Dental Caries Clinical Trial
Official title:
Medico-economic Comparative Assessment of Conventional and CAD/CAM Dental Restorations; Impact on Hospital Dentistry Departments
Dental restorations (crowns, inlays or onlays) can be made conventionally or by CAD/CAM. The
current literature is weak and does not separate the medical results of these two techniques.
However, the efficiencies enabled by CAD/CAM could, for the price of an initial investment,
improve service to the patient by reducing the time required for these restorations, and
possibly lower care costs.
The aim of the study is to compare immediate medical results and short-term prosthetic
restorations made conventionally or by CAD/CAM in randomized patients, and evaluate economic
impacts and organizational aspects.
The medico-economic objective of this study is to assess an organizational innovation for
patients treated at the hospital for dental substance loss. The intervention study is the
availability of such information for the management of patients, not that of its systematic
use.
The economic evaluation of this innovation consists of several parts:
1. A costing study seeking to determine the costs of compensation for dental substance loss
by conventional technique and CAD/CAM per patient ;
2. Evaluate the cost from an hospital perspective to substitute CAD/CAM to conventional
dental treatment equipments;
3. To built a cost-effectiveness ratio comparing the conventional technique and the CAD/CAM
on the criterion of proportions of effective restorations obtained .
Assess the medical and medico-technical impact of prosthesis availability from CAD/CAM:
Modifications of treatment plans (some indications of plastic fillings could shift toward
CD/CAM restorations?) and/or their chronology (order of execution phases).
The patient cohort is cared for in a hospital Department of Dentistry for oral
rehabilitation.
There is indication of at least a partial or total dental crown restoration either by
conventional methods or by CAD/CAM (equipoise).
Directly assessable elements are:
at the individual restoration level: Effective restoration time between indication and
effective restoration, quality of the restoration, number of clinical sessions required,
unitary cost of the restoration at the patient level: compliance, overall duration of
treatment, duration of the restoration phase, number of clinical sessions (global and
restoration phase) , criteria of quality of life (OHIP, SF36), treatment costs (global and
restoration phase) at the hospital level: number of patients cared for per unit of time,
number of restorations, revenues, expenses
Patients seeking dental restorations in one of the study centers an needing at least one
fixed restoration feasible either by CAD/CAM or conventional means will be selected during
their first consultation (excluding emergency consultations). Quality of life (QOL) indices
are then recorded.
Two treatment plans are then created, one using conventional means and another using CAD/CAM
means as required ; those two plans may differ in steps order. The last treatment step where
these plans are identical is the randomization point.
The treatment plans are maintained during the pre-prosthetic phases of the treatment, and
updated in case of intercurrent events.
The patient is formally included at the randomization point, and the plan selected by the
randomization is carried out. The resource consumptions entailed by the prosthetic steps are
recorded.
At the end of treatment, patient satisfaction and QOL indices are recorded. An identical
record is made 6 months after the end of treatment.
Further long-term follow-up of the patients included in this study is planned, but will be
the object of another protocol.
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