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Biomedical subjects

Urs Braegger

Publications and source records attributed to Urs Braegger.

2 recordsLinked to original sources

Cost-benefit, cost-effectiveness and cost-utility analyses of periodontitis prevention.

OBJECTIVE: The aim of this paper was to determine whether there is evidence that periodontitis prevention is economically justified. MATERIAL AND METHODS: The characteristics of economic assessments such as cost-benefit, cost-effectiveness and cost-utility analyses were first derived from the literature on health economy. A literature search was conducted using PubMed up to December 2004. Inclusion criteria required that economic analyses be based on scientific principles including a hypothesis, valid comparative groups as well as a cost/benefit, cost/effectiveness and cost/utility assessment. RESULTS: Only 14 papers were located, which included, in the broadest sense, economic parameters. From these papers, three were systematic reviews, three were randomized controlled studies, four were controlled studies, one was a longitudinal cohort study and three papers were based on statistical modelling. Only one paper reported actual costs for periodontal and dental treatment. Extensive programmes aimed at prevention of periodontal disease in a general population group showed no economic benefit. Adjunctive genetic/and or microbiological testing likewise showed no economic benefit. Economic assessments and real costs are not generally available in the literature. Statistical modelling suggested that non-surgical periodontal procedures are more economical compared with surgical interventions. The use of local delivery devices as an adjunct to Sc/RP showed no economic advantage. CONCLUSION: It is suggested that economic parameters as well as patient-centred outcomes be included in clinical trials. These data are essential for the appropriate allocation of resources for preventive measures on an individual patient and population base.

Anti-Infective Agents, Local↗

Quality of dental implants.

BACKGROUND: Clinicians need quality research data to decide which dental implant should be selected for patient treatment. AIM(S)/OBJECTIVE(S): To present the scientific evidence for claims of relationship between characteristics of dental implants and clinical performance. STUDY DESIGN: Systematic search of promotional material and Internet sites to find claims of implant superiority related to specific characteristics of the implant, and of the dental research literature to find scientific support for the claims. MAIN OUTCOME MEASURES: Critical appraisal of the research documentation to establish the scientific external and internal validity as a basis for the likelihood of reported treatment outcomes as a function of implant characteristics. RESULTS: More than 220 implant brands have been identified, produced by about 80 manufacturers. The implants are made from different materials, undergo different surface treatments and come in different shapes, lengths, widths and forms. The dentist can in theory choose among more than 2,000 implants in a given patient treatment situation. Implants made from titanium and titanium alloys appear to perform well clinically in properly surgically prepared bone, regardless of small variations of shapes and forms. Various surface treatments are currently being developed to improve the capacity of a more rapid anchorage of the implant into bone. A substantial number of claims made by different manufacturers on alleged superiority due to design characteristics are not based on sound and long-term clinical scientific research. Implants are, in some parts of the world, manufactured and sold with no demonstration of adherence to any international standards. CONCLUSIONS: The scientific literature does not provide any clear directives to claims of alleged benefits of specific morphological characteristics of dental implants.

Clinical Trials as Topic↗