Cost and time differences between three types of dental restorations

Objectives: The aim of this study was to measure treatment cost differences for amalgam, composite and atraumatic restorative treatment (ART) restorations evaluating possible factors that could influence the cost of treatment. Methods: The study was approved by the IRB and parents of participants were consented. The study was carried out in children with primary teeth aged 5 – 10 years old. Sixty restorations with two surfaces (20 amalgam, 20 resin composite and 20 ART) and 60 with three surfaces (20 amalgam, 20 composite and 20 ART) were made by two operators at a community clinic in California. Each operator performed the same number of each type of restoration for both two and three surfaces. Children were randomly assigned to operators. Statistical analysis of data consisted of a linear regression using the natural logarithm of variable cost ((minutes for procedure) x (dentist earnings per minute + assistant earnings per minute) + (cost of restoration materials)) as the dependent variable. Overhead costs were fixed and were not economically relevant for this comparison. Covariates included type of restoration (amalgam, composite, ART), number of surfaces (two or three), and tooth type (seven types). Results: ART was found to be 7.0% (p=.01) less costly than amalgam and 62.6% (p<.01) less costly than composite. Conclusions: ART was found to be the least costly treatment compared to amalgam and composite restoration procedures. ART also showed the shortest time during the clinical procedure; therefore, this kind of treatment could be very beneficial in terms of cost benefit and time efficiency in a clinical setting.