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A randomized controlled trial on immediate surgery versus root planing in patients with advanced periodontal disease: a cost-effectiveness analysis

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Abstract
AIM: To compare immediate surgery to scaling and root planing (SRP) in the treatment of advanced periodontal disease focusing on the prevalence of residual sites and cost-effectiveness (1); to evaluate the adjunctive effects of azithromycin in a second treatment phase (2). MATERIALS AND METHODS: Thirty-nine patients (18 males, 21 females; mean age: 54.6) received oral hygiene instructions and were randomly allocated to surgery (n=19) or SRP (n=20). Patients with residual pockets (≥6 mm) at 6 months received re-debridement of these sites and systemic azithromycin. Treatment groups were followed up to 12 months and evaluated in terms of clinical response parameters and cost-effectiveness. Chair-time was used to assess the financial impact of treatment. RESULTS: Both treatment arms were equally effective in terms of clinical outcome demonstrating less than 1% residual pockets at 12 months. Surgery imposed an extra 746 Euro on the patient up to 6 months when compared to SRP. At 12 months, 46 Euro of this amount could be offset as a result of a reduced need for supportive care. Only 6 patients in the surgery group needed systemic antibiotics, whereas 14 patients in the SRP needed such additional treatment. CONCLUSIONS: Although 700 Euro could be saved on average by performing SRP instead of surgery, the latter significantly reduced the need for supportive care and systemic antibiotics.
Keywords
cost effectiveness, azithromycin, periodontitis, randomized controlled trial, scaling and root planing, surgery, PROBING ATTACHMENT LOSS, NONSURGICAL TREATMENT, AZITHROMYCIN, THERAPY, ADJUNCT, MAINTENANCE, CARE

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Chicago
Miremadi, Seyed Reza, Hugo De Bruyn, HAROLD STEYAERT, KATRIJN PRINCEN, Mehran Moradi Sabzevar, and Jan Cosyn. 2014. “A Randomized Controlled Trial on Immediate Surgery Versus Root Planing in Patients with Advanced Periodontal Disease: a Cost-effectiveness Analysis.” Journal of Clinical Periodontology 41 (2): 164–171.
APA
Miremadi, S. R., De Bruyn, H., STEYAERT, H., PRINCEN, K., Sabzevar, M. M., & Cosyn, J. (2014). A randomized controlled trial on immediate surgery versus root planing in patients with advanced periodontal disease: a cost-effectiveness analysis. JOURNAL OF CLINICAL PERIODONTOLOGY, 41(2), 164–171.
Vancouver
1.
Miremadi SR, De Bruyn H, STEYAERT H, PRINCEN K, Sabzevar MM, Cosyn J. A randomized controlled trial on immediate surgery versus root planing in patients with advanced periodontal disease: a cost-effectiveness analysis. JOURNAL OF CLINICAL PERIODONTOLOGY. 2014;41(2):164–71.
MLA
Miremadi, Seyed Reza, Hugo De Bruyn, HAROLD STEYAERT, et al. “A Randomized Controlled Trial on Immediate Surgery Versus Root Planing in Patients with Advanced Periodontal Disease: a Cost-effectiveness Analysis.” JOURNAL OF CLINICAL PERIODONTOLOGY 41.2 (2014): 164–171. Print.
@article{4189458,
  abstract     = {AIM: To compare immediate surgery to scaling and root planing (SRP) in the treatment of advanced periodontal disease focusing on the prevalence of residual sites and cost-effectiveness (1); to evaluate the adjunctive effects of azithromycin in a second treatment phase (2).
MATERIALS AND METHODS: Thirty-nine patients (18 males, 21 females; mean age: 54.6) received oral hygiene instructions and were randomly allocated to surgery (n=19) or SRP (n=20). Patients with residual pockets (\ensuremath{\geq}6 mm) at 6 months received re-debridement of these sites and systemic azithromycin. Treatment groups were followed up to 12 months and evaluated in terms of clinical response parameters and cost-effectiveness. Chair-time was used to assess the financial impact of treatment.
RESULTS: Both treatment arms were equally effective in terms of clinical outcome demonstrating less than 1\% residual pockets at 12 months. Surgery imposed an extra 746 Euro on the patient up to 6 months when compared to SRP. At 12 months, 46 Euro of this amount could be offset as a result of a reduced need for supportive care. Only 6 patients in the surgery group needed systemic antibiotics, whereas 14 patients in the SRP needed such additional treatment.
CONCLUSIONS: Although 700 Euro could be saved on average by performing SRP instead of surgery, the latter significantly reduced the need for supportive care and systemic antibiotics.},
  author       = {Miremadi, Seyed Reza and De Bruyn, Hugo and STEYAERT, HAROLD and PRINCEN, KATRIJN and Sabzevar, Mehran Moradi and Cosyn, Jan},
  issn         = {0303-6979},
  journal      = {JOURNAL OF CLINICAL PERIODONTOLOGY},
  keyword      = {cost effectiveness,azithromycin,periodontitis,randomized controlled trial,scaling and root planing,surgery,PROBING ATTACHMENT LOSS,NONSURGICAL TREATMENT,AZITHROMYCIN,THERAPY,ADJUNCT,MAINTENANCE,CARE},
  language     = {eng},
  number       = {2},
  pages        = {164--171},
  title        = {A randomized controlled trial on immediate surgery versus root planing in patients with advanced periodontal disease: a cost-effectiveness analysis},
  url          = {http://dx.doi.org/10.1111/jcpe.12201},
  volume       = {41},
  year         = {2014},
}

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