Department of Oral Diagnostics, Digital Health, Health Services Research, Charité - Universitätsmedizin Berlin, Germany.
Department of Oral Diagnostics, Digital Health, Health Services Research, Charité - Universitätsmedizin Berlin, Germany.
J Dent. 2021 Jul;110:103689. doi: 10.1016/j.jdent.2021.103689. Epub 2021 May 9.
This study compared survival, restoration quality and costs of glass hybrid (GH; EQUIA Forte Fil/EQUIA Forte Coat) and resin composite restorations (RC; OptiBond FL/Filtek Supreme XTE) of sclerotic non-carious cervical lesions.
This is a cluster-randomized trial (ClinicalTrials.gov: NCT02631161). 88 patients (50-70 years) with 175 sNCCLs were randomized to receive GH or RC. Restorations were placed without mechanical cavity preparation and followed for a mean 36 (min/max: 31/55) months (variable follow-up due to COVID-19 lockdown). Restoration quality was re-evaluated at 1-, 18- and 36-months using FDI-criteria. Survival was assessed using multi-level Cox-regression analysis. Costs were estimated from a payer's perspective in Germany. Initial costs were determined based on micro-costing using time recordings and hourly costs, and follow-up costs based on statutory insurance fee-item-catalogues.
88 patients (175 restorations) were treated; 43 received GH (83 restorations), 45 RC (92 restorations). 17 GH and 19 RC showed total retention loss, 5 GH were partially lost (p = 0.396/Cox). FDI ratings were not sufficiently different for any domain except surface luster, where RC showed higher score (p < 0.001). Costs were initially lower for GH (32.57; SD 16.36 €) than RC (44.25; SD 21.40 €), while re-treatment costs were similar (GH: 9.15; SD 15.70 €; RC: 7.35; SD 14.51 €), resulting in significantly lower costs for GH (GH: 41.72; SD 25.08 €) than RC (51.60; 26.17 €) (p < 0.001/GLM).
While survival was not significantly different, GH was significantly less costly both initially and long-term than RC for restoring non-carious cervical lesions.
Within this trial, survival was not significantly different between GH and RC to restore sclerotic NCCLs. As GH was significantly less costly both initially and long-term than RC, using RC was only cost-effective for payers willing to invest high additional expenses per minimal survival gains.
本研究比较了玻璃混合（GH；EQUIA Forte Fil/EQUIA Forte Coat）和树脂复合材料修复（RC；OptiBond FL/Filtek Supreme XTE）硬化性非龋性颈病变的生存率、修复质量和成本。
这是一项集群随机试验（ClinicalTrials.gov：NCT02631161）。88 名（50-70 岁）患有 175 例 sNCCL 的患者被随机分为 GH 或 RC 组。在没有机械腔制备的情况下放置修复体，并平均随访 36 个月（min/max：31/55）（由于 COVID-19 封锁，可变随访）。使用 FDI 标准在 1、18 和 36 个月时重新评估修复质量。使用多级 Cox 回归分析评估生存率。成本从德国付款人的角度进行估算。初始成本基于使用时间记录和每小时成本的微观成本核算确定，后续成本基于法定保险费项目目录确定。
治疗了 88 名患者（175 例修复体）；43 例接受 GH（83 例修复体），45 例 RC（92 例修复体）。17 例 GH 和 19 例 RC 出现完全保留损失，5 例 GH 部分损失（p=0.396/Cox）。除表面光泽外，任何领域的 FDI 评分均无明显差异，RC 评分较高（p<0.001）。GH 的初始成本（32.57；SD 16.36 欧元）低于 RC（44.25；SD 21.40 欧元），而再治疗成本相似（GH：9.15；SD 15.70 欧元；RC：7.35；SD 14.51 欧元），导致 GH 的成本明显低于 RC（GH：41.72；SD 25.08 欧元）低于 RC（51.60；SD 26.17 欧元）（p<0.001/GLM）。
虽然生存率无显著差异，但 GH 在初始和长期成本方面均显著低于 RC，用于修复非龋性颈病变。
在本试验中，GH 和 RC 修复硬化性非龋性颈病变的生存率无显著差异。由于 GH 的初始和长期成本均显著低于 RC，因此对于愿意为每一点生存获益投入高额外费用的支付者来说，使用 RC 仅具有成本效益。
