Objective: The aim of this study was to assess the cost effectiveness of silicone and alginate impressions for complete dentures.
Methods: Cost effectiveness analyses were undertaken alongside a UK single centre, double blind, controlled, crossover clinical trial. Taking the perspective of the healthcare sector, effectiveness is measured using the EuroQol (EQ-5D-3L) which provides a single index value for health status that may be combined with time to produce quality adjusted life years (QALYs); and Oral Health Impact Profile (OHIP-EDENT). Incremental cost effectiveness ratios are presented representing the additional cost per one unit gained.
Results: Mean cost was higher in the silicone impression group (388.57 pound vs. 363.18) pound. Negligible between-group differences were observed in QALY gains; the silicone group had greater mean OHIP-EDENT gains. The additional cost using silicone was 3.41 pound per change of one point in the OHIP-EDENT.
Conclusions: The silicone group was more costly, driven by the cost of materials. Changes in the EQ-5D and QALY gains over time and between arms were not statistically significant. Change in OHIP-EDENT score showed greater improvement in the silicone group and the difference between arms was statistically significant. Given negligible QALY gains and low level of resource use, results must be treated with caution. It is difficult to make robust claims about the comparative cost-effectiveness.
Clinical significance: Silicone impressions for complete dentures improve patients' quality of life (OHIP-EDENT score). The extra cost of silicone impressions is 30 pound per patient. Dentists, patients and health care funders need to consider the clinical and financial value of silicone impressions. Different patients, different dentists, different health funders will have individual perceptions and judgements. (C) 2014 The Authors. Published by Elsevier Ltd.
Bibliographical noteOpen Access funded by Department of Health UK
Under a Creative Commons license
This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0408-16300). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health (UK).
- quality-of life
- impression materials
- cost effectiveness
- important difference