ArticleBMJ open2026
Economic evidence on provider-level implications of direct posterior amalgam alternatives following the EU phase-out: a scoping review.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo map and characterise economic evaluations (EEs) and provider-level cost/resource reporting related to direct posterior restorative alternatives following the European Union (EU) dental amalgam phase-out.
designScoping review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidance. DATA SOURCES: PubMed, Embase, Web of Science, CINAHL and LIVIVO (ZB MED search portal for life sciences (Germany)). ELIGIBILITY CRITERIA: Peer-reviewed studies (English/German; 1 January 2021-22 February 2026) reporting EEs or cost/resource-use components for direct posterior restorations in permanent teeth. DATA EXTRACTION AND SYNTHESIS: Data were charted using a predefined extraction framework focusing on analytic perspective, time horizon, modelling approach and granularity of provider-level resource components. Two reviewers independently screened records and charted data; disagreements were resolved by discussion and, if needed, by consultation with a third reviewer.
resultsSix studies met the inclusion criteria (four model-based or trial-based EEs; two cross-sectional surveys). Most analyses adopted payer, societal or mixed perspectives and used decision-analytic models with medium- to long-term horizons. Outcomes included cost per complication-free month, cost per tooth-year retained and lifetime cost projections. Detailed provider-level reporting (eg, chair time, personnel allocation, overheads or warranty-related retreatment burden) was limited, and survey evidence relied on self-reported estimates. Heterogeneity in methods and metrics precluded quantitative synthesis.
conclusionsEconomic evidence regarding direct posterior restorative alternatives after the EU amalgam phase-out is sparse and primarily based on modelled or reimbursement-derived inputs from payer, societal or mixed perspectives, rather than explicitly measured provider-level microcosting. Greater transparency in analytic perspective and microcosting components may support evidence-informed adaptation to restorative material substitution policies.
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Registered trials
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