Economic aspects of single-tooth replacement

The aim of this study was to assess and compare economic parameters of two treatment options in patients requiring single-tooth replacements in private practice. Thirty-seven patients received 41 conventional three-unit fixed partial dentures (FPDs). Fifty-two patients received 59 single crowns on implants (I). Treatment assignment was not random. All except one were metal ceramic reconstructions. All except one were crowns cemented on solid abutments of the ITI (R) Dental Implant System. Economic parameters were noted for the preparatory phase, the actual reconstruction and for treatment of biological and/or technical complication thereafter (range 1-4 years): number of visits, chair-side time, treatment costs, costs for implant components and laboratory work. Costs were based on the tariffs between the Swiss dentists association and the insurers (Sfr 3.1 per tariff point). Implant treatment required more visits than FPD (8.1 +/- 2/4.8 +/- 2.3, chi(2): P=0.02). However, the total treatment time was similar (I: 4.8 h +/- 0.9 h/FGM: 5.1 h +/- 1.3 h, NS). Laboratory costs were higher for FPD (1527.8 +/- 209 SFr) vs. 579.6 +/- 106.9 CHF for I. Costs for treatment of technical and biological complications were similar. Total costs amounted to 3939.4 +/- 766.4 SFr for FGM vs. 3218 +/- 512.2 SFr for I (P < 0.003, Kolmogorov-Smirnov). Even when considering opportunity costs (50 SFr) for each visit the implant solution was less expensive: 3623.2 +/- 656.1 SFr vs. 4178.7 +/- 822.1 SFr (P < 0.04, Kolmogorov-Smirnov). Costs for treatment of complications were similar. In conclusion, over a short observation period, the implant reconstruction demonstrated a more favorable cost/effectiveness ratio. Especially in clinical situations with either non- or minimally restored teeth and sufficient bone, the implant reconstruction is to be recommended from an economical point of view.