In contrast to the overall trend towards a decrease in edentulism, the group in greatest need of complete oral rehabilitation is the rapidly growing aging population. Loss of all teeth (edentulism) induces functional and esthetic burdens, which in turn affects patients’ psychosocial well-being, even for patients who can handle their removable conventional dentures reasonably well. Based on the report of the National Health Care Institute (Zorginstituut Nederland), approximately 150,000 patients are treated annually with conventionally produced implant overdentures (C-IODs) with a total annual cost for manufacturing by the dental technician alone, ie without dental fees, of approximately €130 million.Our hypothesis is that an IOD which is designed digitally, and subsequently 3D manufactured (3D-IOD), can be made cheaper, faster, and more patient friendly. To prove such a statement, patients should at least be even satisfied about their 3D-IOD as their C-IOD (non-inferiority). At the same cost and time spent on treatment sessions should be significantly lower. In literature no publications can be found which compare C-IODs with 3D-IODs, simply because a digitally designed and 3D-manufactured IOD is a novel technique.Thereto all patients were randomly assigned into two groups: 18 started with the 3D-IOD and after one year switched to the C-IOD. Another 18 participants began with the C-IOD and ended with the 3D-IOD. At baseline and after wearing the 3D-IOD and C-IOD for one year each, patients were surveyed using the OHIP-20, VAS-score, SF-36, EQ-5D-5L and iMTA Productivity Cost Questionnaire. To perform a cost-effectiveness analysis (CEA), initial and reparation costs for each IOD-type, the treatment & travel time, the number of visits and the loss of productivity were analyzed.To conclude, patients turned out to be more satisfied with the 3D-IOD. Furthermore, depending on the number of implants installed, bar-retained 3D-IOD’s were 17-42% cheaper than the C-IOD. Based on the prices of 2021, the budget impact analysis showed that if a digital workflow is implemented for bar-retained IODs, around 50 million euros would be saved in the Netherlands.
Date: 27-10-2021
Date: 2018-02-09
Date Submitted: 2023-07-25
