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Replacement of amalgams with crowns: a cost-effectiveness analysis
G A Maryniuk1, S O Schweitzer, R J Braun
1Department of Fixed Prosthodontics, University of North Carolina, Chapel Hill 27599-7450.
Community Dentistry and Oral Epidemiology
|October 1, 1988
Summary
For a failed amalgam filling, replacing it with another amalgam is more cost-effective than a crown initially. This strategy can save patients 11-24% in lifetime dental costs.
Area of Science:
- Dental restorative materials
- Health economics
- Clinical decision-making
Background:
- No formal cost-effectiveness analyses exist comparing amalgam vs. crown replacement for failed dental fillings.
- Optimal treatment strategies based on lifetime patient costs are undetermined.
Purpose of the Study:
- To determine the optimum treatment strategy for replacing failed amalgam restorations based on lifetime costs.
- To compare the cost-effectiveness of replacing a failed amalgam with another amalgam versus a crown.
Main Methods:
- Decision analysis modeling was used to simulate lifetime restorative needs for an adult's posterior tooth.
- A cost-effectiveness analysis was performed comparing amalgam and crown replacement strategies.
Main Results:
- The optimal initial treatment decision is to replace a failed amalgam with another amalgam.
- Subsequent replacement, upon failure of the second amalgam, may then be a crown.
- Lifetime cost savings of 11% to 24% are possible with an initial amalgam replacement strategy.
Conclusions:
- Decision analysis is an effective tool for evaluating clinical decision-making in dentistry.
- The findings suggest a cost-saving strategy for managing failed amalgam restorations.
- This approach accounts for various levels of clinical uncertainty in dental treatment planning.