著者

河野 雅臣 福田 治久 藤久保 美紀 佐伯 康弘 菅原 えりさ 木村 哲

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.41, no.2, pp.91-102, 2020 (Released:2020-06-15)

参考文献数

71

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Abstract : Background : Aseptic root-canal treatment (aRCT), in which a bacteria-free protocol is used, results in a high success rate of approximately 90%. However, most Japanese patients do not receive aRCT due to unsuitable procedures that put emphasis on saving cost. Purpose : The aim of this study was to estimate the cost-effectiveness of aRCT in Japan with a cost-utility analysis (CUA). Methods : We used CUA to estimate the cost-effectiveness of aRCT against septic RCT (sRCT) which is thought to be commonly performed in Japan, and evaluated CUA using the incremental cost-effectiveness ratio (ICER). The ICERs were compared with criteria. The expected costs of aRCT were estimated using the fees of Medicaid in the United States and the scheduled fees of the Swedish medical insurance system. The expected cost of sRCT and endodontic surgery (ES) were estimated using the fees of the Japanese reimbursement system. The utility of RCT and ES were quantified with quality-adjusted life years (QALY) calculated by the QOL value of one tooth loss, the rate of RCT failure, and the life expectancy of the median age of the Japanese population. Results : In Japan, the ICERs of aRCT compared with sRCT were lower than the smallest criterion, 5,000,000 yen. Conclusion : The results of this study revealed that aRCT may be a cost-effective procedure in Japan.