Comparison of potential long-term costs for preventive dentistry treatment of post-orthodontic labial versus lingual enamel cavitations and esthetically relevant white-spot lesions: a simulation study with different scenarios

Head & Face Medicine

Hans-Joachim Helms¹  Roberto Vogel Alvarez²  Moritz Blanck-Lubarsch³  Michael Knösel⁴ 

[1] Department of Medical Statistics, University Medical Center Göttingen;Department of Orthodontics and Paediatric Dentistry, Universidad de La Frontera (UFRO);Department of Orthodontics, University Hospital Münster;Department of Orthodontics, University Medical Center Göttingen;

关键词: Orthodontic treatment;    Long-term costs;    Decalcification;    White spot lesion;    Lingual treatment;    Cost simulation;   

DOI  :  10.1186/s13005-019-0204-x

来源: DOAJ

【 摘 要 】

Abstract Background Post-orthodontic white-spot lesions (WSL) in esthetically relevant incisor and canine areas impair dentofacial esthetics, and preventive dentistry treatment is definitely required in case of enamel cavitations. The incidence of lingual post-orthodontic WSL and cavitation following lingual MB treatment has been reported to be distinctively decreased compared to labial MB treatment. Moreover, lingual WSL do not impair dentofacial esthetics. It was the objective of this study to calculate consequential costs of preventive dental care necessary to recover labial or lingual post-orthodontic cavitations as well as esthetically relevant WSL following either labial or lingual MB interventions. Methods MB treatments (labial / lingual) were simulated in 1,000,000 patients between the ages of 12-18Y, with a median residual life time expectancy of 58Y based on local mortality tables. Range of MB Tx duration was 9–45 mo. Frequencies of post-orthodontic (labial / lingual) enamel damages were derived from large-scale WSL incidence studies. Anterior composite survival rates were based on a systematic review on the subject. Within the context of the German dental fee system (GOZ 2.3 and 3.5 fee increments), simulation of costs for enamel damage treatment and re-treatment (maximum: 5x) were based on single-surface composite restorations for lingual or labial cavitations and labial WSL treatment; and lingual WSL fluoridation. Results Overall mean total costs for Tx and re-Tx of both WSLs and cavitations may sum up to 1718.91 Eur in the high-cost (GOZ 3.5) scenario for conventional MB cases, versus 19.94 Eur for lingually treated cases, given that renewal of simulated single-surface restorations takes place at 15-year intervals. When focussing on patients diagnosed with least of one WSL, and/or cavitation, these mean costs increase up to 2332.35 Eur for conventionally treated MB patients, or 65.03 Eur for lingual MB patients. Conclusion Costs for repeated treatment of post-orthodontic enamel damages produced by conventional vestibular fixed appliances may easily exceed the initially higher costs associated with lingual orthodontic treatment. Judged economically in the long term, lingual MB Tx may be considered as a more cost-effective solution for a correction of malocclusion.

【 授权许可】

Unknown