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Of these, 43 were randomised to the Restorative treatment group (ReTG) and 32 to the Extraction treatment group (ExTG). Healthcare costs were calculated from dental records, while non-healthcare costs, were collected through surveys. Effectiveness was measured using the Child Perceptions Questionnaire (CPQ11-14) and the proportion of patients achieving a minimally important difference (MID). Incremental cost-effectiveness ratios (ICERs) were calculated as the difference in costs divided by the difference in effectiveness between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The ExTG incurred higher mean healthcare (\u20ac1,417 vs. \u20ac1,051;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029) and total costs (\u20ac2,950 vs. \u20ac2,161;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029) compared with the ReTG, almost entirely due to general anaesthesia (GA), while non-healthcare costs were (\u20ac1,531 vs. \u20ac1,111;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.117). When patients treated under GA were excluded, the ExTG became less costly, with lower healthcare costs (\u20ac868 vs. \u20ac1,051;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039), fewer visits (9.2 vs. 11.4;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025), and shorter chair time (324 vs. 401\u00a0min;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040). ICERs showed that with GA, extraction was associated with higher incremental costs per MID responder (\u20ac2,593 healthcare; \u20ac6,110 total). Without GA, extraction was either dominant when only healthcare costs were considered or showed a cost of \u20ac4,201 per MID responder when considering total costs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with restorative treatment, extraction was associated with higher healthcare and total costs, primarily due to general anaesthesia, but also linked with a greater proportion of patients achieving clinically meaningful improvements in oral health-related quality of life at the age of 11\u00a0years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>The study was retrospectively registered on ClinicalTrials.gov 29th of January 2024, registration number: NCT06228989.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-025-07633-4","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T14:05:00Z","timestamp":1768226700000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["GuREx-MIH: cost-effectiveness analysis of extraction versus restorative treatment for first permanent molars affected by Molar-Incisor Hypomineralisation in 11-year-old Swedish children"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3707-6303","authenticated-orcid":false,"given":"Adnan","family":"Hajdarevi\u0107","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5139-0300","authenticated-orcid":false,"given":"Emina","family":"\u010cirgi\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7634-9423","authenticated-orcid":false,"given":"Birgitta","family":"J\u00e4levik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agneta","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Fagrell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1113-7478","authenticated-orcid":false,"given":"Mikael","family":"Svensson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6707-4811","authenticated-orcid":false,"given":"Nina","family":"Sabel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"issue":"5","key":"7633_CR1","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1159\/000047479","volume":"35","author":"KL Weerheijm","year":"2001","unstructured":"Weerheijm KL, J\u00e4levik B, Alaluusua S. 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