Background: The cost-effectiveness of immediate versus conventional loading of two-implant overdentures (2-IODs) remains unclear. This exploratory randomized clinical trial compared the economic and clinical outcomes of these protocols over 24 months. Methods: Seventeen edentulous patients were randomly assigned to conventional (CL, n = 7) or immediate loading (IL, n = 10). Outcomes included longitudinal changes (Δ) in Oral Health-Related Quality of Life (OHIP-EDENT-J), Patient Denture Assessment (PDA), and satisfaction. Costs were analyzed from a healthcare provider perspective. Between-group comparisons of Δ scores were performed using Mann–Whitney U tests to adjust for baseline imbalances. Results: Both protocols showed trends toward clinical improvement. However, between-group analysis of longitudinal change scores (Δ) revealed no statistically significant differences (p > 0.05). The immediate loading protocol incurred 44.7% higher direct costs without demonstrating statistically superior patient-reported benefits. Individual-level analysis via a cost-effectiveness plane showed high variability and significant overlap between groups. Conclusions: Within the limitations of this exploratory pilot study, no statistically significant differences in clinical outcomes were found between loading protocols. Descriptively, conventionally loaded 2-IODs were associated with lower resource intensity and a more stable clinical trajectory in this cohort. These preliminary findings suggest that immediate loading may not offer a clear economic advantage, though larger multicenter trials are required for a definitive assessment.
Namano et al. (Sun,) studied this question.
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