Retention costs of periodontally compromised molars in a German population

Abstract

Aim: This study assessed the long-term costs per retention year for periodontally affected molars.

Methods: A cohort of 379 compliant subjects was retrospectively evaluated. Periodontal, restorative, endodontic, prosthetic and surgical treatment costs were estimated based on fee items of the private German health insurance. Costs/year were calculated and the impact of tooth- and subject-related factors on this cost-effectiveness ratio assessed using generalized linear-mixed modelling.

Results: 2306 molars received non-regenerative initial and supportive therapy and were followed until extraction or censoring (in mean (SD): 16.5 [6.8] years). Per year, 0.07 (SD: 0.12) deep scalings, 0.04 (0.11) open flap debridements, 0.01 (0.04) resective therapies and 2.49 (0.12) SPTs had been provided. Few teeth received non-periodontal treatments. Costs/year decreased significantly with each tooth a patient had at baseline (mean difference: -0.01, 95% CI: -0.02/-0.01 Euro/year), and increased with each mm of probing-pocket depth (0.04 [0.03/0.06] Euro/year), in upper (0.07 [0.11/0.31] Euro/year) or mobile molars (up to 0.33 [0.18/0.48] Euro/year), those with bone loss (up to 0.11 [0.04/0.17] Euro/year), endodontic treatment (0.24 [0.15/0.33] Euro/year), peri-apical lesions (0.24 [0.11/0.38]) and prosthetic treatment (0.54 [0.49/0.59] Euro/year).

Conclusions: Annual costs for retaining periodontally affected molars were limited, and associated mainly with tooth-level factors.

Keywords: dental; furcation; health economics; molar; periodontal.