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Journal of Clinical Periodontology

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


  • 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.

Professor P. A. Heasman
School of Dental Sciences
Newcastle University
Framlington Place
Newcastle upon Tyne, NE2 4BW


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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