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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Detecting Proximal Secondary Caries Lesions: A Cost-effectiveness Analysis.

F Schwendicke1, F Brouwer2, S Paris2

  • 1Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany falk.schwendicke@charite.de.

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|November 18, 2015
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Summary

Combining specific detection methods for secondary caries lesions, like laser fluorescence with radiography, is most cost-effective for tooth retention. Using methods alone or at sensitive settings increases costs and reduces effectiveness.

Keywords:
Markov processdental cariesfluorescencehealth economicsprevalenceradiography

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Area of Science:

  • Dental diagnostics
  • Health economics

Background:

  • Choosing secondary caries detection methods involves balancing sensitivity for early treatment against specificity to prevent overtreatment.
  • Accurate diagnosis is crucial to avoid unnecessary invasive procedures and costs.

Purpose of the Study:

  • To assess the cost-effectiveness of different detection methods for proximal secondary caries.
  • To compare the lifetime cost and effectiveness (tooth retention) of tactile, radiographic, and laser fluorescence detection methods.

Main Methods:

  • Monte Carlo microsimulations modeled a vital permanent molar with a restoration over a lifetime.
  • Evaluated methods individually and in pairwise combinations at sensitive and specific thresholds.
  • Applied a mixed public-private payer perspective within the German healthcare system.

Main Results:

  • Radiographic detection verified by tactile assessment (specific thresholds) was least costly (€1,060) with 50 years of tooth retention.
  • Laser fluorescence verified by radiography (specific thresholds) was most effective (53 years retention) but more costly (€1,157).
  • Combining methods at specific thresholds was generally more effective and less costly than using single methods or sensitive thresholds.

Conclusions:

  • Combined detection methods, particularly at specific thresholds, are recommended for secondary caries to minimize false positives and overtreatment.
  • Future longitudinal studies should assess the predictive value of different diagnostic methods.