Affiliation:
1. Department of Periodontics and Oral Medicine The University of Michigan School of Dentistry Ann Arbor Michigan USA
2. Department of Periodontics and Preventive Dentistry University of Pittsburgh School of Dental Medicine Pittsburgh Pennsylvania USA
3. Department of Periodontics The Virginia Commonwealth University Richmond Virginia USA
4. Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention (CDC) Atlanta Georgia USA
Abstract
AbstractThe study aims were (1) to explore whether “periodontal treatment” consisting of surgical therapy (flap, resective, or regenerative) or scaling and root planing treatment with long‐term periodontal maintenance treatment, is cost‐effective in terms of preventing periodontitis‐attributable tooth extraction and replacement by implant‐supported crowns (“extraction/replacement”); (2) to assess the effect of cigarette smoking on this cost‐effectiveness. Data for this observational retrospective study were collected from dental charts of patients who had received periodontal therapy and at least annual follow‐up visits for >10 years were analyzed by linear regression generalized estimating equations and generalized linear models. Among 399 adults (199 males, 200 females), those with the least mean annual treatment cost experienced the greatest mean annual costs for extraction/replacement, indicating general cost‐effectiveness. Cigarette smoking adversely impacted this cost‐effectiveness, with current heavy smokers experiencing no cost‐effectiveness. Former smokers with Grade C periodontitis benefitted most, whereas smoking did not influence cost‐effectiveness for Grade B periodontitis. Assessed by mean annual costs of “extraction/replacement,” periodontal treatment was cost‐effective, which decreased in a dose–response manner by former and current smoking intensity. Cigarette smoking should be factored into treatment planning and cost‐effective analyses of periodontal treatment. Smoking cessation should be encouraged.
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