Background To assess the financial impact of incorporating a new (reciprocal) technology into endodontic treatments in the public health system (SUS). Methods This was a economic evaluation study (comparing the 3 different endodontic instrumentation techniques—manual, rotary and reciprocating), allocative efficiency analysis to optimize existing resources in the SUS, and financial contribution impact analysis of incorporation of a new technology. Thirty-one (31) 12 years-old volunteers were evaluated. Results The incremental cost-effectiveness ratio (ICER) was calculated at R$1.34/min, − R$0.60/min and BRL 0.10/min for the single-rooted, bi-rooted and tri-rooted teeth, respectively, when the rotary technique was compared with the manual type. In turn, the ICER was R$ 21.04/min, − R$ 0.73/min and − R$ 2.81/min for the 3 types of teeth, respectively, when the reciprocating technique was compared with the manual type. The incremental financial impact of replacing manual endodontic with rotary endodontic treatments would be − R$ 2060963.66 in the case of single-rooted teeth, but the number of treatments would also be reduced (− 19,379). In the case of two-rooted teeth, the incremental financial impact would be BRL 34921540.62 with the possibility of performing an additional 204,110 treatments. In turn, BRL 11523561.50 represented the incremental financial impact for teeth with 3 or more roots and with an increase of 72,545 procedures. When we analyzed the incremental financial impact of replacing manual endodontic with reciprocating endodontic treatments, it would be − R$ 730227.80 in the case of single-rooted teeth, allowing for an additional 2538 treatments. In turn, R$ 21674853.00 represented the incremental financial impact for bi-radicular teeth, with an increase of 121,700 procedures. In the case of two-rooted teeth, the incremental financial impact would be BRL 13591742.90 with the possibility of performing an additional 40,670 treatments. Conclusions The reciprocating technique could improve access to endodontic treatment in the SUS as it allowed a simultaneous reduction in clinical time and associated costs. However, the higher number of endodontic treatments performed would have a financial impact.

The root canal therapy consists of phases aimed at cleaning and disinfection of the root canal system. The chemomechanical preparation is the one that makes use of instruments that can be used by means of mechanized techniques (rotary and reciprocation) and manual. The present study seeks to compare the three instrumentation techniques, based on cost and outcome, using the cost – minimization analysis in the perspective of the Social Service of Commerce (SESC - Brazil), and a time horizon of 10 years. The effectiveness of the techniques were raised through literature review and selection of systematic review studies. The costs were measured by the microcosting technique, in addition to the information from the SESC databases. In the analyzed period, the study shows that the use of the rotary system can increase the capacity of care by 44,67%, while the reciprocation system by 168 %.  The financial impact would be R$ 103,683.87 and R$ 735,179.46 for the rotary and reciprocation, respectively. Using as reference the conventional technique, R$ 44.58 more is spent for the treatment with rotary instruments and R$ 84,03 for the reciprocation. Even with the highest allocating efficiency for the reciprocating technique with much greater coverage, the budget impact needs to be analyzed with caution. The incorporation of reciprocating technology demonstrating to be the technique with the highest allocating efficiency, best minimization cost ratio and reasonable cost of additional treatment in relation to other techniques.

It is a study of Financial Impact Analysis, where the financial consequences arising from the possibility of inclusion of the dentist in the Intensive Care Units (ICU), within the reality of the Unified Health System (SUS), were evaluated in Brazil. It was based on a quick review of the literature and economic evaluation with reference to the year 2018. Information on costs and hospitalizations were collected from the official databases of the Ministry of Health, the Federal Council of Medicine and the Union of Dentists of the State of São Paulo. Only the direct medical costs related to the hospitalizations were calculated. Scenarios were simulated for a time horizon of 1 year (2018) and a sensitivity analysis was made for a more optimistic scenario (values 20% lower) and another less optimistic (values 20% higher). On average, the presence of a dentist in the ICU reduces the development of pneumonia cases by 56% and 8.18 days, which represents a savings of 34.92% in hospitalization costs in the evaluated scenario. In Brazil, when hiring dentists in all ICUs, each avoided case would contribute to savings of R$ 7,949.45 (1US$ = R$ 4,02 in 30/10/2019), ranging from R$ 6,359.56 to R$ 9,539.35 in the optimistic and pessimistic scenarios, respectively, where each case avoided is higher than the dentist's monthly salary. It would be necessary to spend R$ 142,060,140.00 on hiring the dentist to cover the ICUs, making the final savings more than 865 million reais. It is concluded that the inclusion of the Dental Surgeon (DS) in ICU teams would have a positive economic impact, with savings in hospitalization costs from the perspective of SUS. The COVID-19 pandemic in Brazil, depending on the State's action in containment strategies, could require 2.17 times more in the bests of scenarios where the action of total suppression would be used. Such a situation requires emergency measures, and the role of the dentist is a strategy that can support the health system. Key messages Dental care in the ICU is an important and cost-effectiveness strategy for the control of microorganisms that act in the evolution of the pneumonia nosocomial. Such a situation requires emergency measures, and the role of the dentist is a strategy that can support the health system.

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