Budget Impact Analysis: Digital Workflow Significantly Reduces Costs of Implant Supported Overdentures (IODs).

BACKGROUND: For edentulism, an implant supported removable complete overdenture (IOD) is an attractive solution to restore patients' chewing capacity, aesthetics, and self-esteem, however, treatment is expensive and time consuming. PURPOSE/AIM: To estimate the decline in costs for digitally designed and CAD/CAM fabricated IODs (3D-IODs) compared to conventionally fabricated IODs (C-IODs) at comparable general health related quality of life (GHRQoL). MATERIALS AND METHOD: A randomized crossover study enrolled 36 fully edentulous patients, in whom six maxillary implants were placed together with two mandibular implants, if not already present. At the start of the study, a set of C-IODs and 3D-IODs was fabricated for each patient. All patients wore each IOD-type for 1 year: first the 3D-IOD and the second year a C-IOD, or vice versa. At all three-time points patients general QoL was assessed using the EQ-5D-5L questionnaire as well as the SF-36 from which the SF-6D was obtained, to research the anticipation of no significant difference. To enable cost consequence analysis (CCA), both costs made within healthcare and patient costs were assessed. Subsequently, a budget impact analysis (BIA) was performed to demonstrate the potential savings. RESULTS: No differences in general GHRQoL were seen between C-IOD (M = 0.840, SD = 0.177) and 3D-IOD (M = 0.837, SD = 0.156) (paired t-test (N = 31): p = 0.880). With respect to the total costs for a complete IOD, however, the digital approach showed a reduction in initial total costs of 14.2% (euro4700.33 vs. euro4030.61: p < 0,001), in treatment time of 41.1% (309 vs. 182 min: p < 0.001), and in number of treatment sessions of 47.1% (5.68 vs. 3.0: p < 0.001). For repairs for an IOD in both the upper and lower jaw, the C-IOD and 3D-IOD scored similar for treatment time as well as additional costs. CONCLUSION: Implementing a 3D workflow in the production of IOD's supplies patients with a high-quality 3D-IOD at lower costs. TRIAL REGISTRATION: NL-OMON44248 https://onderzoekmetmensen.nl/en/trial/44248.