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Root Canal Treatment Versus Vital Pulp Therapy After Carious Exposure: A Cost-Effectiveness Analysis in the United States Healthcare System
This cost-effectiveness analysis compared root canal therapy (RCT), direct pulp cap (DPC), partial pulpotomy (PP) and full pulpotomy (FP) in the U.S. healthcare system. Methods: A decision tree was constructed for a simulated adult patient with a permanent, mature, cariously exposed, asymptomatic tooth. Transition probabilities were obtained from previously published literature. National average costs for each treatment were obtained from published dental fees survey. A Monte Carlo simulation served for analysis of the CEA. Results: Monte Carlo simulation found cost-effectiveness ratio of7.19, 29.53, 37.02 and 41.32 for FP, DPC, RCT and PP respectively. Conclusions: Our study found FP to be significantly more cost-effective than NSRCT, DPC and FP. More research is needed in assessing and defining parameters for future CEAs in endodontics and dentistry in general.
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