Cost analysis of endodontic treatment in primary teeth: results from a randomized clinical trial

Abstract

This study compared the cost of endodontic treatment in primary teeth involving a technique that does not require root canal instrumentation using antibiotic paste (CTZ) with that of the instrumented technique using iodoform paste (GP). This study is part of a randomized, controlled, parallel arm, noninferiority, 1:1 allocation, blinded (patient) multioperator study of 52 primary incisors of children aged 3 to 6 years with caries lesion and pulp involvement. Each technique was performed according to the creators' descriptions. The cost was assessed by analyzing the costs of capital, dental supplies, and professional labor according to the time taken to perform the procedure and the CHEERS guidelines were used to report the cost assessment. Endodontic treatment with CTZ had a 58.33% lower execution cost than GP (US$6.73 and US$16.15, respectively). The t-test showed significant differences between groups regarding treatment time and total cost (p < 0.0001). The CTZ technique seems to be more economically viable than GP for endodontic treatment of primary teeth, requiring a shorter treatment time and lower costs.

Economic analysis of the different endodontic instrumentation techniques used in the Unified Health System

“…Although there are studies available, so far few advances have been made with regard to the materials used since the main component of the files is stainless steel which, in spite of its elastic properties and resistance to fracture, has not proved to be totally suitable for conformation of the root canal system. The most obvious advantage, when the two procedures were compared, was the time savings, due to the possibility of working with rotary instrumentation at high rotations, more continuously and using fewer instruments [16][17][18].…”

Efficacy of the non-instrumentation endodontic treatment with CTZ paste in primary molars: Protocol of a multicenter randomized clinical trial with two years of follow-up

“…In addition, the CTZ paste promotes the reduction of pathogenic bacteria within the root canals, considering those accessory canals in inaccessible locations (Garrocho-Rangel, et al, 2021). Furthermore, it was previously reported (de Oliveira et al, 2021) that an endodontic treatment with the CTZ paste had a 58.33% lower execution cost than the conventional endodontic treatment using an iodoform paste (US$6.73 and US$16.15, respectively). This is an important aspect to be considered especially in the public health system.…”

Health economic evaluation of endodontic therapies

“…The included studies covered four main endodontic subdisciplines: (1) endodontic procedures in primary teeth (Oliveira et al 2021), (2) vital pulp therapy (Asgary et al 2014; Schwendicke & Stolpe 2014; Schwendicke et al 2015; Brodén et al 2019; Emara et al 2020), (3) primary root canal treatment (Balevi & Shepperd 2007; Pennington et al 2009; Schwendicke & Göstemeyer 2016) and (4) (non‐) surgical retreatment (Kim & Solomon 2011; Schwendicke & Stolpe 2015).…”

“…Different types of analyses were performed, with data stemming from two sources: Two studies performed cost‐of‐disease analyses nested within clinical trials (Asgary et al 2014; Oliveira et al 2021), focusing on the costs of providing endodontic therapy. One study additionally considered the costs associated with failure of the provided therapy.…”

“…One study combined cost‐utility and cost‐benefit analyses (Balevi & Shepperd 2007). The reported horizon of the two clinically grounded studies ranged from 0 (Oliveira et al 2021) to 2 years (Asgary et al 2014). The horizon of the modelling studies varied, ranging from 5 years (Balevi & Shepperd 2007) up to the remaining lifespan of the modelled patients.…”