Cost analysis of endodontic treatment in primary teeth: results from a randomized clinical trial

Oliveira, Suzana Cavalcanti Monteiro de; Floriano, Isabela; Tedesco, Tamara Kerber; Gimenez, Thaís; Imparato, José Carlos Pettorossi; Calvo, Ana Flávia Bissoto

doi:10.1590/1807-3107bor-2021.vol35.0126

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Original Research, Pediatric Dentistry • Braz. oral. res. 35 • 2021 • https://doi.org/10.1590/1807-3107bor-2021.vol35.0126 copy

Cost analysis of endodontic treatment in primary teeth: results from a randomized clinical trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract:

This study compared the cost of endodontic treatment in primary teeth involving a technique that does not require root canal instrumentation using antibiotic paste (CTZ) with that of the instrumented technique using iodoform paste (GP). This study is part of a randomized, controlled, parallel arm, noninferiority, 1:1 allocation, blinded (patient) multioperator study of 52 primary incisors of children aged 3 to 6 years with caries lesion and pulp involvement. Each technique was performed according to the creators’ descriptions. The cost was assessed by analyzing the costs of capital, dental supplies, and professional labor according to the time taken to perform the procedure and the CHEERS guidelines were used to report the cost assessment. Endodontic treatment with CTZ had a 58.33% lower execution cost than GP (US$6.73 and US$16.15, respectively). The t-test showed significant differences between groups regarding treatment time and total cost (p < 0.0001). The CTZ technique seems to be more economically viable than GP for endodontic treatment of primary teeth, requiring a shorter treatment time and lower costs.

Keywords:
Costs and Cost Analysis; Tooth, Deciduous; Pulpectomy; Endodontics

Protocols	CTZ	GP
1	Local anesthesia
2	Complete rubber dam isolation of operative field
3	Removal of carious tissue with dentin excavators
4	Access opening of pulp chamber with diamond round bur
5	Access regularization (contour and convenience shape) with endo-Z bur
6	Turn on the timer
7	Irrigation with 20 mL of sterile saline 0.9% and aspiration with endo suction	Irrigation with 20mL of 1% NaOCl and aspiration with endo suction
8	Location of the orifices of the root canals with endodontic exploratory probe # 47
9	–	Placement of Endo-PTC paste with two drops of 1% NaOCl at the orifice
10	Irrigation with 20 mL of sterile saline 0.9% and aspiration with endo suction	Irrigation with 20mL of 1% NaOCl and aspiration with endo suction
11	–	Manual instrumentation using three K-files alternating with 20mL of 1 % NaOCl irrigation to each file
12	–	Final irrigation with 10mL 17% EDTA-T
13	Pulp chamber drying with sterile cotton ball	Canals drying with sterile paper points
14	Insertion of the CTZ paste at the entrance of the root canal with exploratory endodontic probe #47, followed by a gentle pressure with sterile cotton ball. PCTZ was manipulated at the time of use (1 capsule of PCTZ 1:1:2, 2 drops of eugenol)	Canals filling with Guedes-Pinto paste manipulated at the time of use (1cm rifamycin ointment, 1cm iodoform [measured in anesthetic tube] and 2 drops of camphorated paramonochlorophenol)
15	Laying of a thin layer of Guta percha
16	Coronary chamber cleaning with 70% alcohol to remove debris
17	Turn off the timer and record endodontic time (in seconds)
18	Restoration with resin modified glass ionomer cement

Sample characteristic		Frequency n (%)
Sample characteristic		CTZ Group (n = 26)	GP Group (n = 26)
Sex
	Female	12 (46.15%)	14 (53.85%)
	Male	14 (53.85%)	12 (46.15%)
Age range (years)
	3–4	11 (42.31%)	10 (38.46%)
	4–5	11 (42.31%)	9 (34.62%)
	5–6	3 (11.54%)	7 (26.92%)
	+ 6	1 (3.84%)	0 (0%)
Treated tooth
	52	11 (42.31%)	15 (57.69%)
	51	5 (19.23%)	5 (19.23%)
	61	8 (30.77%)	2 (7.69%)
	62	2 (7.69%)	4 (15.39%)

Expenses	CTZ Group (U$)		GP Group (U$)
Expenses	Mean (± SD)	%	Mean (± SD)	%
Dental supplies	0.98 (±0.07)	15	3.07 (±0.13)	19
Depreciation (Equipment and Instruments)	0.28 (±0.16)	4	0.63 (±0.24)	4
Working time cost	5.47 (±3.13) (C)	81	12.45 (±4.46) (D)	77
Total	6.73 (±0.89) (E)		16.15 (±4.69) (F)

Dental supplies / Instruments / Equipment	Unit cost (U$)	CTZ Group		GP Group
Dental supplies / Instruments / Equipment	Unit cost (U$)	Mean*	Cost (U$)	Mean*	Cost (U$)
CTZ (capsule)	0.57	1	0.57	0	–
Camphorated paramonochlorophenol (drop)	0.01	0	–	1.85	0.02
EDTA (10 mL)	0.63	0	–	1.04	0.66
Endo-PTC (1cm)	0.25	0	–	1	0.25
Eugenol (goat)	0.01	1.88	0.02	0	–
Iodoform (1cm)	0.98	0	–	1	0.98
Matrix band (unit)	0.96	0	–	0	–
1% NaOCl (20mL)	0.04	0	–	3.35	0.13
Rifamycin (1cm)	1.03	0	–	1	1.03
sterile saline 0.9% (20mL)	0.21	1.88	0.39	0	–
Wedge (unit)	0.10	0.04	–	0	–
Total dental supplies			0.98		3.07
K-file	14.39	0	–	1	14.39
Endo ruler	2.90	0	–	1	2.90
Total instruments			0.00		17.29
Dental chair	5,557.71	1	5,557.71	1	5,557.71
Stools	2,58.76	2	517.52	2	517.52
Air Compressor	1,278.26	1	1,278.26	1	1,278.26
High Low Speed Hand Kit	514.41	1	514.41	1	5,14.41
Total equipment			7,867.90		7,867.90
TOTAL			7,868.88		7,888.26

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[1] Corresponding Author: Suzana Cavalcanti Monteiro de Oliveira, E-mail: suzanacmo19@gmail.com