AbstractDesignA systematic appraisal without statistical aggregation.Data sourcesThe researchers utilized Ovid (Medline), Embase, Web of Science, and CINAHL databases. They performed a comprehensive literature search, which concluded in July 2023. References of selected studies and systematic reviews were examined for additional relevant articles.Study selectionThe review included studies (randomized controlled trials [RCTs], systematic reviews [SRs], narrative reviews, retrospective studies, cross-sectional studies, case series, case reports) discussing the cost-effectiveness of preserving teeth versus replacing them with implants in patients with severe periodontal disease.

摘要设计是一种没有统计汇总的系统评价。数据来源研究人员利用了Ovid（Medline），Embase，Web of Science和CINAHL数据库。他们进行了全面的文献检索，于2023年7月结束。审查了选定研究和系统评价的参考文献，以获取其他相关文章。研究选择该评价包括研究（随机对照试验（RCT），系统评价（SRs），叙述性评论，回顾性研究，横断面研究，病例系列，病例报告），讨论了保留牙齿与用植入物替代牙齿的成本效益。严重牙周病患者。

Non-English publications, letters, conference abstracts, and brief reports were excluded.Data extraction and synthesisTwo reviewers independently screened titles and abstracts using a systematic review screening tool, resolving conflicts with a third reviewer. The extracted data included study design, patient demographics, treatment details, economic models, costs, and clinical implications.

非英语出版物，信件，会议摘要和简要报告被排除在外。数据提取和综合两位审稿人使用系统评价筛选工具独立筛选标题和摘要，解决与第三位审稿人的冲突。提取的数据包括研究设计，患者人口统计学，治疗细节，经济模型，成本和临床意义。

Quality was assessed using Joanna Briggs Institute (JBI) critical appraisal tools, with scores converted to percentages.ResultsA total of 633 studies were identified for periodontal treatment, with 9 included after screening, while 114 studies were identified for dental implants, of which 3 were included after screening.

使用乔安娜·布里格斯研究所（JoannaBriggs Institute，JBI）的关键评估工具评估质量，并将分数转换为百分比。结果共鉴定出633项牙周治疗研究，其中9项在筛查后纳入，114项牙种植研究，其中3项在筛查后纳入。

The included studies were published between 2008 and 2018, predominantly from Germany, and mainly comprised retrospective designs, along with some prospective and model-based analyses. Follow-up periods ranged from 36 months to 33 years. Treatment costs were found to increase with disease severity, with surgical treatments being more expensive than nonsurgical ones, and supportive periodontal t.

。随访时间从36个月到33年不等。发现治疗费用随着疾病的严重程度而增加，手术治疗比非手术治疗更昂贵，并且支持牙周t。

A Commentary onNagpal D, Ibraimova L, Ohinmaa A, Levin L.The cost-effectiveness of tooth preservation vs implant placement in severe periodontal disease patients: a systematic review. Quintessence Int. 2024; https://doi.org/10.3290/j.qi.b4500025.GRADE Rating: CommentarySevere periodontitis affects approximately 11% of the global population, as indicated by the Global Burden of Disease Study 2017 and the European Federation of Periodontology (EFP)1.

关于Nagpal D，Ibraimova L，Ohinmaa A，Levin L的评论。严重牙周病患者牙齿保存与种植体植入的成本效益：系统评价。精粹国际2024；https://doi.org/10.3290/j.qi.b4500025.GRADE评级：评论严重牙周炎影响全球人口的约11%，如2017年全球疾病负担研究和欧洲牙周病联合会（EFP）1所示。

This condition leads to the loss of periodontal support, impairing chewing ability and negatively impacting oral health-related quality of life2. Treatment success centers on several factors including home care, dental hygiene, risk management, disease control, and supportive periodontal therapy (SPT)3.

这种情况导致牙周支持丧失，咀嚼能力受损，并对口腔健康相关的生活质量产生负面影响2。治疗成功的因素包括家庭护理，牙齿卫生，风险管理，疾病控制和支持性牙周治疗（SPT）3。

Despite its chronic nature, regular SPT is required to maintain long-term stability4. Modern dental implants are popular for replacing missing teeth, but accurate diagnosis and prognosis assessment are necessary before deciding on treatment5. Despite high survival rates, implants can fail, especially with peri-implant inflammations like mucositis and peri-implantitis6,7.

尽管其具有慢性性质，但需要定期进行SPT才能保持长期稳定4。现代牙科植入物在替代缺失的牙齿方面很受欢迎，但在决定治疗之前，必须进行准确的诊断和预后评估5。尽管存活率很高，但植入物可能会失败，特别是植入物周围炎症如粘膜炎和植入物周围炎6,7。

Levin and Halperin-Sternfeld found implant survival does not exceed that of properly maintained natural teeth8. Thus, economic evaluations are fundamental for deciding treatment strategies, considering costs and outcomes, making it an area requiring further investigation. The reviewed meta-analysis by Nagpal et al.9 aimed to determine the cost-effectiveness of periodontal treatment versus dental implants for periodontally compromised teeth, considering both clinical and economic aspects.The primary strength of this systematic review is its adherence to the PRISMA statement guidelines, providing a robust and transparent methodological framework.

Levin和Halperin-Sternfeld发现植入物的存活率不超过正确维持的天然牙齿8。因此，经济评估对于决定治疗策略，考虑成本和结果至关重要，因此需要进一步调查。Nagpal等[9]的荟萃分析旨在确定牙周治疗与牙周受损牙齿种植体的成本效益，同时考虑临床和经济方面。这项系统评价的主要优势在于它遵守了PRISMA声明指南，提供了一个强大而透明的方法框架。

The comprehensi.

综合。

Maintaining periodontally compromised teeth is generally more cost-effective than replacing them with dental implants, considering long-term maintenance costs.

考虑到长期维护成本，维护牙周受损的牙齿通常比用牙科植入物替代它们更具成本效益。

Dental implants, although effective, require strict maintenance and present potential complications that can increase overall treatment costs.

牙科植入物虽然有效，但需要严格维护，并存在可能增加整体治疗成本的潜在并发症。

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J Evid Based Dent Pract. 2024;24:101931.Download referencesFundingOpen access funding provided by University of Bern.Author informationAuthors and AffiliationsDepartment of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, SwitzerlandKelvin I. AfrashtehfarCollege of Dentistry, Ajman University, Ajman City, UAEKelvin I.

J基于Evid的Dent Pract。2024年；24:101931.下载参考文献基金开放获取资金由伯尔尼大学提供。。

AfrashtehfarDental Consultant, Private Practice, Abu Dhabi City, UAEKelvin I. Afrashtehfar & Khaled A. K. AlblooshiDepartment of Periodontology, Eastman Institute for Oral Health, Rochester, University of Rochester, Rochester, NY, USANasser M. AsseryDivision of Periodontology and Peri-implant Diseases, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandPatrick R.

Afrashtehfar牙科顾问，私人诊所，阿布扎比市，UAEKelvin I.Afrashtehfar＆Khaled A.K.AlblooshiDepartment of periodonology，Eastman Institute for Oral Health，Rochester，University of Rochester，Rochester，NY，USANasser M.AsseryDivision of Periodonology and Peri-implant Diseases，Clinic of Conservative Dentistry，Center of Dental Medicine，苏黎世大学，苏黎世，瑞士帕特里克R。

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Reprints and permissionsAbout this articleCite this articleAfrashtehfar, K.I., Assery, N.M., Alblooshi, K.A.K. et al. Maintaining periodontally compromised teeth seems more cost-effective than replacing them with dental implants.

转载和许可本文引用本文Afrashtehfar，K.I.，Assery，N.M.，Alblooshi，K.A.K.等人。维护牙周受损的牙齿似乎比用牙种植体替代它们更具成本效益。

Evid Based Dent (2024). https://doi.org/10.1038/s41432-024-01050-2Download citationReceived: 02 August 2024Accepted: 05 August 2024Published: 19 August 2024DOI: https://doi.org/10.1038/s41432-024-01050-2Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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