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J Clin Periodontol. 2008 Sep;35(8 Suppl):67-82. doi: 10.1111/j.1600-051X.2008.01261.x.

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

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1
Faculty of Medical Sciences, School of Dental Sciences, Newcastle University, Framlington Place Newcastle upon Tyne, UK.

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.

[Indexed for MEDLINE]

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