Calcium Hydroxide versus Mineral Trioxide Aggregate for Direct Pulp Capping: A Cost-effectiveness Analysis.

Area of Science:

• Dental materials science
• Health economics
• Clinical dentistry

Background:

• Mineral trioxide aggregate (MTA) shows greater efficacy than calcium hydroxide (CH) for direct pulp capping (DPC).
• Cost-effectiveness of MTA versus CH for DPC requires evaluation.

Purpose of the Study:

• To assess the cost-effectiveness of MTA compared to CH for direct pulp capping (DPC).
• To model long-term outcomes and costs from a healthcare payer perspective.

Main Methods:

• A Markov model simulated lifetime tooth retention for a 20-year-old patient undergoing DPC with MTA or CH.
• Data on transition probabilities were systematically and nonsystematically collected.
• Costs were estimated via microcosting, dentist surveys, and market prices; sensitivity analyses addressed uncertainty.

Main Results:

• MTA resulted in longer tooth retention (52 years) and lower lifetime costs (€1368) compared to CH (49 years, €1527).
• MTA demonstrated a higher probability of cost-effectiveness across various willingness-to-pay thresholds.
• Results remained robust under probabilistic and univariate sensitivity analyses.

Conclusions:

• MTA is more cost-effective than CH for DPC due to reduced need for retreatment, offsetting higher initial expenses.
• The findings support the use of MTA for DPC from a healthcare payer perspective.
• Estimates are based on current evidence and the German healthcare setting.