Tuesday, June 18, 2024

Cost-Effectiveness Analysis of Quad Helix and Rapid Maxillary Expanders in Children

Similar articles

The financial implications of orthodontic treatments, especially when publicly funded, necessitate a careful evaluation of both efficacy and costs. This study delves into the cost-effectiveness of two commonly used appliances—quad helix (QH) and rapid maxillary expanders (RME)—in treating unilateral posterior crossbite in children. Conducted across two centers, the research involved 72 patients randomized to receive either QH or RME treatment. The study meticulously collected data on various factors including success rates, treatment durations, and costs, in conjunction with patient feedback on school absences and pain management.

The primary objective of the study was to compare the cost-effectiveness of QH and RME in early mixed dentition stages. Researchers employed both an intention-to-treat (ITT) and a per-protocol approach, along with a deterministic sensitivity analysis, to ensure comprehensive results.

Methodology and Data Collection

Data were gathered from patient records, focusing on success rates, number of visits, total treatment time, and emergency visits. Additionally, patient questionnaires provided insights into school absences and analgesic usage. These factors formed the basis for the cost-effectiveness analysis.

Results and Findings

One year post-treatment, success rates did not significantly differ between the QH and RME groups, according to the ITT analysis. From a healthcare perspective, QH showed a mean cost advantage of €32.05 over RME, although this difference was not statistically significant (P = 0.583). Similarly, from a societal perspective, QH was €32.61 less expensive than RME (P = 0.742). However, the appliance costs were notably higher for RME (€202.67) compared to QH (€155.58, P = 0.001).

The study also revealed a 71% probability that RME incurs higher costs from a healthcare perspective, with a 62.7% likelihood from a societal perspective. Interestingly, the total treatment time was longer by 97 days for the QH group. Sensitivity analysis, considering higher educational loss valuations, indicated QH could be €58 more costly than RME.

Key Inferences

– The choice of appliance impacts the overall cost, with QH generally being less expensive than RME.
– Treatment duration is significantly longer for QH, which may affect patient compliance and satisfaction.
– Variations in chair time and visit frequencies across centers highlight the importance of efficient work procedures in cost management.

In conclusion, while the cost differences between RME and QH are not statistically significant, RME tends to be slightly more expensive. The study emphasizes the significance of logistical efficiency in reducing the number of visits, saving chair time, and consequently lowering costs, rather than the choice of the appliance itself.

Original Article: Eur J Orthod. 2024 Jun 1;46(3):cjae028. doi: 10.1093/ejo/cjae028.

You can follow our news on our Telegram and LinkedIn accounts.

Subscribe to our newsletter

To be updated with all the latest news, offers and special announcements.

Latest article