scholarly journals Bone Augmentation in Extrusive Teeth Repositioned Using Bone Grafts

2021 ◽  
Vol 16 (Supp. 1) ◽  
pp. 83-90
Author(s):  
Charissa Roderica Hoediono ◽  
Ghita Hadi Hollanda

Extrusive luxation is a traumatic dental injury (TDI) due to the action of forces, especially in the oblique angle. Partial displacement of the tooth is one of its characteristics. Repositioning is the treatment of choice for this type of trauma. The mechanism of bone augmentation and splint in managing the post extrusive luxation teeth reposition was explored and reported. An 18-year-old male with a history of traffic accident which caused extrusive luxation of 11 and 21 with no alveolar bone fracture. The patient was managed by repositioning the teeth and applicating arch-bar on anterior maxillary teeth. After eight weeks of evaluation, periapical radiograph showed the distal bone of 21 had radiolucent appearance followed by Class 1 mobility. The arch-bar was removed, and the periosteal flap was made on the buccal side of 21 and the distal part was curetted then irrigated with 0.9% sodium chloride, then supplemented with bone graft material and pericardium membrane. Lastly, the flap was returned, the tooth was then stabilised using self-curing adhesive resin cement (Super-Bond). The tooth was kept under observation for two months. It was observed that the tooth was asymptomatic and still in function with no radiographic signs of pathosis. These results suggested that tooth reposition might be an alternative to prosthetic or implant dentistry. However, further human research is recommended with long standing follow-up periods and comparative studies to be carried out to identify whether dental implant replacement or reposition is the cost-effective treatment for extruded tooth.

Cephalalgia ◽  
2006 ◽  
Vol 26 (12) ◽  
pp. 1473-1482 ◽  
Author(s):  
JS Brown ◽  
G Papadopoulos ◽  
PJ Neumann ◽  
M Price ◽  
M Friedman ◽  
...  

The aim of this study was to assess the cost-effectiveness of topiramate vs. no preventive treatment in the UK. Model inputs included baseline migraine frequency, treatment discontinuation and response, preventive and acute medical cost per attack [2005 GBP (£)] and gain in health utility. Outcomes included monthly migraines averted, acute and preventive treatment costs and cost per quality-adjusted life year (QALY). Topiramate was associated with 1.8 fewer monthly migraines and a QALY gain of 0.0384. The incremental cost of topiramate vs. no preventive treatment was about £10 per migraine averted and £5700 per QALY. Results are sensitive to baseline monthly migraine frequency, triptan use rate and the gain in utility. Incorporating savings from reduced work loss (about £36 per month) suggests that topiramate would be cost saving compared with no preventive treatment. This analysis suggests that topiramate is a cost-effective treatment for migraine prevention compared with no preventive treatment.


Author(s):  
Vineetha Venugopalan ◽  
Anegundi Raghavendra Vamsi ◽  
Santhosh Shenoy ◽  
Karishma Ashok ◽  
Biju Thomas

Successful implant treatment requires prosthetically driven placement of an implant, primary stability at placement, and careful living bone management. The resorptive changes of alveolar bone are an inevitable process following tooth loss, periodontal disease or trauma which causes bone defects. This results in various aesthetic and functional complications such as soft tissue recession, infection and inflammation. Various methods have been tried and advocated for augmenting these bone deficiencies. Guided Bone Regeneration (GBR) is a successful modality for bone augmentation with a wide range of indications and helps restore the alveolar ridge dimensions. It utilises the principle of Guided Tissue Regeneration (GTR) for space maintenance within a bony defect. Different types of barrier membranes are being utilised along with various bone grafts in GBR. Thorough knowledge regarding the biology of bone is required before the initiation of any bone augmentation procedure. A combination of Collagen Membrane (CM) and graft material was found successful for GBR. Hence, this review focuses on presentation of best available evidence for various aspects of GBR.


PHARMACON ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 968
Author(s):  
Monica D. Lestari ◽  
Gayatri Citraningtyas ◽  
Hosea Jaya Edi

ABSTRACTPneumonia is an infectious disease in the lower respiratory tract that affects the lung tissue. Ceftriaxone and Gentamicin antibiotics are the most numerous and good for use in the treatment of pneumonia, but of the two antibiotics is not yet known the options for more cost effective treatment, so it needs to be done the cost effectiveness analysis in order to facilitate the selection of more cost-effective treatment options especially in toddler. This study aims to determine which therapies are more cost-effective than the use of antibiotics Ceftriaxone and Gentamicin in pneumonia patients in the January-December 2018 period in the Bhayangkara Manado Hospital using descriptive research methods with retrospective data collection. The sample in this study were 22 patients, 12 patients using ceftriaxone antibiotics and 10 patients using gentamicin antibiotics. The results showed that pneumonia treatment in infants using Ceftriaxone antibiotics was more cost-effective with ACER ceftriaxone value of Rp. 503,872 / day and ICER value of Rp. 145,588 / day. Keywords : Antibiotics, CEA (Cost-Effectiveness Analysis), Pharmacoeconomy, Toddler Pneumonia. ABSTRAKPneumonia merupakan penyakit infeksi pada saluran pernapasan bagian bawah yang mengenai jaringan paru. Antibiotik Seftriakson dan Gentamisim yang paling banyak dan baik untuk digunakan dalam pengobatan pneumonia, namun dari kedua antibiotik tersebut belum diketahui pilihan terapi yang lebih cost-effective, sehingga perlu dilakukan analisis efektivitas biaya agar dapat mempermudah dalam pemilihan alternatif pengobatan yang lebih cost-effective khususnya pada balita. Penelitian ini bertujuan untuk menentukan terapi yang lebih cost-effective dari penggunaan antibiotik Seftriakson dan Gentamisin pada pasien pneumonia rawat inap periode Januari-Desember 2018 di Rumah Sakit Bhayangkara Manado dengan menggunakan metode penelitian deskriptif dengan pengambilan data secara retrospektif. Sampel pada penelitian ini sebanyak 22 pasien yaitu 12 pasien menggunakan antibiotik Seftriakson dan 10 pasien menggunakan antibiotik Gentamisin. Hasil penelitian menunjukkan pengobatan pneumonia pada balita menggunakan antibiotik Seftriakson lebih cost-effective dengan nilai ACER seftriakson sebesar Rp. 503,872/hari dan nilai ICER sebesar Rp. 145.588/hari. Kata Kunci : Pneumonia Balita, Antibiotik, CEA (Cost-Effectiveness Analysis), Farmakoekonomi


Author(s):  
Amir Hashemi-Meshkini ◽  
Hedieh Sadat Zekri ◽  
Hasan Karimi-Yazdi ◽  
Pardis Zaboli ◽  
Mohammad Ali Sahraian ◽  
...  

Background: Pegylated (PEG) interferon beta 1a has been approved by the United States Food and Drug Administration (USFDA) as an alternative to interferon beta 1a for multiple sclerosis (MS). Due to its higher price, this study aimed to evaluate the cost-effectiveness of PEG-interferon beta 1-a compared with interferon beta 1a from an Iranian payer perspective. Methods: A Markov model was designed according to health states based on Expanded Disability Status Scale (EDSS) and one-month cycles over a 10-year time horizon. Direct medical and non-medical costs were included from a payer perspective. Results: The incremental cost-effectiveness ratio (ICER) was estimated around 11111 US dollars (USD) per quality-adjusted life-year (QALY) gained for the PEG-interferon versus interferon regimen [with currency rate of 29,000 Iranian Rial (IRR) to 1 USD in 2016]. Conclusion: Considering the cost-effectiveness  threshold in Iran [three times of gross domestic product (GDP) per capita or 15,945 USD], PEG-interferon beta 1-a could be considered as a cost effective treatment for Iranian patients with MS.


2021 ◽  
Vol 30 (7) ◽  
pp. 544-552
Author(s):  
Julian F Guest ◽  
Karen Staines ◽  
Nina Murphy

Objective: To estimate whether thigh-administered intermittent pneumatic compression (IPC) could potentially afford the UK's National Health Service (NHS) a cost-effective intervention for the management of hard-to-heal venous leg ulcers (VLUs). Method: A Markov model was constructed depicting the management of hard-to-heal VLUs with IPC plus standard care or standard care alone over a period of 24 weeks. The model estimated the cost-effectiveness of the two interventions in terms of the incremental cost per quality-adjusted life year (QALY) gained at 2019/20 prices. Results: Treatment of hard-to-heal VLUs with IPC plus standard care instead of standard care alone is expected to increase the probability of healing by 58% (from 0.24 to 0.38) at 24 weeks and increase health-related quality of life over 24 weeks from 0.32 to 0.34 QALYs per patient. Additionally, the cost of treating with IPC plus standard care (£3,020 per patient) instead of standard care alone (£3,037 per patient) has the potential to be cost-neutral if use of this device is stopped after 6 weeks in non-improving wounds. Sensitivity analysis showed that the relative cost-effectiveness of IPC plus standard care remains <£20,000 per QALY with plausible variations in costs and effectiveness. Conclusion: Within the limitations of this study, the addition of IPC to standard care potentially affords a cost-effective treatment to the NHS for managing hard-to-heal VLUs. However, a controlled study is required to validate the outcomes of this analysis.


1987 ◽  
Vol 3 (4) ◽  
pp. 575-586 ◽  
Author(s):  
Akira Sasaki ◽  
John M. Eisenberg

AbstractWe analyzed the cost-effectiveness of nonemergent treatment for esophageal varices commonly used in Japan (endoscopic injection sclerotherapy, nonshunting direct interruption procedure, and selective shunt). We assessed the cost per survivor from the perspective of the Japanese government and other payors. Epidemiologic and economic data from published Japanese literature and from Japanese hospital-cost information were applied in decision analysis. While sclerotherapy is the most cost-effective treatment, the popular surgical procedures save the most lives, thus raising difficult ethical issues regarding trade-offs of cost and quality.


2019 ◽  
Vol 8 (13) ◽  
pp. 1125-1141
Author(s):  
Soyoung Kim ◽  
Adrian Yit Reen Ooi ◽  
Thomas Stephens ◽  
Hongsi Jiang

Aim: Therapy for lupus nephritis (LN) requires treatment with immunosuppressive regimens, often including intravenous cyclophosphamide (IVCY), mycophenolate mofetil (MMF) or azathioprine. Additionally, tacrolimus (original form or generic) is recommended to treat LN patients in Asia, including China. However, the cost–effectiveness of tacrolimus therapy has not previously been assessed. We aimed to estimate the cost–effectiveness of tacrolimus in the treatment of moderate-to-severe LN versus standard therapies in China. Materials & methods: This cost–effectiveness model combined a decision-tree/Markov-model structure to map transitions between health states during induction and maintenance treatment phases. Induction with tacrolimus, IVCY or MMF, was followed by tacrolimus, MMF or azathioprine maintenance. Results: According to the model, during induction, complete remission rates were higher with tacrolimus versus IVCY (relative risk 1.40 vs IVCY [deterministic sensitivity analysis minimum 0.92, maximum 2.13]) and time to response was shorter. Relapse rates were lower with tacrolimus versus azathioprine or MMF during maintenance. Tacrolimus induction and maintenance was the most cost-effective regimen, incurring the lowest total costs (CN¥180,448) with the highest quality-adjusted life-years. Conclusion: The model demonstrated that tacrolimus use in both induction and maintenance therapy may be an efficacious and cost-effective treatment for LN in China.


2015 ◽  
Vol 45 (14) ◽  
pp. 3019-3031 ◽  
Author(s):  
L. Koeser ◽  
V. Donisi ◽  
D. P. Goldberg ◽  
P. McCrone

Background.The National Institute of Health and Care Excellence (NICE) in England and Wales recommends the combination of pharmacotherapy and psychotherapy for the treatment of moderate to severe depression. However, the cost-effectiveness analysis on which these recommendations are based has not included psychotherapy as monotherapy as a potential option. For this reason, we aimed to update, augment and refine the existing economic evaluation.Method.We constructed a decision analytic model with a 27-month time horizon. We compared pharmacotherapy with cognitive–behavioural therapy (CBT) and combination treatment for moderate to severe depression in secondary care from a healthcare service perspective. We reviewed the literature to identify relevant evidence and, where possible, synthesized evidence from clinical trials in a meta-analysis to inform model parameters.Results.The model suggested that CBT as monotherapy was most likely to be the most cost-effective treatment option above a threshold of £22 000 per quality-adjusted life year (QALY). It dominated combination treatment and had an incremental cost-effectiveness ratio of £20 039 per QALY compared with pharmacotherapy. There was significant decision uncertainty in the probabilistic and deterministic sensitivity analyses.Conclusions.Contrary to previous NICE guidance, the results indicated that even for those patients for whom pharmacotherapy is acceptable, CBT as monotherapy may be a cost-effective treatment option. However, this conclusion was based on a limited evidence base, particularly for combination treatment. In addition, this evidence cannot easily be transferred to a primary care setting.


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