Cost-effectiveness of glass ionomer cements in Atraumatic Restorative Treatment

Abstract

Background High-viscosity glass ionomer cements are the preferred materials for conducting restorations using Atraumatic Restorative Treatment (ART). However, there are more affordable alternatives available in the market that do not possess high viscosity. The objective of this study was to evaluate the cost-effectiveness of Glass Ionomer Cement (GIC) for Atraumatic Restorative Treatment (ART) in deciduous teeth. Methods The study conducted an economic analysis of the cost-effectiveness type. The cost of ART was determined using micro-costing techniques, and the survival rates after 1 year (effectiveness) were obtained from existing literature studies. Decision trees were constructed to compare the materials used in ART for both simple and composite cavities, considering the perspective of the local health manager. To estimate the cost-effectiveness of treating 1000 primary teeth, a Monte Carlo microsimulation was performed. The incremental cost-effectiveness ratio (ICER) was used to indicate the additional cost required to increase effectiveness after 1 year. The analyses were conducted using TreeAge Pro software. Results Regarding ART in single cavities, Maxxion R (FGM) was found to have a lower cost (BRL 22,945.23), while Ketac Molar (3M ESPE) exhibited greater effectiveness (891.3 teeth). The alternatives FUJI IX (GC America, ICER = 3.12) and Ketac Molar (ICER = 5.27) were considered more cost-effective. For composite cavities, Ketac Molar (ICER = 3.65) was identified as the most cost-effective option. Conclusion The study revealed variations in both cost and effectiveness among different materials used in ART. Lower cost may indicate lower effectiveness.