Economic analysis of the different endodontic instrumentation techniques used in the Unified Health System

Laura Paredes Merchan; Livia Fernandes Probst; Ana Clara Correa Duarte Simões; Augusto Cesar Santos Raimundo; Yuri Wanderley Cavalcanti; Denise de Fátima Barros Cavalcante; João Victor Frazão Câmara; Antonio Carlos Pereira

doi:10.1186/s12903-022-02369-x

Economic analysis of the different endodontic instrumentation techniques used in the Unified Health System

BMC Oral Health. 2022 Aug 11;22(1):344. doi: 10.1186/s12903-022-02369-x.

Authors

Laura Paredes Merchan¹, Livia Fernandes Probst², Ana Clara Correa Duarte Simões², Augusto Cesar Santos Raimundo², Yuri Wanderley Cavalcanti³, Denise de Fátima Barros Cavalcante⁴, João Victor Frazão Câmara⁵, Antonio Carlos Pereira⁶

Affiliations

¹ Department of Public Health, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil.
² Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil.
³ Department of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, PB, Brazil.
⁴ Department of Public Health, Israelita Albert Einstein Hospital, São Paulo, Brazil.
⁵ Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Homburg, Saar, Germany.
⁶ Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil. apereira@fop.unicamp.br.

Abstract

Background: To assess the financial impact of incorporating a new (reciprocal) technology into endodontic treatments in the public health system (SUS).

Methods: This was a economic evaluation study (comparing the 3 different endodontic instrumentation techniques-manual, rotary and reciprocating), allocative efficiency analysis to optimize existing resources in the SUS, and financial contribution impact analysis of incorporation of a new technology. Thirty-one (31) 12 years-old volunteers were evaluated.

Results: The incremental cost-effectiveness ratio (ICER) was calculated at R$1.34/min, - R$0.60/min and BRL 0.10/min for the single-rooted, bi-rooted and tri-rooted teeth, respectively, when the rotary technique was compared with the manual type. In turn, the ICER was R$ 21.04/min, - R$ 0.73/min and - R$ 2.81/min for the 3 types of teeth, respectively, when the reciprocating technique was compared with the manual type. The incremental financial impact of replacing manual endodontic with rotary endodontic treatments would be - R$ 2060963.66 in the case of single-rooted teeth, but the number of treatments would also be reduced (- 19,379). In the case of two-rooted teeth, the incremental financial impact would be BRL 34921540.62 with the possibility of performing an additional 204,110 treatments. In turn, BRL 11523561.50 represented the incremental financial impact for teeth with 3 or more roots and with an increase of 72,545 procedures. When we analyzed the incremental financial impact of replacing manual endodontic with reciprocating endodontic treatments, it would be - R$ 730227.80 in the case of single-rooted teeth, allowing for an additional 2538 treatments. In turn, R$ 21674853.00 represented the incremental financial impact for bi-radicular teeth, with an increase of 121,700 procedures. In the case of two-rooted teeth, the incremental financial impact would be BRL 13591742.90 with the possibility of performing an additional 40,670 treatments.

Conclusions: The reciprocating technique could improve access to endodontic treatment in the SUS as it allowed a simultaneous reduction in clinical time and associated costs. However, the higher number of endodontic treatments performed would have a financial impact.

Keywords: Endodontic treatments; Health evaluation; Oral health.

MeSH terms

Child
Cost-Benefit Analysis
Humans
Root Canal Preparation*
Tooth Root*