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Cost-effectiveness of partial versus stepwise caries removal of deep caries lesions - a decision-analytic approach
Nikki Savolainen1, Thomas Kvist1, Johanna Mannila1
1Department of Endodontics, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Objective:
The aim was to compare the cost-effectiveness of partial caries removal (PCR) and stepwise caries removal (SW) in mature permanent teeth diagnosed with deep caries lesions, in a Swedish Public Dental Care organization.
Materials And Methods:
A decision tree model was used to calculate the cost-effectiveness for PCR and SW. Probability values were obtained through a literature search in PubMed and Scopus. Treatment times were estimated by a group of dentists practicing at public dental care clinics in Västra Götaland county, Sweden.
Results:
The expected costs for PCR and SW were 187,63 and 414,35 €, respectively, indicating that PCR was more cost-effective. Four articles were identified through the literature search. The p-values for PCR outcomes were 94% (success), 0% (pulp exposure) and 6% (pulpitis/apical periodontitis etc.). For SW, the p-values were 76% (success), 2% (pulp exposure during the first visit), 13% (pulp exposure during the second visit) and 9% (pulpitis/apical periodontitis etc.).
Conclusions:
Given the presumptions in this decision analysis, the PCR method used on mature permanent teeth is more cost-effective (p < ,05) compared to the SW method in protecting the pulp from exposure and avoiding the need for root canal treatment.
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