An economic evaluation of different sinus lift techniques

作者：Listl Stefan^*; Faggion Clovis Mariano Jr

来源：Journal of Clinical Periodontology, 2010, 37(8): 777-787.

DOI：10.1111/j.1600-051X.2010.01577.x

• cost-effectiveness
• decision analytical modelling
• maximum net benefit
• probabilistic sensitivity analysis
• sinus floor elevation

P>Purpose
To identify the most cost-effective approach to sinus lifting on the basis of currently available evidence.
Methods
We incorporate the costs and clinical outcomes of nine different sinus lift techniques within a decision tree model in which costs are based on insurance regulations in Germany and health outcomes follow two recent meta-analyses. The most cost-effective treatment option is identified on the basis of the maximum net benefit criterion. Uncertainties regarding health outcomes are incorporated via probabilistic sensitivity analysis based on Monte-Carlo simulation.
Results
When there are no financial restrictions, the optimum treatment strategy is the lateral approach with autogenous particulate bone and a resorbable membrane. When, however, monetary resources for sinus-floor elevation are scarce, the most cost-effective option is the transalveolar technique without bone grafting. Only if relatively high costs can be afforded or if initial bone height at implant site is below 5 mm is the maximum net benefit achieved by lateral approaches.
Conclusions
On the basis of currently available evidence, the transalveolar technique is advisable when monetary resources for sinus-floor elevation are scarce and initial bone height is sufficiently high. Lateral approaches are primarily recommended for lower pre-operative bone heights.

• 出版日期2010-8