a Department of Endodontics, Faculty of Odontology , Malmö University , Malmö , Sweden.
b Department of Endodontics , Swedish Public Dental Service, Specialist Clinic Kaniken , Uppsala , Sweden.
Acta Odontol Scand. 2019 May;77(4):275-281. doi: 10.1080/00016357.2018.1538536. Epub 2019 Feb 15.
To contribute with information on cost-effectiveness of pulp capping and root canal treatment of posterior permanent vital teeth in children and adolescents with pulp exposures due to caries.
Cost-effectiveness by means of a Markov simulation model was studied in a Scandinavian setting. In a simulated 12-year-old patient, treatment of pulpal exposure of a permanent tooth, either by the initial treatment pulp capping or root canal treatment, was followed for 9 years until the patient was 21. The model was based on outcome data obtained from published literature and cost data based on reference prices.
In the simulated case, with the annual failure probalility (AFP) of 0.034 for pulp capping, the total cost for an initial treatment with pulp capping and any anticipated following treatments during the 9 years, was 367 EUR lower than for a root canal treatment as the initial treatment. After an initial treatment with pulp capping 10.4% fewer teeth, compared with initial root canal treatment, were anticipated to be extracted. Pulp capping was thus considered to be the cost-effective alternative. The sensitivity analyses showed that the AFP of a tooth requiring a root canal treatment after an initial pulp capping needed to be 0.2 before root canal treatment may be considered being the cost-effective treatment.
This model analysis indicated initial treatment by pulp capping to be cost-effective compared to root canal treatment in children and adolescents with pulp exposures due to caries.
提供有关因龋导致牙髓暴露的儿童和青少年的活髓保存治疗和根管治疗的成本效益信息。
在斯堪的纳维亚环境中，通过马尔可夫模拟模型研究成本效益。在模拟的 12 岁患者中，对恒牙牙髓暴露进行初始治疗（牙髓盖髓或根管治疗），随访 9 年，直至患者 21 岁。该模型基于已发表文献中的结果数据和基于参考价格的成本数据。
在模拟病例中，牙髓盖髓的年失败概率（AFP）为 0.034，初始牙髓盖髓治疗和 9 年内任何预期后续治疗的总费用比初始根管治疗低 367 欧元。与初始根管治疗相比，初始牙髓盖髓治疗预计需要拔除的牙齿减少 10.4%。因此，牙髓盖髓被认为是更具成本效益的选择。敏感性分析表明，初始牙髓盖髓治疗后需要根管治疗的牙齿的 AFP 需要达到 0.2，根管治疗才可能具有成本效益。
该模型分析表明，与根管治疗相比，因龋导致牙髓暴露的儿童和青少年的初始牙髓盖髓治疗具有成本效益。
