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Journal of Clinical Periodontology

The cost-effectiveness of supportive periodontal care for patients with chronic periodontitis

Authors


  • Conflict of interest and source of funding statement
    The authors declare that they have no conflict of interests.
    This review has been self-supported by the authors and Newcastle University.
    The 6th European Workshop on Periodontology was supported by an unrestricted educational grant from Straumann AG.

Address:
Professor P. A. Heasman
School of Dental Sciences
Newcastle University
Framlington Place
Newcastle upon Tyne, NE2 4BW
UK
E-mail: p.a.heasman@newcastle.ac.uk

Abstract

Objective: To systematically evaluate the evidence for effectiveness of supportive periodontal care (SPC) provided in specialist care and general practice for patients with chronic periodontitis; to construct a model for the cost effectiveness of SPC.

Search Strategy: Electronic database searches of MEDLINE, EMBASE and SCOPUS were performed with hand searching of relevant journals and Workshops of Periodontology.

Selection Criteria: SPC for patients with chronic periodontitis, at least 12 months follow-up and clinical attachment level as a primary outcome.

Results: Three articles addressed the question (Nyman et al. 1975, Axelsson & Lindhe 1981, Cortellini et al. 1994): Δs CAL for patients undergoing “specialist” SPC were 0.1 mm (2 years), 0.2 mm (6 years) and −0.01 mm (3 years) respectively. In generalist care the Δs CAL during SPC were −2.2, −1.8 and −2.8 mm. Differences between specialist and generalist SPC were an extra 20.59 tooth years and 3.95 mm attachment loss for generalist SPC. Incremental cost-effectiveness ratios were an extra €288 for one tooth year or an extra €1503/1 mm reduction in loss of attachment for SPC delivered in specialist care.

Conclusion: SPC delivered in specialist as compared with general practice will result in greater stability of clinical attachment but this will be achieved at relatively greater cost.

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