{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:01:54Z","timestamp":1787727714770,"version":"build-2784847793"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Malocclusions occur at high frequencies in children and adolescents. While early orthodontic (interceptive) interventions may reduce the need for later comprehensive treatment, their cost-effectiveness in publicly funded health systems is unclear. This study compares the cost-effectiveness of interceptive orthodontic care and fixed-appliance therapy, focusing on total costs, treatment outcomes, and resource use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A decision tree model was developed using observational data on treatment success rates, duration, and appointments to estimate resource use and costs for interceptive orthodontic care; Fixed Appliance therapy was modeled as an optimal 2-year treatment pathway. A health-care payer perspective was applied. Incremental costs and effects were calculated for four interceptive modalities: Quad Helix, Extraoral Traction (EOT), Removable Plates, and Activator appliances, as compared to fixed appliance therapy. Minimum required success rates were estimated for achieving cost-neutrality. Probabilistic sensitivity analyses (10 000 Monte Carlo simulations) and scenario analyses assessed the robustness of the results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All the interceptive treatments demonstrated lower expected costs than the fixed appliance therapy, albeit with lower clinical effectiveness. Quad Helix exceeded the minimum required success rate 20% points, representing a clear margin of cost-effectiveness. Removable Plates also exceeded the minimum required success rate, but with a smaller margin of 6% points. The Activator and EOT appliances were more dependent on patient compliance and failed to meet the minimum required success rate, requiring increases of 13% and 10% points, respectively, to achieve cost-neutrality. Sensitivity analyses confirmed these patterns and underscored the importance of long-term treatment stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>The model assumed a 100% success rate for fixed appliances and relied on expert opinion for long-term stability parameters, given the limited availability of relapse data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the publicly funded dental care context studied, the use of Quad Helix and removable plates in publicly funded health-care systems appears to be cost-effective. Activator and EOT appliances should be used selectively. The study also contributes a transparent, adaptable modeling framework that can incorporate locally relevant costs and future long-term outcome data, supporting use in other publicly funded settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejo\/cjag022","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T12:43:42Z","timestamp":1774356222000},"source":"Crossref","is-referenced-by-count":1,"title":["Cost-effectiveness of interceptive orthodontics: a long-term evaluation of early treatment strategies"],"prefix":"10.1093","volume":"48","author":[{"given":"Sara","family":"Bj\u00f6rns","sequence":"first","affiliation":[{"name":"Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg , Box 450, 405 30 Gothenburg, Sweden"},{"name":"Department of Preventive and Community Dentistry, Public Dental Service, Region V\u00e4stra G\u00f6taland, Public Dental Service V\u00e4stra G\u00f6taland , Box 7163, 402 33 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara","family":"Leffler","sequence":"additional","affiliation":[{"name":"Department of Mathematical Sciences, University of Copenhagen , Universitetsparken 5, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Davidson","sequence":"additional","affiliation":[{"name":"Department of Health, Medicine and Caring Sciences, Link\u00f6ping University , 581 83 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-8516","authenticated-orcid":false,"given":"Anna","family":"Westerlund","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg , Box 450, 405 30 Gothenburg, 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