Replacing amalgam with a high-viscosity glass-ionomer in restoring primary teeth: A cost-effectiveness study in Brasilia, Brazil
| Autor: | R. G. de Amorim, Soraya Coelho Leal, Jo E. Frencken, Ann S. Goldman |
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| Rok vydání: | 2018 |
| Předmět: |
Time Factors
Cost estimate Cost effectiveness Cost-Benefit Analysis Acrylic Resins Glass ionomer cement Dental Caries engineering.material Dental Amalgam Cost burden 03 medical and health sciences 0302 clinical medicine All institutes and research themes of the Radboud University Medical Center Willingness to pay Humans Medicine Operations management Dental Restoration Failure Tooth Deciduous Child General Dentistry Cost database Viscosity business.industry 030503 health policy & services Dental Atraumatic Restorative Treatment Other Research Radboud Institute for Health Sciences [Radboudumc 0] 030206 dentistry Cost-effectiveness analysis Dentin Sensitivity Silicon Dioxide Amalgam (dentistry) Glass Ionomer Cements engineering 0305 other medical science business Brazil |
| Zdroj: | Journal of Dentistry, 70, pp. 80-86 Journal of Dentistry, 70, 80-86 |
| ISSN: | 0300-5712 |
| Popis: | Objectives When planning primary oral health care services the cost implications of adopting new intervention practices are important, especially in resource-strapped countries. Although on a trajectory to be phased-out, amalgam remains the standard of care in many countries. Methods Adopting a government perspective, this study compared the costs of performing amalgam and ART/high-viscosity glass-ionomer cement (HVGIC) restorations and the consequences of failed restorations over 3 years in suburban Brasilia, Brazil. Cost data were collected prospectively; cost estimates were developed for the study sample and a projection of 1000 single- and 1000 multiple-surface restorations per group. Probabilistic sensitivity analysis was conducted in TreeAge Pro. Results Results were mixed. For single-surface restorations, ART/HVGIC will cost US$51 per failure prevented, while for multiple-surface restorations, ART/HVGIC was cost-effective with a savings of US$11 compared to amalgam. Probabilistic sensitivity analysis (Monte Carlo simulation) predicted amalgam would be cost-effective 49.2% of the time compared to HVGIC at 50.6% of the time at a willingness to pay threshold of US$237 per failure prevented. Personnel accounted for more than half the cost burden for both methods; instruments and supplies accounted for about one third. The per restoration cost to replace amalgam with HVGIC ranges from US$1 to a savings of US$0.84. Conclusion Replacing amalgam with a high-viscosity glass-ionomer as part of the ART method comes at a minimal increase in cost for governments. Increasing the number of restorations seems to diminish the cost burden. Clinical significance ART/HVGIC could be considered a viable alternative to amalgam in primary teeth. |
| Databáze: | OpenAIRE |
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