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Cost-effectiveness of Different Post-retained Restorations.

Falk Schwendicke¹, Michael Stolpe²

¹Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Journal of Endodontics

|March 28, 2017

Summary

Preformed metal posts are the most cost-effective for dental restorations when no additional investment is desired. Glass fiber posts offer longer tooth retention for a slightly higher cost, making them a viable option for those willing to pay more.

Keywords:

Computer modelling Markov model dental care fiber posts health economics prosthetics

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Area of Science:

Dental materials science
Health economics
Prosthodontics

Background:

Dentists select between metal and fiber post systems for post-retained restorations.
Different post systems present varying risks of tooth loss and complications, alongside differing initial treatment costs.

Purpose of the Study:

To evaluate the cost-effectiveness of four post-retained restoration systems: cast metal (MC), preformed metal (MP), glass fiber (GF), and carbon fiber (CF).

Main Methods:

A mixed public-private payer perspective within the German healthcare system was adopted.
Systematic reviews provided data on complication risks; costs were based on 2016 fee items and material expenses.
A Markov model with Monte Carlo microsimulations assessed lifetime costs and tooth retention for a 50-year-old patient.

Main Results:

Preformed metal posts (MP) were least expensive (€692), retaining teeth for 26.7 years.
Glass fiber posts (GF) cost more (€745) but retained teeth longer (27.6 years).
Cast metal (MC) and carbon fiber (CF) posts were less cost-effective, with CF being the most expensive and least effective.

Conclusions:

MP is most suitable for payers prioritizing cost-effectiveness without additional investment.
GF posts are recommended for payers willing to invest more for longer tooth retention.
MC posts are cost-effective only at very high willingness to pay; CF posts are not recommended.