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COST-EFFECTIVENESS ANALYSIS OF PERIODONTAL-DISEASE CONTROL

JOURNAL OF DENTAL RESEARCH 1987年第11期66卷 1630-1635页

作者： ANTCZAKBOUCKOMS, AA WEINSTEIN, MC HARVARD UNIV SCH PUBL HLTHDEPT HLTH POLICY & MANAGEMENT677 HUNTINGTON AVEBOSTONMA 02115 USA

Cost-effectiveness analysis was used to evaluate alternative methods of periodontal disease control. The alternatives considered included non-surgical and surgical procedures as well as the use of antimicrobial agents. Data on costs were obtained from American Dental Association publications of average charges for periodontal services. The concept of quality-adjusted tooth-years (QATYs) was developed to provide an outcome measure which could be compared across treatments. The conclusions of this analysis are as follows: (1) Conservative non-surgical treatments for periodontal disease control not only have costs lower than surgical alternatives, as would be expected, but also maximize expected quality-adjusted tooth-years over a wide range of estimates; (2) antimicrobial therapy used as an adjunct to non-surgical treatment is likely to be both effective and cost-effective; and (3) quality of tooth-years is a critical consideration in the determination of outcome of periodontal treatment. For example, when tooth-years are not adjusted for quality, differences between treatments are diminished, and surgical treatment becomes as good as or better than more conservative treatments for some levels of disease severity-

关键词：牙槽成形术/经济学抗菌药/经济学抗菌药/治疗应用抗感染药/经济学抗感染药/治疗应用费用效益分析决策支持技术牙疾病预防/经济学牙科刮治术/经济学卫生保健费用甲硝唑/经济学甲硝唑/治疗应用结果评价(卫生保健)/经济学牙周疾病/经济学牙周疾病/预防和控制牙周疾病/外科学牙周疾病/治疗牙周袋/经济学牙周袋/外科学质量校正寿命相对价值表牙根平滑术/经济学敏感性与特异性牙龈下刮治术/经济学外科皮瓣/经济学四环素/经济学四环素/治疗应用人类中年人

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Adjunctive periodontal therapy

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JOURNAL OF THE AMERICAN DENTAL ASSOCIATION 1999年第6期130卷 869-870页

作者： Christensen, GJ Clin Res Associates Provo UT USA

Many dental patients will not or cannot have conventional periodontal surgery. This arti- cle has suggested that perio- dontal adjunctive therapies, in- cluding local antibiotic therapy and systemic enzyme-inhibiting drugs, should be combined with frequent SRP to reduce, control or maintain periodontal dis- ease. These procedures are a measurable service to patients and provide an economic stimu- lus for general dentists and their personnel to become more involved with treatment of periodontal disease.

关键词：抗菌药/投药和剂量迟效制剂牙科刮治术/统计学和数值数据多西环素/投药和剂量开业医生牙科牙周疾病/经济学牙周疾病/治疗人类

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The cost, effectiveness and cost effectiveness of removal and retention of asymptomatic, disease free third molars

引用

BRITISH DENTAL JOURNAL 1999年第7期187卷 380-383页

作者： Edwards, MJ Brickley, MR Goodey, RD Shepherd, JP Univ Wales Coll Cardiff Coll Med Sch Dent Dept Oral Surg Med & Pathol Cardiff CF4 4XY S Glam Wales

Purpose of investigation The study was undertaken to identify the least costly, most effective and most cost-effective management strategy for asymptomatic, disease free mandibular third molars. Methods and patients A decision tree model of the outcomes of mandibular third molar retention and removal was constructed. Probability data for possible outcomes were obtained from a comprehensive literature review and entered into the decision tree. The cost to the NHS in treating each outcome was calculated. 100 patients attending the oral surgery clinics, University of Wales Dental Hospital rated the effect of each outcome on their own life. The cost and effectiveness data for each outcome were entered into the decision tree and the analyses were conducted by 'folding back' the decision tree based on the probabilities. Main findings Mandibular third molar retention was less costly (pound 170), more effective (69.5 effectiveness units on a 100 point scale) and more cost-effective (pound 2.43 per unit of effectiveness) than removal (pound 226, 63.3 and pound 3.57 respectively). These findings were sensitive to changes in the probability of pericoronitis, periodontal disease and caries. Principal conclusions Mandibular third molar retention is less costly to the NHS, more effective for the patient and more cost-effective to both parties than removal. However, should the likelihood of developing pericoronitis, periodontal disease and caries increase substantially then removal becomes the more cost-effective strategy.

关键词：费用效益分析决策树龋齿/经济学龋齿/病因学卫生保健费用/统计学和数值数据磨牙第三/外科学结果与过程评价(卫生保健)/方法冠周炎/经济学冠周炎/病因学牙周疾病/经济学牙周疾病/病因学公费牙科医疗/经济学拔牙/经济学拔牙/统计学和数值数据牙阻生/并发症牙阻生/经济学人类

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