The aim of this study was to analyze the costs and effectiveness of fixed orthodontic treatment by closing loop mechanics and sliding mechanics in the Orthodontic Clinic of the Faculty of Dentistry, Mahidol University, in fiscal year 2005. Cost components of both methods of treatment in provider perspective were identified and valued in term of capital and recurrent costs. The study population was consisted of 3 parts: dental records, dental casts and panoramic radiographs of 47 complete cases aged 12-18 years at the start of the treatment with class I malocclusion. Most of the patients were treated during 1988-2004 by postgraduate students under supervision of the Orthodontic Department. The research tools consisted of data recording forms for costing, and record forms for scoring effectiveness. According to the criteria of the American Board of Orthodontics (ABO), scores was divided into 3 levels: good (<20), acceptable (21-30) and unacceptable (>30). Data were analyzed using t-tests for independent groups. Sensitivity analysis was performed to allow for uncertainty by testing whether plausible changes in the values of main variables affect the results of the analysis. The results indicated that unit cost of fixed orthodontic treatment for closing loop mechanics and sliding mechanics was 36,810.04 baht at the average treatment duration 32.61 months, and 35,985.30 baht at the average treatment duration 34.36 months. The mean ABO score for the closing loop mechanics was 28.52 +_ 4.71 compared with 26.50 +_ 5.60 for the sliding mechanics. There was no significant difference in effectiveness scores between closing loop mechanics and sliding mechanics. It was recommended that resource management strategies, especially the human resource management, should be reconsidered to decrease costs by having suitable working time allocations. Supervision to monitor treatment duration could be adjusted to reduce the treatment time. In terms of effectiveness, instructors should pay more attention to marginal ridge and contact point before having the appliance removed by the students.

M.Sc. (PUBLIC HEALTH) HOSPITAL ADMINISTRATION คณะ FACULTY OF PUBLIC HEALTH มหาวิทยาลัยมหิดล ปี 2548

effectiveness, Cost, Treatment, APPLIANCES, FIXED, ORTHODONTIC