用氟化二胺银、氟化钠和直接修复治疗牙根龋：成本效益分析。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-09-04 DOI:10.1016/j.jdent.2025.106093

Shijia Hu , Catherine Hsu Ling Hong , Xiaoli Gao , Hwee-Lin Wee , Yi Wang , Bien Wen Pui Lai , Shenna Yu-En Ho , Patrick Finbarr Allen , Sharon Hui Xuan Tan

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引用次数: 0

摘要

目的：评价氟化二胺银（SDF）相对于氟化钠（NaF）和传统树脂改性玻璃离子水门合剂（RMGIC）修复60岁及以上老年人牙根龋的成本-效果。方法：选择马尔可夫模型设计并构建两个模型：1)基于诊所的模型-可以使用牙科设施，允许放置传统修复体；2)基于社区的模型-由于行动不便，缺乏执行功能或经济障碍而无法使用牙科设施。建模时间跨度为10年，周期为一年。关于转移概率和相对风险的数据是从已发表的文献中获得的。关注的结果是每增加控制龋齿年的增量成本和每增加无拔牙年的增量成本。进行了概率敏感性分析，以解释基本情况中的不确定性。结果：在基于临床的模型中，SDF和NaF均以传统RMGIC修复体为主，其成本较低，且具有较高的龋病控制和无拔牙年限，具有90%的成本效益。在以社区为基础的模型中，NaF以SDF为主，其成本更低，控制龋齿和无拔牙的年数更高，几乎100%具有成本效益。结论：传统的RMGIC修复是治疗牙根龋的最经济有效的选择。在社区环境中提供治疗的情况下，SDF比NaF更具成本效益。临床意义：基于有限的临床研究和在新加坡口腔卫生系统内，传统的RMGIC修复在临床环境中治疗牙根龋最具成本效益，而SDF在社区环境中最具成本效益。

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Managing root caries with silver diamine fluoride, sodium fluoride and direct restorations: A cost-effectiveness analysis

Objective

To assess the cost-effectiveness of silver diamine fluoride (SDF) relative to sodium fluoride (NaF) and traditional resin-modified glass ionomer cements (RMGIC) restorations for the management of root caries in older adults aged 60 and above.

Methods

A Markov model design was chosen and two models were constructed: 1) Clinic-based model - with access to dental facility that allows for placement of traditional restorations, 2) Community-based model - without access to dental facility due to mobility, lack of executive function, or financial barriers. Modelling was done over a 10-year time horizon with a cycle length of one year. Data on transition probabilities and relative risks were obtained from published literature for the base case. Outcomes of interest were incremental cost per incremental caries-controlled year and incremental cost per incremental extraction-free year. Probabilistic sensitivity analyses were conducted to account for uncertainty in the base case.

Results

In the clinic-based model, both SDF and NaF were dominated by traditional RMGIC restorations, which had lower cost, and higher number of caries-controlled and extraction-free years, with a 90% probability of being cost-effective. In the community-based model, NaF was dominated by SDF, which incurred lower cost and resulted in a higher number of caries-controlled and extraction-free years, with almost 100% probability of being cost-effective.

Conclusions

Traditional RMGIC restoration was the most cost-effective option for managing root caries when full dental facility is available. In situations where treatment is provided in a community setting, SDF was more cost-effective than NaF.

CLINICAL SIGNIFICANCE

Based on limited clinical studies and within the Singapore oral health system, traditional RMGIC restoration was most cost-effective in clinical settings for managing root caries, while SDF was most cost-effective in community settings.

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.