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Long-term cost-effectiveness of single indirect restorations in selected dental practices
1Macarthur Oral Health Services, South Western Sydney Area Health Service, 5 Thomas Rose Drive, Rosemeadow, NSW 2560, Australia. Philip.Kelly@swsahs.nsw.gov.au
Objective:
To determine the relative cost-effectiveness of alternative methods for restoring large tooth substance loss in adults.
Methods:
Long-term survival estimates and discounted costs for 245 large indirect restorations were used to calculate their incremental cost-effectiveness over 15 years when compared with direct placement Class II cusp-overlay amalgams and Class IV multisurface resin composites, placed in 100 patients from three private dental practices.
Results:
The direct placement restorations were more cost-effective than the indirect restorations at all time intervals over the 15-year study period. The full gold crown and the ceramometal crown were the most cost-effective indirect posterior and anterior restorations respectively. The cast gold onlay and the porcelain jacket crown were the least cost-effective indirect posterior and anterior restorations respectively.
Conclusions:
When clinically practicable, large direct placement restorations should be placed initially in preference to indirect restorations.
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