Cost-effectiveness of anterior implants versus fixed dental prostheses

J Dent Res. 2013 Dec;92(12 Suppl):183S-8S. doi: 10.1177/0022034513504927. Epub 2013 Oct 24.


For the restoration of an anterior missing tooth, implant-supported single crowns (ISCs) or fixed dental prostheses (FDPs) are indicated, but it is not clear which type of restoration is more cost-effective. A self-selected trial was performed with 15 patients with ISCs and 11 with FDPs. Patient preferences were recorded with visual analog scales before treatment, 1 month following restoration, and then annually. Quality-adjusted tooth years (QATYs) were estimated by considering the type of reconstruction for replacing the missing tooth and its effect on the adjacent teeth. A stochastic cost-effectiveness model was developed using Monte Carlo simulation. The expected costs and QATYs were summarized in cost-effectiveness acceptability curves. ISC was the dominant strategy, with a QATY increase of 0.01 over 3 years and 0.04 over 10 years with a higher probability of being cost-effective. While both treatment options provided satisfactory long-term results from the patient's perspective, the lower initial costs, particularly laboratory fees, were responsible for the dominance of ISCs over FDPs.

Keywords: cost effectiveness; dental economics; dental restoration; fixed partial denture; patient satisfaction; single-tooth implants.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Crowns / economics
  • Dental Implants, Single-Tooth / economics*
  • Dental Prosthesis Design
  • Dental Prosthesis, Implant-Supported / economics
  • Denture Design
  • Denture, Partial, Fixed / economics*
  • Esthetics, Dental
  • Follow-Up Studies
  • Humans
  • Jaw, Edentulous, Partially / economics
  • Jaw, Edentulous, Partially / rehabilitation
  • Longitudinal Studies
  • Patient Preference
  • Patient Satisfaction
  • Probability
  • Prospective Studies
  • Quality-Adjusted Life Years
  • Stochastic Processes