# Universal Dental Adhesives: Cost-Effectiveness and Duration of Use
## 3 Results  
The number of days and applications for each adhesive were as follow: SB adhesive lasted for 39 days with 192 applications; TN lasted for 37 days and 185 applications, OB for 20 days and 98 applications, and GP for 38 days and 188 applications. Descriptive statistics are illustrated in Table 3 and Figure 1. \begin{table}
\begin{tabular}{l l} \hline
1. & Basic parameters: \\  & a. & Price per mL (P\({}_{\text{mL}}\)) = P/C \\  & b. & Application per mL (A\({}_{\text{mL}}\)) = \(\Delta\)A/C \\  & c. & Price of each application = P/\(\Sigma\)A \\  & d. & \(\Sigma\)W = Waste in applicator + waste in dosing plate (not applicable for TN) \\
2. & CEA parameters: \\  & a. & Total amount utilized per day = \(\Sigma\)U\({}_{\text{day}}\) \\  & b. & Total waste per day = \(\Sigma\)W\({}_{\text{day}}\) \\  & c. & Efficacy = \(\frac{\Sigma\cup_{\text{day}}}{\Sigma\cup_{\text{day}}}\) \\  & d. & Efficiency = Efficacy\(\times\frac{\Delta_{\text{min}}}{\Sigma\cup_{\text{min}}}\) \\  & e. & ACER = \(\frac{\Delta_{\text{day}}}{\Sigma\cup_{\text{day}}}\) \\  & f. & ICER = \(\frac{\Delta_{\text{Poisson}}\cdot-\text{P}_{\text{SB}}}{\Sigma\cup_{\text{ absence}}\cdot-\text{L}_{\text{SB}}}=\frac{\text{AP}}{\Delta\Sigma\text{U}}\) \\ \hline \end{tabular} \(\text{P}=\text{price}\), C = adhesive capacity, \(\Sigma\)A = total number of applications, \(\Sigma\)W = total waste, \(\Sigma\)D\({}_{\text{day}}=\text{total amount of adhesive dispensed per day}\).  
\end{table} 
Table 2: Equations used for basic and cost-effectiveness analysis parameters. Assessing the assumption of normality with the Shapiro-Wilk test, it was significant in all of the test groups under each CEA parameter except the total amount of adhesive utilized per day. Accordingly, the nonparametric independent-samples Kruskal-Wallis test and Dunn's test with Bonferroni correction for post hoc comparison were used among all of the CEA parameters for days of application in order to standardize the statistical analysis method. The independent-samples Kruskal-Wallis test was significant (\(p<0.001\)) for all CEA parameters except ICER (\(p=0.112\)). In terms of the total amount utilized per day, TN and SB groups were associated with the highest median (0.019 mL (IQR = 0.02, 0.02)), and the least was in the GP group (0.006 mL (IQR = 0.00, 0.01)). Post hoc comparison revealed significant differences among all of the groups except between the TN and SB groups and the SB and OB groups. For the total waste per day, the median amount of waste was found the least in the TN group (0.031 mL (IQR = 0.03, 0.03)). The highest amount of waste was in the OB group (0.758 mL (IQR = 0.69, 0.82)). Post hoc testing showed a significant difference between all of the groups except between the SB and OB groups. With regards to efficacy and efficiency, TN was the most effective and efficient with median efficacy and efficiency value of 0.337 and 3333.089, respectively. GP was the least effective with median value of 0.062, and SB was the least efficient with median value of 0.366. For efficacy post hoc comparison, there was a significant difference between all of  
Figure 1: Whisker plots showing the study parameters: (**a**) efficacy, (**b**) efficiency, (**c**) ACER, and (**d**) ICER. SB: Single-Bond Universal, TN: Tetric N-Bond Universal VivaPen, OB: OptiBond All-In-One, GP: G-Premio Bond. \begin{table}
\begin{tabular}{c c c c c c c c c} \hline \hline
**Dental** & **Number of** & **Applications/** & **Price/** & **Total** & & & & \\
**Adhesive** & **Applications** & **mL** & **Application (USD)** & **Waste (mL)** & **Efficacy** & **Efficiency** & **ACER** & **ICER** \\ \hline SB & 192 & 38.4 & 0.43 & 3.37 & 0.157 & 0.366 & 104.529 & NP \\ TN & 185 & 92.5 & 1.15 & 1.14 & 0.337 & 3333.089 & 316.546 & 504.625 \\ OB & 98 & 19.6 & 0.86 & 1.5 & 0.081 & 26.811 & 206.104 & \(-\)76.070 \\ GP & 188 & 37.6 & 0.51 & 1.73 & 0.062 & 44.637 & 310.612 & 19.089 \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Median values of the tested parameters. the groups except between OB and GP.