Cost-effectiveness of non-surgical peri-implantitis treatments.

AIM The purpose of the present study was to assess the cost-effectiveness of various alternatives of non-surgical peri-implantitis treatment. MATERIALS AND METHODS A decision analytical model was constructed and populated with parameter estimates from recent literature for reduction in pocket probing depth (PPD) in response to eight different treatment alternatives. A micro-costing approach combined with an online expert survey was applied to simulate a decision-making scenario taking place in Germany. The treatment alternatives providing the most advantageous cost/outcome combinations were identified according to the net benefit criterion. Uncertainties regarding model input parameters were incorporated via simple and probabilistic sensitivity analysis based on Monte Carlo simulation. RESULTS In the base case scenario, debridement alone, Air-Flow, debridement combined with PerioChip, and debridement combined with local antibiotics were identified as treatment strategies with comparably better value for money than Er:YAG laser monotherapy, Vector System, debridement combined with CHX, and photodynamic therapy. Sensitivity analysis revealed considerable decision uncertainty corresponding to limited evidence about different treatment alternatives for peri-implantitis treatment. CONCLUSIONS Derivation of robust treatment recommendations for peri-implantitis requires more comprehensive and patient-centred evidence on peri-implantitis treatments.