Does three-dimensional imaging offer a financial benefit for treating maxillary molars with furcation involvement? - A pilot clinical case series

Abstract

Aim: To assess the financial benefit of cone beam computed tomography (CBCT) for the treatment options of maxillary molars including periodontal surgery and extraction followed by implant placement. Material and methods: Twelve patients with generalized chronic periodontitis were recruited, and CBCT was performed in maxillary molars (n = 22) with clinical furcation involvement and increased probing pocket depths. Treatment recommendations were either based on conventional periodontal diagnostics (clinical examinations and periapical radiographs), or based on the additional CBCT data. Clinical recommendations comprised a minimal (e.g. supportive periodontal treatment) and a maximal invasive therapy (e.g. extraction and implant placement), and these were compared with CBCT-based recommendations. According to the Swiss dental tariff structure, the probabilities of saving costs or time, and the numbers needed to treat were analysed with an empirical cumulative distribution function. Results: Average cost reduction from CBCT amounted to CHF 915 ± 1470 and saved 136 ± 217 min. Greatest reductions were found with maximal invasive clinically based treatment decisions (CHF 1566 ± 1840), particularly for second molars (CHF 2485 ± 2226). To compensate CBCT costs, 1.7 subjects were needed to treat to at least break even. Conclusions: Data from CBCT facilitated a reduction in treatment costs and time for periodontally involved maxillary molars in Switzerland. Based on these cost analyses, however, CBCT as additional diagnostic measure is justified only when more invasive therapies are planned. © 2011 John Wiley & Sons A/S.