title: Cost-effectiveness of endodontic molar retreatment compared with fixed partial dentures and single-tooth implant alternatives.
abstract: BACKGROUND
  One of the most challenging situations in dentistry is a failed root canal treatment case. Should a failed root canal-treated tooth be retreated nonsurgically or surgically, or should the tooth be extracted and replaced with an implant-supported restoration or fixed partial denture? These four treatment alternatives were compared from the perspective of cost-effectiveness on the basis of the current best available evidence.
  
  
  METHODS
  The costs of the four major treatment modalities were calculated using the national fee averages from the 2009 American Dental Association survey of dental fees. The outcome data of all treatment modalities were retrieved from meta-analyses after electronic and manual searches were undertaken in the database from MEDLINE, Cochrane, ISI Web of Knowledge, and Scopus up to April 2010. The treatment strategy model was built and run with TreeAge decision analysis software (TreeAge Software, Inc, Williamstown, MA).
  
  
  RESULTS
  Endodontic microsurgery was the most cost-effective approach followed by nonsurgical retreatment and crown, then extraction and fixed partial denture, and finally extraction and single implant-supported restoration.
  
  
  CONCLUSIONS
  The cost-effectiveness analysis showed that endodontic microsurgery was the most cost-effective among all the treatment modalities for a failed endodontically treated first molar. A single implant-supported restoration, despite its high survival rate, was shown to be the least cost-effective treatment option based on current fees.
authors.affiliation: Division of Endodontics, College of Dental Medicine, Columbia University, New York, NY 10032, USA. sgk2114@columbia.edu
authors.forename: Sahng G
authors.initials: SG
authors.lastname: Kim
authors.forename: Charles
authors.initials: C
authors.lastname: Solomon
mesh_terms: D001047:Apicoectomy / Q000191:economics*; D003362:Cost-Benefit Analysis; D016556:Crown Lengthening / Q000191:economics; D003442:Crowns / Q000191:economics; D000044:Dental Abutments / Q000191:economics; D019250:Dental Implants, Single-Tooth / Q000191:economics*; D003776:Dental Porcelain / Q000191:economics; D019094:Dental Prosthesis, Implant-Supported / Q000191:economics; D003830:Denture, Partial, Fixed / Q000191:economics*; D004708:Endodontics / Q000191:economics; D005250:Fees, Dental; D005792:General Practice, Dental / Q000191:economics; D006801:Humans; D016876:Metal Ceramic Alloys / Q000191:economics; D008866:Microsurgery / Q000191:economics; D008963:Molar / Q000473:pathology* / Q000601:surgery; D010517:Periodontics / Q000191:economics; D011176:Post and Core Technique / Q000191:economics; D011476:Prosthodontics / Q000191:economics; D019233:Retreatment / Q000191:economics; D012390:Root Canal Therapy / Q000191:economics*; D016019:Survival Analysis; D014081:Tooth Extraction / Q000191:economics; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D016876:Metal Ceramic Alloys; D003776:Dental Porcelain