Long-term cost-effectiveness of single indirect restorations in selected dental practices.
OBJECTIVE
To determine the relative cost-effectiveness of alternative methods for restoring large tooth substance loss in adults.


METHODS
Long-term survival estimates and discounted costs for 245 large indirect restorations were used to calculate their incremental cost-effectiveness over 15 years when compared with direct placement Class II cusp-overlay amalgams and Class IV multisurface resin composites, placed in 100 patients from three private dental practices.


RESULTS
The direct placement restorations were more cost-effective than the indirect restorations at all time intervals over the 15-year study period. The full gold crown and the ceramometal crown were the most cost-effective indirect posterior and anterior restorations respectively. The cast gold onlay and the porcelain jacket crown were the least cost-effective indirect posterior and anterior restorations respectively.


CONCLUSIONS
When clinically practicable, large direct placement restorations should be placed initially in preference to indirect restorations.
Kelly
P G
PG
Macarthur Oral Health Services, South Western Sydney Area Health Service, 5 Thomas Rose Drive, Rosemeadow, NSW 2560, Australia. Philip.Kelly@swsahs.nsw.gov.au
Smales
R J
RJ
D000328:Adult; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D003442:Crowns / Q000191:economics*; D003723:Dental Amalgam / Q000191:economics*; D019232:Dental Restoration Failure; D006047:Gold Alloys / Q000191:economics; D006801:Humans; D007284:Inlays / Q000191:economics*; D015993:Life Tables; D016876:Metal Ceramic Alloys / Q000191:economics; D012189:Retrospective Studies
D006047:Gold Alloys; D016876:Metal Ceramic Alloys; D003723:Dental Amalgam