One-year costs’ comparison between the Modified ICCMS^TM and Conventional Colombian Adjusted caries management systems

Objectives: A multicenter RCT is being conducted in six Colombian dental-school clinics evaluating the 3-year clinical effectiveness of updated (Modified-ICCMS^TM Derived from ICDAS) vs. Conventional-Colombian-Adjusted caries management systems.This study aimed to compare the costs of these two caries management systems in the 6 to 7-yr. olds multicenter RCT conducted in El Bosque University.
Methods: Forty dental records from this study in El Bosque University dental clinic were included from both groups (n=20: Modified-ICCMS^TM, n=20: Conventional-Colombian-Adjusted). The Modified-ICCMS™ activities included: according to patient’s risk probability: detailed oral-health instructions, sealants on risk pits/fissures, motivational interview including diet counseling, non/every 3/6-month fluoride-varnish application; and according to present active/inactive initial/moderate/extensive lesions: sealants, fluoride-varnish application, composite/glass-ionomer/steel-crown/Hall-technique restorations. The Conventional-Colombian-Adjusted activities included (high risk): general oral-health instructions, occlusal sealants in all molar teeth, every 6-month fluoride-gel application; and according to present cavitated active/inactive lesions: composite/glass-ionomer/amalgam restorations. All dental-record clinical activities were included from May-2014 until April-2015. The cost of each activity was determined to the dental-clinic price table ( year: 2015). The cost of the activities not included in this price table was obtained from the Bogota’s Health-Secretary dentists’ salary table, calculating the dedication time for the clinical activity. With these data the total 1-year costs of each patient’s management was calculated as well as the mean for each management system.
Results: The 1-year average costs were for the Modified-ICCMS^TM group of COP $217.420±187.756 and for the Conventional-Colombian-Adjusted group of COP $207.228±104.705 (Mann-Whitney; p=0.64).
Conclusions: The costs of the Modified-ICCMS^TM system clinical activities were slightly higher than that of the Conventional-Colombian-Adjusted system after one year. The 1- and 3-year effectiveness and cost-effectiveness of each management system should be assessed in the whole multicenter sample to decide with more power which one would work better under Colombian conditions.