IADR Abstract Archives
Influence of Defect Size on Material Choice for Restoration Repair
Objectives: This economic evaluation aims to assess whether the defect size influences the cost-effectiveness (CE) when using encapsulated Glass Ionomer Cement (GIC) to repair restorations in primary teeth.
Methods: We simulated the choice of repairing restorations in primary teeth using encapsulated GIC as an alternative for a universal adhesive system associated with Bulk fill resin composite (BULK). Simple decision trees were made for major and minor failures, with a 1-year time horizon and considering possible transitions after repair (success, failures and exfoliation). The data for the model was obtained from an ongoing clinical study that evaluated repairs with encapsulated GIC (Riva Self Cure, SDI) versus BULK (Single Bond Universal, Filtek Bulk Fill, and Filtek Bulk Fill Flow, 3M ESPE) in primary molars. We considered the transition probabilities observed so far and the cost of procedures in the baseline or in the literature. CE analyzes were performed from the perspective of the public health system, and costs (△C), effects (△E), and Incremental Cost-Effectiveness Ratio (ICER) were calculated. Sensitivity analyses were performed to handle uncertainties.
Results: For major failures, there is a 76% probability that using GIC will be a cost-effective option for repairs compared to BULK (△C: $8.23, △E: 10%, ICER: 689.97). In minor failures, the probability of GIC being cost-effective for repairs drops to 50%, associated with a higher ICER (△C: $11.93, △E: 0%, ICER: 118,664.59). By reducing the GIC cost by 20%, it becomes a cost-effective option for major repairs, but only with a reduction of 30% does it become cost-effective for minor repairs.
Conclusions: From an economic perspective, the size of the defect is a relevant factor for choosing the appropriate material. Encapsulated GIC is a cost-effective alternative compared to bulk fill restorative materials for major repairs on primary molars.
Methods: We simulated the choice of repairing restorations in primary teeth using encapsulated GIC as an alternative for a universal adhesive system associated with Bulk fill resin composite (BULK). Simple decision trees were made for major and minor failures, with a 1-year time horizon and considering possible transitions after repair (success, failures and exfoliation). The data for the model was obtained from an ongoing clinical study that evaluated repairs with encapsulated GIC (Riva Self Cure, SDI) versus BULK (Single Bond Universal, Filtek Bulk Fill, and Filtek Bulk Fill Flow, 3M ESPE) in primary molars. We considered the transition probabilities observed so far and the cost of procedures in the baseline or in the literature. CE analyzes were performed from the perspective of the public health system, and costs (△C), effects (△E), and Incremental Cost-Effectiveness Ratio (ICER) were calculated. Sensitivity analyses were performed to handle uncertainties.
Results: For major failures, there is a 76% probability that using GIC will be a cost-effective option for repairs compared to BULK (△C: $8.23, △E: 10%, ICER: 689.97). In minor failures, the probability of GIC being cost-effective for repairs drops to 50%, associated with a higher ICER (△C: $11.93, △E: 0%, ICER: 118,664.59). By reducing the GIC cost by 20%, it becomes a cost-effective option for major repairs, but only with a reduction of 30% does it become cost-effective for minor repairs.
Conclusions: From an economic perspective, the size of the defect is a relevant factor for choosing the appropriate material. Encapsulated GIC is a cost-effective alternative compared to bulk fill restorative materials for major repairs on primary molars.