Appendix
Table S1: Costs
For the basecase analysis, patients were assumed to be enrolees of the private insurance. In addition,
we calculated costs for enrolees of the statutory, i.e. public, German health insurance. The public
insurance fully reimburses most, but not all treatments (implants, crowns, professional dental cleaning,
i.e. scale and polish etc.). Those fees not covered by the public fee catalogue (BEMA) are calculated
via the private fee catalogue (GOZ, or, for certain items, the private medical fee catalogue GOÄ). The
private insurance covers all performed treatments; we used the standard multiplication factor (×2.3) to
determine private prices. Laboratory costs were estimated using the respective fee catalogue (L).
For the calculations, the number of treatments (N) was assumed to be ‘1’ if not indicated otherwise.
Costs provided to one tooth only are highlighted in yellow. Services which were provided to more than
one tooth (e.g. clinical examination, treatment planning, oral hygiene assessment and advice,
antibiotics) were distributed among the teeth present. Sub-tables present costs per course of treatment.
Antibiotic courses during initial or follow-up treatments did not generate costs for the prescription (as
patients had not attended for prescription only, but further assessment, advice and treatment, which
prohibits separately charging for the prescription). Thus, only costs for the medication were charged,
assuming prescription of amoxicillin 3×500 mg (minimum package size: 14.49 Euro) and metronidazole
(3×400 mg, 18.58 Euro). Costs were estimated from pharmaceutical price lists for 2015
(http://www.medizinfuchs.de).
Deep scaling and root planing
Clinical examination
Position
BEMA/GOÄ/GOZ
01
Sensitivity testing
8
Radiographic
assessment
Anaesthesia
925a
10.68
5000
5.24
40/41a
11.34
0090/0100
8.41
Periodontal treatment
plan
Scaling and root
planing
Post-surgical control
4
34.71
4000
20.70
P201
23.14
4075
16.82
8.90
4150
0.91
Treatment
111
Euro
GOZ
Euro
16.02
0010
12.94
5.34
0070
6.47
Distributed costs
78.09
55.21
Single tooth costs
32.04
17.73
Surgical flap debridement
Clinical examination
Position
BEMA/GOÄ/GOZ
01
Sensitivity testing
8
Radiographic
assessment
Anaesthesia
GOÄ925a
10.68
5000
5.24
40/41a
11.34
0090/0100
8.41
Periodontal treatment
plan
Flap debridement
4
34.71
4000
20.70
P203
30.26
4100
35.57
Post-surgical control
111
8.90
4150
0.91
Treatment
Euro
GOZ
Euro
16.02
0010
12.94
5.34
0070
6.47
Distributed costs
78.09
55.21
Single tooth costs
39.16
36.48
Root resection (amputation*, hemisection*, premolarisation**)
Clinical examination
Position
BEMA/GOÄ
01
Sensitivity testing
8
Radiographic
assessment
Anaesthesia
GOÄ925a
10.68
5000
5.24
40/41a
11.34
0090/0100
8.41
Periodontal treatment
plan
Flap debridement
4
34.71
4000
20.70
P203
30.26
4100
35.57
Root resection
47b
64.08
3130
36.22
Post-surgical control
111
8.90
4150
0.91
Treatment
Euro
GOZ
Euro
16.02
0010
12.94
5.34
0070
6.47
Distributed costs
78.09
55.21
Single tooth costs
103.24
72.70
* only covered by the public insurance if a continous arch or a prosthetic restoration is maintained
** only covered by private insurance (i.e. cost estimations only via GOZ)
Tunneling
Clinical examination
Position
BEMA/GOÄ/GOZ
01
Sensitivity testing
8
Radiographic
assessment
Anaesthesia
GOÄ925a
10.68
5000
5.24
40/41a
11.34
0090/0100
8.41
Periodontal treatment
plan
Flap debridement
4
34.71
4000
20.70
P203
30.26
4100
35.57
Tunneling
4136
25.87
4136
28.87
Post-surgical control
111
8.90
4150
0.91
Treatment
Euro
GOZ
Euro
16.02
0010
12.94
5.34
0070
6.47
Distributed costs
78.09
55.21
Single tooth costs
65.03
65.35
Supportive periodontal therapy
Treatment
Position
GOZ
Euro
Oral hygiene
assessment
1000
Scale and polish
1040
3.62
Antiseptic irrigation
4020
5.82
Fluoridation
1020
6.47
24.80
Distributed costs
37.09
Single tooth costs
3.62
Composite restoration
Treatment
Position
Euro
GOZ
Euro
11.34
0090/0100
8.41
2040
8.41
BEMA/GOÄ/GOZ
Anaesthesia
40/41a
Special
measurements during
restorative therapy
12
8.90
Adhesive restoration,
one surfaces
13a
2060
68.17
28.48
Single tooth costs
84.99
48.82
Root canal treatment
Treatment
Position
BEMA/GOÄ/GOZ
Euro
GOZ
Euro
Sensitivity testing
8
5.34
0070
6.47
Radiographic
assessment1
GOÄ925a
Anaesthesia
40/41a
Rubberdam1
5000
32.04
5.24
11.34
0090/0100
8.41
12
8.90
2040
8.41
Direct core build-up
13b
34.71
2180
19.40
Vital pulp exstirpation1
28
48.06
2360
42.69
Root canal treatment1
32
77.43
2140
152.13
Root canal filling1
35
45.39
2440
100.11
Single tooth costs
1 n=3
283.19
355.80
Full metal crown
Treatment
Position
BEMA/GOÄ/GOZ/L
Euro
GOZ
Euro
Sensitivity testing
8
5.34
0070
6.47
Radiographic
assessment
GOÄ925a
Anaesthesia
40/41a
Special measurements
during restorative
therapy
12
Temporary crown
19
Crown full metal
20a
5000
10.68
11.34
5.24
0090/0100
8.41
2030
8.41
14.77
2270
34.93
115.01
2210
217.06
8.90
Dental materials
22.07
22.07
Laboratory
Situation model1
0010
11.48
0010
11.48
Used resin
0023
12.14
0023
12.14
Single-tooth dye
0051
9.19
0051
9.19
Occludator
0120
8.42
0120
8.42
Full-metal crown
1021
72.27
1021
72.27
Non-precious metal
alloy
9700
11.68
9700
11.68
Delivery2
9330
15.92
9330
15.92
Single tooth costs
329.21
443.69
1 n=2
2 n=3
Tooth removal
Treatment
Position
BEMA/GOÄ/GOZ
Radiographic
assessment1
GOÄ925a
Anaesthesia
40/41a
Extraction multirooted tooth
44
Single tooth costs
1 N=2
Euro
GOZ
Euro
5000
21.36
11.34
5.24
0090/0100
8.41
3010
14.23
13.35
46.05
27.88
Dental material costs used in surgery
Alginate impression (2.15)
Siloxane impression (9.96)
Bite registration material (9.96)
per crown: 2 alginate, 1 siloxane, 1 bite registration: 22.07 Euro in total
Table S2: Mean (SD) total treatment costs per retention year and patient. Estimations were
based on the assumption of a privately insured patient (basecase). Differences between
groups are indicated in bold (p<0.05, ANOVA).
Parameter
Patients‘age at T0
N
Total treatment costs per
year
<50
≥50
123
256
male
female
159
220
139.84 (524.00)
136.45 (195.41)
Aggressive periodontitis
Chronic periodontitis
68
311
145.46 (266.44)
136.12 (394.79)
≥24
258
141.45 (584.39)
<24
121
136.20 (204.73)
Gender
Diagnosis
Number of teeth at T0
Smoking status
Non-smoker
86
117.55 (143.23)
Former smoker
244
139.12 (700.60)
Smoker
49
147.67 (313.27)
0/1
153
117.21 (142.72)
2
101
99.65 (50.65)
3
124
194.80 (626.29)
Maximum FI at T1
Tab. S3: Association of patients’ costs per total follow-up time with patient-level variables. Basecase
(privately insured patient) analyses are shown. Significant associations are highlighted in bold.
Parameter
N
Patients‘age at T0 (per year)
Gender
Mean difference (95% CI)
p-value
0.02 (0.00/0.03)
0.085
male
female
159
220
0.15 (-0.02/0.33)
0.085
Aggressive periodontitis
Chronic periodontitis
68
311
-0.13 (-0.40/0.15)
0.365
0.00 (-0.02/0.02)
0.900
Diagnosis
Number of teeth at T0
Smoking status
Non-smoker
86
-
-
Former smoker
244
-0.45 (-0.67/-0.23)
<0.001
Smoker
49
0.35 (0.06/0.65)
0.018
0/1
153
-
-
2
101
-0.07 (-0.28/0.14)
0.506
3
124
0.52 (0.32/0.72)
<0.001
Maximum FI at T1