Dental technology services and industry trends in New Zealand from 2010 to 2012.

OBJECTIVE: To provide a snapshot of the New Zealand dental technology industry and influencing factors. BACKGROUND: Developing an understanding of the commercial dental laboratory environment in New Zealand can provide insight into the entire dental industry. METHODS: A web-based survey was the primary method for data collection, with separate questionnaires used for dental laboratory owners and dental technician employees. RESULTS: The mean net income for dental laboratory owners in New Zealand was similar to that of the United Kingdom, at $40.50 per hour. Clinical dental technicians are the highest paid employees, with a mean of $33.49 per hour. The mean technical charge for complete dentures was $632.59; including clinical services, it was $1907.00. The mean charge for a porcelain-fused-to-metal (PFM) crown was $290.27. Dental laboratory owners expressed fear about the possibility of losing dental clients to overseas laboratories due to the availability and cheap charge of offshore work. Only 25.4% of dental laboratories surveyed had computer-aided design (CAD) facilities, and even fewer (7.9%) had computer-aided manufacturing (CAM) systems. CONCLUSION: Clinical dental technology appears to be prospering. The dental technology industry appears to be adapting and remains viable, despite facing many challenges.

Cost-effectiveness of endodontic molar retreatment compared with fixed partial dentures and single-tooth implant alternatives.

INTRODUCTION: One of the most challenging situations in dentistry is a failed root canal treatment case. Should a failed root canal-treated tooth be retreated nonsurgically or surgically, or should the tooth be extracted and replaced with an implant-supported restoration or fixed partial denture? These four treatment alternatives were compared from the perspective of cost-effectiveness on the basis of the current best available evidence. METHODS: The costs of the four major treatment modalities were calculated using the national fee averages from the 2009 American Dental Association survey of dental fees. The outcome data of all treatment modalities were retrieved from meta-analyses after electronic and manual searches were undertaken in the database from MEDLINE, Cochrane, ISI Web of Knowledge, and Scopus up to April 2010. The treatment strategy model was built and run with TreeAge decision analysis software (TreeAge Software, Inc, Williamstown, MA). RESULTS: Endodontic microsurgery was the most cost-effective approach followed by nonsurgical retreatment and crown, then extraction and fixed partial denture, and finally extraction and single implant-supported restoration. CONCLUSIONS: The cost-effectiveness analysis showed that endodontic microsurgery was the most cost-effective among all the treatment modalities for a failed endodontically treated first molar. A single implant-supported restoration, despite its high survival rate, was shown to be the least cost-effective treatment option based on current fees.

Long-term cost-effectiveness of single indirect restorations in selected dental practices.

OBJECTIVE: To determine the relative cost-effectiveness of alternative methods for restoring large tooth substance loss in adults. METHODS: Long-term survival estimates and discounted costs for 245 large indirect restorations were used to calculate their incremental cost-effectiveness over 15 years when compared with direct placement Class II cusp-overlay amalgams and Class IV multisurface resin composites, placed in 100 patients from three private dental practices. RESULTS: The direct placement restorations were more cost-effective than the indirect restorations at all time intervals over the 15-year study period. The full gold crown and the ceramometal crown were the most cost-effective indirect posterior and anterior restorations respectively. The cast gold onlay and the porcelain jacket crown were the least cost-effective indirect posterior and anterior restorations respectively. CONCLUSIONS: When clinically practicable, large direct placement restorations should be placed initially in preference to indirect restorations.

Long-term survival and cost-effectiveness of five dental restorative materials used in various classes of cavity preparations.

This retrospective study examined the survival and cost-effectiveness of five different types of dental materials used to restore various classes of cavity preparations in permanent teeth. Information on the restorations was obtained from the casenote records of 100 long-term adult patients treated at various times by 20 dentists in three city practices. Patients attended for checkups and restorative treatments on a regular basis for around 25 years on average, ranging from 10 to 46 years. All of the restorative materials lasted well, despite the frequent patient checkups and changes of dentists. Cusp-covered amalgams were approximately 3.8 times more cost-effective than were either cast gold or ceramometal crowns, and resin composites were approximately 3.7 times more cost-effective than were cast gold inlays for restoring Class IV preparations. However, there were no significant differences found in the cost-effectiveness of using either resin composites or glass-ionomer cements to restore Class III preparations, or between using either of these two materials, or amalgams, to restore Class V preparations.

Alternatives to gold.

Despite, or perhaps because of, its antiquity the lost wax casting process which we use in dentistry still produces the most accurate and durable restorations in our armamentarium. Although high-gold content alloys still act as the benchmark of quality, fit, and durability in the aggressive conditions of the mouth, their inherent cost, high density and low modulus have stimulated a search for alternatives. This has ranged widely through the metallurgical world and across the periodic table of the elements. As a result dental alloys for casting into inlays, crowns and bridges (with or without facings of dental porcelain) have become incredibly complex. This article will explain some of the reasons behind the developments.

Quantification of noble alloy used in 'porcelain-fused-to-metal' restorations.

High costs of gold alloys used in metal substructures of ceramo-metal restorations increase the cost of restorative treatment. This study determined the per unit weight of a noble metal alloy used in ceramo-metal crowns and three-unit fixed-partial dentures. Generally, tooth size and extent of the metal substructure determined the quantity of alloy used.