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Technology assessment in dentistry: A comparison of the longevity and cost-effectiveness of inlays

Published online by Cambridge University Press:  04 August 2005

Afschin Gandjour ,
Thomas Kerschbaum ,
Andreas Reis  and
Karl Wilhelm Lauterbach
Afschin Gandjour
Affiliation:
University of Cologne
Thomas Kerschbaum
Affiliation:
University of Cologne
Andreas Reis
Affiliation:
World Health Organization
Karl Wilhelm Lauterbach
Affiliation:
University of Cologne
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Abstract

Objectives: An example of technology assessment in dental care by evaluating the (cost-)effectiveness of types of three-surface inlays (gold, laboratory-fabricated ceramic, and chairside CAD/CAM ceramic) is provided.

Methods: MEDLINE, EMBASE, and the Cochrane Library were searched for studies published between 1966 and June 2003 that reported annual survival probabilities and annual observations. The longevity of different types of inlays was measured by the number of failure-free years. Annual survival rates from different studies were pooled by weighing the rates of each study by the inverse of the variance of the effect estimate. A cost-effectiveness analysis from the perspective of German private health insurers was performed using billing charges.

Results: Three, five, and two case series on laboratory-fabricated ceramic, chairside CAD/CAM ceramic, and gold inlays, respectively, were included. Over a 9-year observation period, the number of undiscounted failure-free years was 8.62 (95 percent confidence interval, 8.40–8.85), 8.65 (8.58–8.73), and 8.76 (8.72–8.80) for laboratory-fabricated ceramic, chairside CAD/CAM ceramic, and gold inlays, respectively. Laboratory-fabricated ceramic inlays were the most expensive.

Conclusions: While laboratory-fabricated ceramic, chairside CAD/CAM ceramic, and gold inlays had a strikingly similar failure-free survival rate, laboratory-fabricated ceramic inlays had the highest costs and, thus, were less cost-effective than chairside CAD/CAM ceramic and gold inlays.

Keywords

EfficiencyInlaysLongevityTechnology assessment
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 21 , Issue 3 , July 2005 , pp. 319 - 325
Copyright
© 2005 Cambridge University Press

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