more cost-effective treatment compared to fixed prosthodontic treatment.