Is there a Difference in Cost between Standard and Virtual Surgical Planning for Orthognathic Surgery?

Abstract Purpose Virtual surgical planning (VSP) and three-dimensional (3D) printing of surgical splints are becoming the standard of care for orthognathic surgery, but costs have not been thoroughly evaluated. The purpose of this study was to compare the cost of VSP and 3D printing of splints (“VSP”) versus two-dimensional cephalometric evaluation, model surgery, and manual splint fabrication (“standard planning”). Materials and Methods This is a retrospective cohort study including patients planned for bimaxillary surgery from January 2014 to January 2015 at Massachusetts General Hospital. Subjects were divided into 3 groups by case type: symmetric, nonsegmental (Group 1), asymmetric (Group 2) and segmental (Group 3). All cases underwent both VSP and standard planning with times for all activities recorded. The primary and secondary predictor variables were method of treatment planning and case type, respectively. Time-driven activity-based micro-costing analysis was used to quantify the differences in cost. Results were analyzed using a paired t-test and ANOVA. Results The sample included 43 subjects (19 Group 1, 17 Group 2, and 7 Group 3). The average times and costs for VSP were 194±14.1 minutes and $2765.94, and for standard planning were 540.9±99.5 minutes and $3519.18. The average times and costs for VSP for the simple group were 188±17.8 minutes and $2,700.52, and for standard planning were 524.4 ± 86.1 minutes and $3,380.17. The average times and costs for the asymmetric group were 187.4±10.9 minutes and $2,713.69 for VSP and 556.1±94.1 minutes and $3,640.00 for standard planning. For the segmental group, the average times and costs were 208.8±13.5 minutes and $2,883.62 for VSP and 542.3±118.4 minutes and $3,537.37 for standard planning. All time and cost differences were statistically significant (p < 0.001). Conclusion The results of this study indicate that VSP for bimaxillary orthognathic surgery utilizes significantly less time and is less expensive than standard planning for the 3 types of cases analyzed.