Is root canal treatment and an indirect coronal restoration of a mandibular first molar cost-effective compared to extraction and an implant-supported crown? A decision analytic approach.

OBJECTIVE

The aim was to compare the cost-effectiveness of root canal treatment and an indirect restoration (RCT + PC) versus an implant-supported single crown (ISSC) in the case of a decayed first mandibular molar with a necrotic pulp. The study was based on Swedish population and the reference prices for dental treatments in Sweden.

MATERIALS AND

METHODS

The cost-effectiveness for RCT + PC and ISSC were calculated with the help of two decision trees. The initial costs were from the Swedish dental reference prices in 2024, and the probability values were from published articles based on Swedish data.

RESULTS

In Decision tree I, the expected costs for RCT + PC and for ISSC were 17,400 and 18,800 SEK, respectively. In the Decision tree II, the respected expected costs were 19,500 SEK and 18,800 SEK. The threshold probability values were 83 and 93% for RCT survival.

CONCLUSIONS

Given the assumptions and limitations of this decision analysis, the probability of survival for RCT + PC needs to be in the range of 83-93% in order for it to be more cost-effective than ISSC, when deciding about treatment on a compromised first mandibular molar.