Cost-effectiveness of endodontic molar retreatment compared with fixed partial dentures and single-tooth implant alternatives.

By Kim SG, Solomon C.

Date: 08/2011
Journal: JOE

Summary: 

Purpose: to evaluate the cost-effectiveness of a failed root canal treatment case. Four different treatment modalities were explored: nonsurgical retreatment with restoration, endodontic microsurgery, extraction with fixed partial denture, and extraction with single implant–supported restoration.

•Materials/Methods:

Treatment Strategy: All retreated cases were followed by full-coverage restorations and only modern endodontic surgeries were included.

Cost: The costs of the different treatment modalities were calculated using the national fee averages from 2009 survey of dental fees conducted by the ADA

Outcome: Systematic reviews with a meta-analysis were used in order to obtain the highest level of evidence in respect to the outcome of individual treatments. Survival & success rate.

Cost-effectiveness Analysis: The cost-effectiveness was determined as the ratio of the survival probability of each individual treatment modality divided by the fee for that individual treatment.

Most highlighted Results: 

1.NS re-RCT success rate was 77% or 78%, survival was 87% over 8 to 10 years. Microsurgery, success rate was calculated to be 94%. FPD success probabilities were 71%, Survival probability was 89% . The survival rate of single implant–supported crowns was 94.5%, whereas the overall implant survival rate was 96.8%.

2.The cost-effectiveness ratio of individual treatment modalities was calculated as in table 1.

Clinical significance 

Endodontic microsurgery was the most cost-effective among all the treatment options. A single implant–supported restoration, despite its high survival rate, was the least cost-effective treatment option based on current fees.