Incorporating severity and risk as factors to the Fardal cost-effectiveness model to create a cost-benefit model for periodontal treatment.

BACKGROUND: A previously described economic model was based on average values for patients diagnosed with chronic periodontitis (CP). However, tooth loss varies among treated patients and factors for tooth loss include CP severity and risk. The model was refined to incorporate CP severity and risk to determine the cost of treating a specific level of CP severity and risk that is associated with the benefit of tooth preservation. METHODS: A population that received and another that did not receive periodontal treatment were used to determine treatment costs and tooth loss. The number of teeth preserved was the difference of the number of teeth lost between the two populations. The cost of periodontal treatment was divided by the number of teeth preserved for combinations of CP severity and risk. RESULTS: The cost of periodontal treatment divided by the number of teeth preserved ranged from (US) $1,405 to $4,895 for high or moderate risk combined with any severity of CP and was more than $8,639 for low risk combined with mild CP. The cost of a three-unit bridge was $3,416, and the cost of a single-tooth replacement was $4,787. CONCLUSION: Periodontal treatment could be justified on the sole basis of tooth preservation when CP risk is moderate or high regardless of disease severity.

Análise de custos dos procedimentos clínicos e laboratoriais de oito opçöes para recuperaçäo estética e funcional da coroa de um incisivo central superior / Cost analysis of clinical and laboratorial procedures of eight options for the functional and aesthetical recuperation of the crown of an upper central incisor

Diante de oito opçöes para reconstruçäo do dente 21 que teve a coroa totalmente fraturada, após a endutoterapia e preparo do canal para recebimento de pinos, moldaram-se as arcadas e construiram-se oito modelos em gesso pedra tipo IV. Sobre eles, confeccionou-se a parte coronária com resina composta, resina composta e coroa metalocerâmica, resina composta e coroa de porcelana pura, ionômero de vidro e coroa metalocerâmica, núcleo metálico e coroa metalocerâmica, núcleo metálico e coroa metaloplástica, ionômero de vidro e coroa metaloplástica, dente obtido de banco de dentes e resina composta. Na parte radicular, colocou-se pino pré-fabricado (Radix Anker), pino metálico fundido pino de dente natural obtido de bancos de dentes. De acordo com a tabela mostrada, as coroas em porcelana pura foram as mais onerosas, seguidas das coroas metalocerâmicas. Da recuperaçäo feita a partir de um dente natural e reconstruído com resina composta, obteve-se um valor insignificante e o trabalho ficou altamente satisfatório