Cost Effectiveness of Various Implant Placement Protocols in the Esthetic Zone

Summary

Loss of teeth in the anterior upper jaw significantly affects both well-being and chewing function. Nowadays, dental implants are the treatment of choice for replacing missing teeth with fixed dental prostheses and are often placed in the anterior upper jaw.

Depending on various patient-related factors, protocols for the placement of dental implants involve the following time points after tooth extraction:

1. On the same day (immediate implantation)
2. After 1-4 months (early implantation)
3. After more than 4 months (late implantation).

The different treatment protocols have been investigated over long periods. The choice of the individually suitable treatment protocol for dental implantation depends on many factors and is of utmost importance in order to achieve the best possible treatment outcomes. Selecting an inappropriate treatment protocol would otherwise result in an increased risk of failure.

After decades of research and development in dental implantology, an expert association (International Team for Implantology, ITI) published an evidence-based decision management tool in 2022. This decision management tool assists dentists in choosing the individually suitable implant treatment protocol for single-tooth replacement in the upper jaw. A structured examination of the tooth to be extracted allows to classify the situation and select the most suitable treatment protocol for the individual situation. The treatment protocols differ in terms of time and material requirements, which are associated with different costs.

There is limited data about the cost-effectiveness of these treatment protocols. The present study aims to assess how the costs of the three treatment protocols differ in relation to treatment success.

Conditions

• Esthetic Zone
• Single Tooth Lost
• Accuracy of Dental Implants
• Dimensional Changes
• Patient Reported Outcome Measures
• Implant Survival and Success
• Cost-effectiveness
• Cost-Benefit Analysis
• Complications
• Frequency of Treatment Protocol
• Single Tooth Dental Implant

Interventions

PROCEDURE

Immediate Implant Placement

The extraction of the failing tooth will be carried out. Subsequently, immediate implant placement and bone grafting of the intra-alveolar space by the means of a well-documented xenogeneic bone substitute will be carried out, will be conducted all in one single surgical intervention. After a healing period of at least 8 weeks, implant reopening takes place (conventional loading protocol).

PROCEDURE

Early Implant Placement

The extraction of the failing tooth will be carried out. Within a healing period of 4-16 weeks, the extraction socket will be completely covered by soft tissues. Implant placement and bone grafting by the means of guided bone regeneration using locally harvested autogenous bone and a well-documented xenogeneic bone substitute will be carried out. After a healing period of at least 8 weeks, implant reopening takes place (conventional loading protocol).

PROCEDURE

Late Implant Placement

The extraction of the failing tooth and a socket grafting procedure using a well-documented xenogeneic bone substitute will be carried out. Within a healing period of at least 16 weeks, the extraction socket will be completely covered by soft tissues and complete bone healing is anticipated. Implant placement and bone grafting by the means of guided bone regeneration using locally harvested autogenous bone and a well-documented xenogeneic bone substitute will be carried out. After a healing period of at least 8 weeks, implant reopening takes place (conventional loading protocol).

Sponsors & Collaborators

• University of Bern

  lead OTHER

Principal Investigators

• Clemens Raabe · Klinik für Oralchirurgie und Stomatologie, Universität Bern

Study Design

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

20 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2029-01-01

Primary Completion

2032-01-01

Completion

2040-01-01

Countries

• Switzerland

Study Locations