Endocrowns have been proposed as an alternative to post-and-core retained complete crowns for structurally compromised endodontically treated teeth. However, an analysis of their cost-effectiveness is lacking. The purpose of this simulation study was to assess the cost-effectiveness of an endocrown versus a complete crown as a definitive restoration for structurally compromised endodontically treated teeth. A Markov simulation model was constructed with endodontically treated permanent molar teeth using TreeAge Pro Healthcare (2023) as a starting point for an 18-year-old patient. Costs were extrapolated from the ADA dental survey based on the United States healthcare, and the probabilities of transition were derived from existing literature. The cost-effectiveness was determined by using Monte Carlo microsimulations. A sensitivity analysis was performed to validate the model internally, whereas an experienced health expert and an endodontist performed the face validation. The complete crown was associated with additional health benefits (1.36 and 0.9 more years over a period of 5 years and lifetime, respectively) but at an increased cost (an additional 1143 USD and 1535 USD over a period of 5 years and lifetime, respectively). Moreover, the endocrown was cost-effective at lower Willingness-To-Pay (WTP) values (92% acceptable at 250 USD for 5 years and 73% acceptable at 250 USD for the lifetime of an individual), whereas at increased WTP threshold values, the complete crown was a cost-effective restoration (98.6% acceptable at 1250 USD for 5 years and 99.5% acceptable at 8000 USD over an individual’s lifetime). The endocrown was a cost-effective restorative option at lower WTP values. However, at an increased WTP threshold, the complete crown became a more cost-effective restoration.

中文翻译：

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牙髓治疗牙齿的修复：内冠与全冠的成本效益分析

对于结构受损的牙髓治疗牙齿，内冠已被提议作为桩核保留全冠的替代品。然而，缺乏对其成本效益的分析。该模拟研究的目的是评估内冠与全冠作为结构受损的牙髓治疗牙齿的最终修复体的成本效益。使用 TreeAge Pro Healthcare (2023) 作为一名 18 岁患者的起点，使用经过牙髓治疗的恒磨牙构建了马尔可夫模拟模型。成本是根据 ADA 牙科调查（基于美国医疗保健）推断出来的，过渡的概率则来自现有文献。成本效益是通过使用蒙特卡罗微观模拟来确定的。进行敏感性分析以在内部验证模型，而经验丰富的健康专家和牙髓病医生则进行面部验证。全冠与额外的健康益处相关（在 5 年期间和终生期间分别增加 1.36 和 0.9 年），但成本增加（在 5 年期间和终生期间分别额外增加 1143 美元和 1535 美元） 。此外，在支付意愿 (WTP) 值较低的情况下，内冠具有成本效益（在 5 年 250 美元的情况下 92% 可以接受，在个人一生中 250 美元的情况下 73% 可以接受），而在 WTP 阈值增加的情况下，内冠具有成本效益。 ，全冠是一种具有成本效益的修复体（5 年 1250 美元，98.6% 可以接受，一生 8000 美元，99.5% 可以接受）。内冠是一种具有较低 WTP 值且具有成本效益的修复选择。然而，随着支付意愿门槛的提高，全冠成为一种更具成本效益的修复体。