Patient preferences for different tooth replacement strategies for the edentulous mandible: A willingness-to-pay analysis

J Prosthodont Res. 2021 May 11. doi: 10.2186/jpr.JPR_D_20_00170. Online ahead of print.

Abstract

Purpose: The aim of this study was to evaluate patients' economic preferences for two different tooth replacement strategies for the edentulous mandible namely conventional complete dentures (CCDs) and implant overdentures supported by two implants (IODs), using a willingness-to-pay (WTP) analysis.

Methods: Twenty-six elderly patients who had been rehabilitated with either a mandibular CCD or IOD were invited to participate in this study. All participants were provided with the details of the two treatment protocols, including advantages, disadvantages, and treatment costs. The patients were then asked to indicate their maximum WTP values for each protocol using a payment card method for contingency evaluation.

Results: Fifteen patients with mandibular CCD (CCD-Group) and 12 patients with IOD (IOD-Group) participated in the study. Overall, the median and maximum WTP values recorded for IOD therapy were significantly higher than those for CCD therapy (p<0.05). Both treatment groups recorded maximum WTP values for CCD therapy, which exceeded the market cost (¥30,000 [US$280]), CCD-Group: ¥50,000 (interquartile range [IQR]: 40,000 - 65,000), and IOD-Group: ¥45,000 (IQR: 30,000-85,000)]. However, both groups registered a median and maximum WTP values for IOD therapy lower than the market cost (¥780,000 [US$7,300]), (CCD-Group: ¥500,000 [IQR: 300,000 - 750,000], IOD-Group: ¥700,000 [IQR: 500,000-800,000]).

Conclusion: The maximum WTP values recorded for IOD therapy were significantly higher than CCD therapy in both treatment groups. While patients were willing to pay more than the current market costs for CCDs, they were not willing to meet the market value for IODs.

Keywords: 2-implant overdenture; Complete denture; Economic preference; Preference-based healthcare; Willingness-to-pay.