Cost-effectiveness of the Hall Technique in a Randomized Trial

Area of Science:

• Pediatric Dentistry
• Dental Public Health
• Health Economics

Background:

• Carious primary molars require effective and cost-efficient treatment strategies.
• The Hall technique (HT) and conventional restoration (CR) are established methods for managing dental caries in primary teeth.
• Previous studies have reported clinical outcomes, but a comprehensive cost-effectiveness analysis is needed.

Purpose of the Study:

• To compare the cost-effectiveness of the Hall technique (HT) versus conventional restoration (CR) for carious primary molars.
• To analyze direct dental treatment costs and indirect/opportunity costs from a societal perspective.
• To evaluate tooth survival and secondary outcomes such as pain and need for retreatment.

Main Methods:

• A 5-year randomized controlled practice-based trial in Scotland involving 132 children (264 primary molars).
• Teeth were allocated to either HT or CR, provided by general dental practitioners.
• Economic analysis included direct costs (NHS perspective) and indirect costs (UK perspective), with bootstrapped sampling for cost-effectiveness estimation.

Main Results:

• Significantly higher tooth survival rates for HT (99%) compared to CR (92%).
• HT group had a significantly higher proportion of molars retained without pain or requiring endodontic treatment/extraction.
• Total cumulative costs were significantly lower for HT (GBP 32) than CR (GBP 49) from a societal perspective.

Conclusions:

• The Hall technique is more cost-effective than conventional restorations for managing carious primary molars.
• HT demonstrates superior long-term tooth survival and fewer complications.
• Lower direct and indirect costs associated with HT support its favorable economic profile.