Cost-effectiveness modeling of dental implant vs. bridge

Aims: We assess the cost-effectiveness of dental implant first-line strategy vs. fixed partial denture strategy in patients suffering from one single missing tooth. Materials and methods: The model used a simulation decision framework over a 20-year period. Potential treatment switches can occur every 5 years. Transition probabilities come from literature, epidemiological reports or expert opinions. They have been programmed using specific distribution ranges to simulate the patients' and practice variability, and to take into account parameter uncertainty. Direct medical costs have been assessed according to a cost survey. Probabilistic sensitivity analyses were conducted using 5000 Monte-Carlo simulations, generating confidence intervals of model outcomes. Results: We found that mean cost-effectiveness of the bridge strategy is higher than the implant strategy. Conclusion: Implant as the first-line strategy appears to be the ‘dominant’ strategy, considering the lower overall costs and the higher success rate.