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Objectives Clinical data on retaining extensively damaged teeth using forced orthodontic extrusion followed by restorative rehabilitation are scarce, and economic evaluations basically absent. Based on a clinical study we performed a health economic evaluation of this treatment approach. Materials and Methods In a convenience sample of individuals recruited from routine care, extensively damaged teeth were orthodontically extruded prior to restoration. Patients were followed up for up to 6 years. Our health outcome was tooth retention time. Direct medical, non-medical and indirect initial and follow-up costs were estimated using the private payer’s perspective in German healthcare. Association of initial direct medical treatment costs and cofounding variables was analyzed using Generalized Linear Models. Results A total of 35 teeth in 30 patients were followed over a mean ± SD of 49 ± 19 months. Five teeth (14%) dropped out during that period. Median initial costs were 1941€ (range: 1284–4392€), median costs for follow-up appointments were 215€ (range: 0–5812€) and median total costs were 2284€ (range: 1453 to 7109€). Tooth survival was 46 ± 20 months. Three teeth had to be extracted and in three patients we observed orthodontic relapse. Endodontic re-treatment and placement of a post had a significant impact on total costs. Conclusions Within the limitations of this clinical study, total treatment costs for forced orthodontic extrusion and subsequent restoration of extensively damaged teeth were considerable. Costs were by large generated initially; endodontic and post-endodontic therapies were main drivers. Costs for retreatments due to complications were limited, as only few complications arose. Clinical Relevance: The restoration of extensively damaged teeth after forced orthodontic extrusion comes with considerable initial treatment costs, but low follow-up costs. Overall and over the observational period and within German healthcare, costs are below those for tooth replacement using implant-supported crowns. The study was registered at the German Clinical Trials Register (DRKS registration number: DRK S00026697).

Objectives To assess clinical, radiological and esthetic outcomes of prosthodontic rehabilitations supported by root-analogue implants (RAIs) or roots of severely damaged teeth after forced orthodontic extrusion (FOE). Materials and Methods Clinical data regarding RAIs and FOE were recorded and retrospectively evaluated for 40 patients by two independent investigators. Functional and esthetic outcomes were assessed for n = 20 pre-molars and n = 20 anterior teeth via comparison of radiographic and digital images applying the novel Functional Implant Prosthodontic Score (FIPS). Krippendorff’s alpha coefficient was calculated to assess inter-rater reliability. Mann-Whitney-U-Test was used to compare the assessed parameters. Level of significance was set to p

In cases of severely compromised teeth, dental practitioners are confronted with the therapeutic decision of whether to restore a tooth or replace it with an implant. Comparative scientific evidence on patient perception of both treatment approaches is scarce. The subject of this prospective clinical study was to compare oral health-related quality of life (OHRQoL) between two treatment groups: restoration of severely destroyed teeth after orthodontic extrusion (FOE) versus tooth extraction and implant-supported single crown restoration (ISC). A self-selected trial was performed with 21 patients per group. OHRQoL was assessed with the aid of the Oral Health Impact Profile (OHIP-G49) at different time intervals: before treatment (T1), after treatment (T2), after restoration (T3) and at recall (T4). Overall, OHIP scores improved from baseline to follow-up for both concepts with no significant differences between groups. There were no significant differences in subscales between FOE and ISC at T1, T3 and T4. In terms of functional limitations (p = 0.003) and physical disability (p = 0.021), patients in the FOE group temporarily exhibited lower OHRQoL at T2 in comparison to the ISC group. However, at baseline, after final restoration and at recall, the study demonstrates the same level of OHRQoL for both treatment concepts.

In cases of severely compromised teeth, dental practitioners are confronted with the therapeutic decision of whether to restore a tooth or replace it with an implant. Comparative scientific evidence on patient perception of both treatment approaches is scarce. The subject of this prospective clinical study was to compare oral health-related quality of life (OHRQoL) between two treatment groups: restoration of severely destroyed teeth after orthodontic extrusion (FOE) versus tooth extraction and implant-supported single crown restoration (ISC). A self-selected trial was performed with 21 patients per group. OHRQoL was assessed with the aid of the Oral Health Impact Profile (OHIP-G49) at different time intervals: before treatment (T1), after treatment (T2), after restoration (T3) and at recall (T4). Overall, OHIP scores improved from baseline to follow-up for both concepts with no significant differences between groups. There were no significant differences in subscales between FOE and ISC at T1, T3 and T4. In terms of functional limitations (p = 0.003) and physical disability (p = 0.021), patients in the FOE group temporarily exhibited lower OHRQoL at T2 in comparison to the ISC group. However, at baseline, after final restoration and at recall, the study demonstrates the same level of OHRQoL for both treatment concepts.

ObjectivesTo evaluate long-term survival and success rates of conventionally cemented partial-coverage crowns (PCCs) manufactured from high noble metal alloys (hn).Material and methodsRestoration-, periodontal- and tooth-related criteria on patients, restored with a single or multiple conventionally cemented hnPCCs in a private dental office were collected from existing patient records. With regard to semi-annual follow-ups, data of the most recent clinical evaluations were considered. Kaplan–Meier and log-rank tests were used for statistical analyses. Level of significance was set at p ≤ .05.ResultsBetween 09/1983 and 09/2009, 1325 hnPCCs were conventionally cemented on 1325 teeth in 266 patients (mean age: 44.5 ± 10.7 years). Due to various reasons, 81 hnPCCs showed complications, documenting a success rate of 93.9% after a mean observation period of 18.8 ± 5.7 years. Of these, additional 14 restorations were counted as survival, resulting in a survival rate of 94.9%. Most frequent complications were periodontal issues (n = 29, 35.8%). Significantly higher success rates were documented for hnPCCs of patients aged between 37 and 51 years (p = .012).ConclusionPartial-coverage crowns from high noble metal alloys showed excellent survival and success rates after a mean observation period of 18.8 ± 5.7 years. Higher patient age was one of the risk factors.Clinical RelevanceAccording to the results of this study, hnPCCs still represent an excellent therapeutic option—even in modern dentistry.

The objective was to investigate clinical and radiological outcomes of rehabilitations with root-analogue implants (RAIs). Patients restored with RAIs, supporting single crowns or fixed dental prostheses, were recruited for follow-up examinations. Besides clinical and esthetical evaluations, X-rays were taken and compared with the records. Patients were asked to evaluate the treatment using Visual Analogue Scales (VAS). For statistical analyses, mixed linear models were used. A total of 107 RAIs were installed in one dental office. Of these, 31 were available for follow-up examinations. For those remaining, survival has been verified via phone. RAIs were loaded after a mean healing time of 6.6 &plusmn, 2.5 months. 12.1 &plusmn, 6.9 months after loading, a mean marginal bone loss (MBL) of 1.20 &plusmn, 0.73 mm was measured. Progression of MBL significantly decreased after loading (p = 0.013). The mean pink and white esthetic score (PES/WES) was 15.35 &plusmn, 2.33 at follow-up. A survival rate of 94.4% was calculated after a mean follow-up of 18.9 &plusmn, 2.4 months after surgery. Immediate installation of RAIs does not seem to reduce MBL, as known from the literature regarding screw-type implants, and might not be recommended for daily routine. Nevertheless, they deliver esthetically satisfying results.