A cost minimization analysis of early correction of anterior crossbite-a randomized controlled trial.
OBJECTIVE
Economic evaluations provide an important basis for allocation of resources and health services planning. The aim of this study was to evaluate and compare the costs of correcting anterior crossbite with functional shift, using fixed or removable appliances (FA or RA) and to relate the costs to the effects, using cost-minimization analysis.


METHODS
Sixty-two patients with anterior crossbite and functional shift were randomized in blocks of 10. Thirty-one patients were randomized to be treated with brackets and arch wire (FA) and 31 with an acrylic plate (RA). Duration of treatment and number and estimated length of appointments and cancellations were registered. Direct costs (premises, staff salaries, material, and laboratory costs) and indirect costs (the accompanying parents' loss of income while absent from work) were calculated and evaluated with reference to successful outcome alone, to successful and unsuccessful outcomes and to re-treatment when required. Societal costs were defined as the sum of direct and indirect costs.


METHODS
Treatment with FA or RA.


RESULTS
There were no significant differences between FA and RA with respect to direct costs for treatment time, but both indirect costs and direct costs for material were significantly lower for FA. The total societal costs were lower for FA than for RA.


CONCLUSIONS
Costs depend on local factors and should not be directly extrapolated to other locations.


CONCLUSIONS
The analysis disclosed significant economic benefits for FA over RA. Even when only successful outcomes were assessed, treatment with RA was more expensive.


BACKGROUND
This trial was not registered.


METHODS
The protocol was not published before trial commencement.
*Department of Oral and Maxillofacial Surgery, Skane University Hospital, Malmö, anna-paulina.wiedel@mah.se.
Anna-Paulina
AP
Wiedel
**Section of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, and.
Anders
A
Norlund
***Department of Orthodontics, Faculty of Odontology, Malmö University, Sweden.
Sofia
S
Petrén
***Department of Orthodontics, Faculty of Odontology, Malmö University, Sweden.
Lars
L
Bondemark
D001071:Appointments and Schedules; D002648:Child; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D004180:Direct Service Costs; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007182:Income; D008297:Male; D008310:Malocclusion / Q000191:economics / Q000628:therapy*; D016382:Orthodontic Appliance Design / Q000191:economics*; D009967:Orthodontic Appliances / Q000191:economics*; D009968:Orthodontic Appliances, Removable / Q000191:economics; D016910:Orthodontic Brackets / Q000191:economics; D009969:Orthodontic Wires / Q000191:economics; D019233:Retreatment; D013997:Time Factors; D016896:Treatment Outcome