Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Conventional treatment, Hall Technique or immediate pulpotomy for carious primary molars: A cost-effectiveness analysis

Schwendicke, F., Stolpe, M. and Innes, N. ORCID: 2016. Conventional treatment, Hall Technique or immediate pulpotomy for carious primary molars: A cost-effectiveness analysis. International Endodontic Journal 49 (9) , pp. 817-826. 10.1111/iej.12537

Full text not available from this repository.


AimTo compare the cost‐effectiveness of three strategies for treating primary molars with cavitated carious lesions and sensible (vital), asymptomatic pulps.MethodologyConventional excavation and restoration, Hall Technique (caries sealing using a preformed crown), and pulpotomy were compared. As the latter would not be applied to all teeth in clinical reality, decision‐making under perfect information was modelled, with teeth at‐risk for pulpal complications receiving immediate pulpotomy, whilst all others were treated conventionally. A Markov model was constructed and transition probabilities derived from randomized trials and systematic reviews. A carious molar in a 5‐year‐old child was followed until exfoliation. Cost‐effectiveness was assessed within the German healthcare system using a public‐payer perspective. Monte Carlo microsimulations were performed to evaluate the primary outcome, costs (in Euros) per year of tooth retention.ResultsConventional treatment was least effective and more expensive than the Hall Technique. Risk‐based pulpotomy was more costly, but also more effective than alternatives. Overall, the Hall Technique was most cost‐effective (9.77 Euros year−1), followed by pulpotomy (11.75 Euros year−1) and conventional treatment (13.31 Euros year−1). For payers willing to invest >59 Euros per additional year of tooth retention, risk‐based pulpotomy was most cost‐effective. Providing pulpotomy to all teeth was not cost‐effective.ConclusionsThe Hall Technique was most cost‐effective, whilst conventional treatment was least effective and more costly. Performing pulpotomy for molars at‐risk of pulpal complications might be effective, but was more expensive than alternatives. Moreover, accurately predicting such pulpal complications is currently not possible. Risk‐based decision‐making does not necessarily reduce costs.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Dentistry
Publisher: Wiley
ISSN: 0143-2885
Last Modified: 07 Nov 2022 11:06

Citation Data

Cited 30 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item Edit Item