Cost-effectiveness analysis: nonsurgical root canal treatment versus single-tooth implant.
Cost-effectiveness
Nonsurgical root canal treatment
Propensity score matching
Single-tooth implant
Journal
BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684
Informations de publication
Date de publication:
15 07 2023
15 07 2023
Historique:
received:
07
02
2023
accepted:
24
06
2023
medline:
17
7
2023
pubmed:
16
7
2023
entrez:
15
7
2023
Statut:
epublish
Résumé
Economic evaluation of nonsurgical root canal treatment (NSRCT) and single-tooth implant (STI) provides useful information for medical decision. This retrospective study aimed to evaluate the cost-effectiveness of NSRCT versus single-tooth implant (STI) after 5-year treatment in a university affiliated hospital in Beijing, China. 211 patients who underwent NSRCT and 142 patients who had STI were included and recalled after 5-year treatment. The propensity scores were used to match the cases of two treatment modalities. At recall, outcomes were determined based on clinical and radiographical examinations. For endodontically treated cases, absence or reduction of radiolucency were defined as success. Marginal bone loss (MBL) ≤ 4 mm were determined as success for implant cases. Direct and indirect costs were calculated in China Yuan (CNY). Patients' willingness to pay (WTP) for each treatment modality was evaluated by questionnaires. A cost-effectiveness analysis was performed from the societal perspective. 170 patients with 120 NSRCT teeth and 96 STI were available at recall. Based on propensity score matching, 76 endodontically treated teeth were matched to 76 implants. Absence of the radiolucency was observed in 58 of 76 endodontically treated teeth (76%) and reduction of the radiolucency in 9 of 76 teeth (12%) and altogether the success rate was 88%. 100% implants were detected with marginal bone loss (MBL) ≤ 4 mm. The cost advantage of NSRCT (4,751 CNY) over STI (20,298 CNY) was more pronounced. Incremental cost effectiveness ratio (ICER) was 129,563 CNY (STI-NSRCT) per success rate gained. It exceeded the patients' willingness to pay value 7,533 CNY. Clinical outcomes of NSRCT and STI could be predictable after 5-year treatment. NSRCT may be more cost-effective than STI for managing endodontically diseased teeth.
Sections du résumé
BACKGROUND
Economic evaluation of nonsurgical root canal treatment (NSRCT) and single-tooth implant (STI) provides useful information for medical decision. This retrospective study aimed to evaluate the cost-effectiveness of NSRCT versus single-tooth implant (STI) after 5-year treatment in a university affiliated hospital in Beijing, China.
METHODS
211 patients who underwent NSRCT and 142 patients who had STI were included and recalled after 5-year treatment. The propensity scores were used to match the cases of two treatment modalities. At recall, outcomes were determined based on clinical and radiographical examinations. For endodontically treated cases, absence or reduction of radiolucency were defined as success. Marginal bone loss (MBL) ≤ 4 mm were determined as success for implant cases. Direct and indirect costs were calculated in China Yuan (CNY). Patients' willingness to pay (WTP) for each treatment modality was evaluated by questionnaires. A cost-effectiveness analysis was performed from the societal perspective.
RESULTS
170 patients with 120 NSRCT teeth and 96 STI were available at recall. Based on propensity score matching, 76 endodontically treated teeth were matched to 76 implants. Absence of the radiolucency was observed in 58 of 76 endodontically treated teeth (76%) and reduction of the radiolucency in 9 of 76 teeth (12%) and altogether the success rate was 88%. 100% implants were detected with marginal bone loss (MBL) ≤ 4 mm. The cost advantage of NSRCT (4,751 CNY) over STI (20,298 CNY) was more pronounced. Incremental cost effectiveness ratio (ICER) was 129,563 CNY (STI-NSRCT) per success rate gained. It exceeded the patients' willingness to pay value 7,533 CNY.
CONCLUSIONS
Clinical outcomes of NSRCT and STI could be predictable after 5-year treatment. NSRCT may be more cost-effective than STI for managing endodontically diseased teeth.
Identifiants
pubmed: 37454076
doi: 10.1186/s12903-023-03173-x
pii: 10.1186/s12903-023-03173-x
pmc: PMC10349452
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
489Informations de copyright
© 2023. The Author(s).
Références
BMC Med Res Methodol. 2003 Dec 22;3:28
pubmed: 14690550
J Dent. 2018 Apr;71:61-66
pubmed: 29499242
Dent Clin North Am. 2006 Jul;50(3):451-61, viii
pubmed: 16818026
J Endod. 2013 Oct;39(10):1226-33
pubmed: 24041382
J Endod. 2008 May;34(5):519-29
pubmed: 18436028
J Esthet Restor Dent. 2005;17(3):139-40
pubmed: 15996381
Clin Oral Implants Res. 2016 Oct;27(10):1207-1211
pubmed: 26577573
J Endod. 2013 Dec;39(12):1534-41
pubmed: 24238442
J Endod. 2008 Nov;34(11):1302-1305
pubmed: 18928836
J Endod. 2006 Sep;32(9):822-7
pubmed: 16934623
J Endod. 2002 Dec;28(12):819-27
pubmed: 12489651
Periodontol 2000. 2002;30:111-22
pubmed: 12236901
J Orthod. 2001 Sep;28(3):246-50
pubmed: 11504904
Aust Endod J. 2006 Aug;32(2):57-63
pubmed: 16869944
Implant Dent. 2008 Mar;17(1):5-15
pubmed: 18332753
Int Endod J. 2007 Dec;40(12):921-39
pubmed: 17931389
Int Endod J. 2012 Aug;45(8):711-23
pubmed: 22775142
Scand J Plast Reconstr Surg. 1969;3(2):81-100
pubmed: 4924041
Int Endod J. 2009 Oct;42(10):874-83
pubmed: 19751289
Dent Update. 2010 Nov;37(9):579-82, 585-6, 589-90 passim
pubmed: 21179928
J Endod. 2015 Apr;41(4):470-2
pubmed: 25649305
J Am Dent Assoc. 2006 Jul;137(7):973-7; quiz 1027-8
pubmed: 16803823
J Endod. 2019 Feb;45(2):99-103
pubmed: 30711185
J Endod. 2008 May;34(5):557-62
pubmed: 18436034
J Esthet Restor Dent. 2005;17(4):197-9
pubmed: 16231489
Clin Oral Implants Res. 2015 Sep;26 Suppl 11:57-63
pubmed: 26077930