IADR Abstract Archives
Management of necrotic immature permanent teeth: A cost-effectiveness analysis of regenerative endodontic treatment versus apexification
Objectives: With the introduction of stem cell engineering in dentistry, regenerative endodontics has emerged as a potential alternative to MTA apexification in the management of necrotic immature permanent teeth, which may prolong the survival of the affected tooth. However, the utility of this modality in terms of cost-effectiveness has not yet been established. Therefore, we performed the cost-effectiveness analysis to determine the dominant treatment modality that would influence decision-making from the perspective of the patients, clinicians, and policymakers.
Methods: A Markov model was constructed following a necrotic immature permanent tooth in a seven-year-old patient over the lifetime using TreeAge Pro Healthcare 2022. Transition probabilities were estimated based on existing literature. Costs were estimated based on the United States health care and cost-effectiveness was determined using Monte Carlo microsimulations. The model was validated internally by sensitivity analyses, and external validation was done by an experienced health economist.
Results: In the base-case scenario, regenerative endodontics did not turn out to be a dominant treatment option as it was associated with an additional cost of USD 1,008 per year and fewer life years gained by a tooth (51.46 years). Likewise, in the probabilistic sensitivity analysis, regenerative endodontics was again dominated by apexification against different WTP values.
Conclusions: Based on current evidence, regenerative endodontic treatment was not found to be cost-effective compared to apexification in the management of necrotic immature permanent teeth over the lifetime of an individual.
Methods: A Markov model was constructed following a necrotic immature permanent tooth in a seven-year-old patient over the lifetime using TreeAge Pro Healthcare 2022. Transition probabilities were estimated based on existing literature. Costs were estimated based on the United States health care and cost-effectiveness was determined using Monte Carlo microsimulations. The model was validated internally by sensitivity analyses, and external validation was done by an experienced health economist.
Results: In the base-case scenario, regenerative endodontics did not turn out to be a dominant treatment option as it was associated with an additional cost of USD 1,008 per year and fewer life years gained by a tooth (51.46 years). Likewise, in the probabilistic sensitivity analysis, regenerative endodontics was again dominated by apexification against different WTP values.
Conclusions: Based on current evidence, regenerative endodontic treatment was not found to be cost-effective compared to apexification in the management of necrotic immature permanent teeth over the lifetime of an individual.