Does three-dimensional imaging offer a financial benefit for treating maxillary molars with furcation involvement? - A pilot clinical case series
Does three-dimensional imaging offer a financial benefit for treating maxillary molars with furcation involvement? - A pilot clinical case series
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DOI：
10.1111/j.1600-0501.2011.02330.x
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发表时间：
2012-03-01
影响因子：
4.3
通讯作者：
Zitzmann, Nicola U.
中科院分区：
文献类型：
--
作者：
Walter, Clemens;Weiger, Roland;Zitzmann, Nicola U.
目的：评估锥形束计算机断层扫描 (CBCT) 对上颌磨牙治疗方案（包括牙周手术和拔牙后再种植种植体）的经济效益。材料和方法：招募了 12 名患有全身性慢性牙周炎的患者，对临床分叉受累和探诊袋深度增加的上颌磨牙 (n = 22) 进行了 CBCT。治疗建议要么基于传统的牙周诊断（临床检查和根尖周X线照片），要么基于额外的CBCT数据。临床建议包括最小侵入性治疗（例如支持性牙周治疗）和最大侵入性治疗（例如拔牙和种植体植入），并将这些建议与基于 CBCT 的建议进行比较。根据瑞士牙科收费结构，使用经验累积分布函数分析节省成本或时间的概率以及需要治疗的人数。结果：CBCT 平均成本降低达 915 +/- 1470 瑞士法郎，节省 136 +/- 217 分钟。基于最大侵入性临床治疗决策的减少幅度最大（CHF 1566 +/- 1840），特别是第二磨牙（CHF 2485 +/- 2226）。为了补偿 CBCT 费用，需要 1.7 名受试者接受治疗才能至少收支平衡。结论：CBCT 数据有助于减少瑞士涉及牙周的上颌磨牙的治疗成本和时间。然而，根据这些成本分析，只有在计划进行更多侵入性治疗时，CBCT 作为额外的诊断措施才合理。
Aim: To assess the financial benefit of cone beam computed tomography (CBCT) for the treatment options of maxillary molars including periodontal surgery and extraction followed by implant placement.Material and methods: Twelve patients with generalized chronic periodontitis were recruited, and CBCT was performed in maxillary molars (n = 22) with clinical furcation involvement and increased probing pocket depths. Treatment recommendations were either based on conventional periodontal diagnostics (clinical examinations and periapical radiographs), or based on the additional CBCT data. Clinical recommendations comprised a minimal (e.g. supportive periodontal treatment) and a maximal invasive therapy (e.g. extraction and implant placement), and these were compared with CBCT-based recommendations. According to the Swiss dental tariff structure, the probabilities of saving costs or time, and the numbers needed to treat were analysed with an empirical cumulative distribution function.Results: Average cost reduction from CBCT amounted to CHF 915 +/- 1470 and saved 136 +/- 217 min. Greatest reductions were found with maximal invasive clinically based treatment decisions (CHF 1566 +/- 1840), particularly for second molars (CHF 2485 +/- 2226). To compensate CBCT costs, 1.7 subjects were needed to treat to at least break even.Conclusions: Data from CBCT facilitated a reduction in treatment costs and time for periodontally involved maxillary molars in Switzerland. Based on these cost analyses, however, CBCT as additional diagnostic measure is justified only when more invasive therapies are planned.