Background: The purpose of the present study was to assess the value for money achieved by bar-retained implant\noverdentures based on six implants compared with four implants as treatment alternatives for the edentulous maxilla.\nMethods: A Markov decision tree model was constructed and populated with parameter estimates for implant and\ndenture failure as well as patient-centred health outcomes as available from recent literature. The decision scenario was\nmodelled within a ten year time horizon and relied on cost reimbursement regulations of the German health care\nsystem. The cost-effectiveness threshold was identified above which the six-implant solution is preferable over the\nfour-implant solution. Uncertainties regarding input parameters were incorporated via one-way and probabilistic\nsensitivity analysis based on Monte-Carlo simulation.\nResults: Within a base case scenario of average treatment complexity, the cost-effectiveness threshold was identified\nto be 17,564 ââ??¬ per year of denture satisfaction gained above of which the alternative with six implants is preferable over\ntreatment including four implants. Sensitivity analysis yielded that, depending on the specification of model input\nparameters such as patientsââ?¬â?¢ denture satisfaction, the respective cost-effectiveness threshold varies substantially.\nConclusions: The results of the present study suggest that bar-retained maxillary overdentures based on six implants\nprovide better patient satisfaction than bar-retained overdentures based on four implants but are considerably more\nexpensive. Final judgements about value for money require more comprehensive clinical evidence including\npatient-centred health outcomes.
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