Cost-Benefit Analysis of the Age One Dental Visit for the Privately Insured

PURPOSE

The purpose of this study was to perform a cost-benefit analysis of the age one dental visit for privately insured patients.

METHODS

A major insurance company provided claims from various states submitted between 2006-2012. Data provided included numbers of procedures and respective costs from the first visit until age six years. Data was organized into five groups based on age, for which the first D0145/D0150 code was submitted [(1) age younger than one year old; (2) age one or older but younger than two years old; (3) age two or older but younger than three years old; (4) age three or older but younger than four years old; and (5) age four or older but younger than five years old]. The ratio of procedures per child and average costs per child were calculated.

RESULTS

Claims for 94,574 children were analyzed; only one percent of these children had their first dental visit by age one. The annual cost for children who had their first dental visit by age one was significantly less than for children who waited until an older age.

CONCLUSION

There is an annual cost benefit in establishing a dental home by age one for privately insured patients.

Alloys for prosthodontic restorations

The numbers and types of alloys for prosthodontic restorations have increased dramatically over the past 25 years, making selection of an alloy for a given clinical situation difficult. Factors such as cost, the need for better strength, and worries about alloy corrosion have pressured the alloy market to change significantly. A number of properties--including yield strength, hardness, elastic modulus, microstructural phases, grain size, corrosion performance, coefficient of thermal expansion, oxide color, and melting range--are relevant to the proper selection of an alloy for a given clinical problem. In this article, a brief historical look at prosthodontic alloys and the nomenclature for alloys is followed by a discussion of the most important physical properties of alloys for clinical practice. A summary of the types of alloys available today and their classification is then presented. Finally, speculations about future trends for alloys are made, and simple guidelines are suggested to help dentists choose appropriate alloys for their practices. This review excludes implant alloys, dental amalgam, and alloys for orthodontic and endodontic applications.

Dentists' opinions on aspects of cast titanium restorations

OBJECTIVES

The purpose of this paper was to study dentists' opinions regarding aspects of the clinical use of cast titanium restorations.

METHODS

Since 1988 more than 10,000 cast titanium units of crowns and fixed partial dentures have been produced by the only dental laboratory that produces cast titanium restorations in Norway. A questionnaire on the clinical behaviour of such restorations was mailed to all 72 dental practitioners who were recorded in the computer file of this laboratory.

RESULTS AND CONCLUSION

In the opinion of the 64 dental practitioners who completed the questionnaire, cast titanium is a useful supplement to conventional casting alloys, particularly because of its favourable cost. It has a satisfactory clinical behaviour, although there may be some problems related to technical and aesthetic aspects.

An evaluation of casting alloys used for restorative procedures

Dental casting alloys have played a major role in the restorative process for three-quarters of a century. Gold-based compositions were used almost exclusively for most of that time-but because of their relatively high cost, they began to be replaced by a number of base metal alloys. This article discusses some of the most recent findings about the composition of alloy systems and the possible tissue responses to those systems.

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.

Metal-ceramic bridges from commercial dental laboratories: alloy composition, cost and quality of fit

The quality of construction of fixed bridge prostheses directly affects their long-term survival. The cost, alloy composition and marginal fit of bridges made by 30 commercial dental laboratories is assessed. Duplicate models of a three unit bridge preparation were sent to 30 different laboratories, as if required for a patient receiving treatment under the General Dental Service. Material was sent via general dental practitioners, requesting metal-ceramic bridges made from 45% Au alloy, precious metal or non-precious metal. Proximal contacts were overbuilt at 65% of sites and pontic tissue contacts were excessive in all but one bridge. Eight laboratories did not use alloys corresponding to the request made. The mean marginal gaps of non-precious metal bridges (145 microns) were significantly greater than those for 45% gold alloy (106 microns). Marginal fit was poor and a number of factors have been observed, with other postulated, which may have contributed to this problem.