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Did Virtual Surgical Planning Make Orthognathic Surgery Cheaper and Safer? A Study of National Trends in Orthognathic Surgery
Yida Cai BA, Ashley Rogers MD, Mohamed Awad MD, Samuel Boas BS, Arvin Smith BS, Marvin Nicoleau BA, Lesley Summerville BS, Stephen Baker MD, Anand Kumar MD
Case Western Reserve University School of Medicine
2020-02-11
Presenter: Yida Cai
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The submitted work represents the authors' original work
Director Name: Anand Kumar MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Purpose: The introduction of virtual surgical planning (VSP) revolutionized orthognathic surgery by reducing pre-surgical planning times and eliminating the need for a dental lab. We hypothesize that the introduction of VSP in 2010 significantly reduced hospital length of stay (LOS) and charges for these procedures. The aim of this study is to evaluate national trends in LOS and charges for orthognathic surgery.
Methods: The NIS was analyzed from January 2007 to December 2014. All patients who were diagnosed with dentofacial and malocclusion conditions and underwent orthognathic surgery were included. Regression discontinuity design (RDD) was used to analyze the effect of VSP on LOS and charges.
Results: 111,367 patients were diagnosed with dentofacial conditions, including facial hypoplasia (36,284, 32.6%), cleft palate (10,856, 17.0%) and other conditions (56,140, 50.4%). 43,900 (39.4%) received orthognathic surgery including: osteoplasty of the maxilla (29,985, 68.3%), osteoplasty of the mandible (9,633, 21.9%), genioplasty (1,386, 3.2%) or other (2,898, 12.8%).
RDD with a cut-off of 2010 showed a significant (p = 0.02) decrease in LOS by 17% (95% CI: 7.4 to 26%). Charges did not change sharply in 2010 (p = 0.4), but rose significantly (p< 0.001) throughout the study period.
Conclusions: Our study demonstrated a significant decrease in LOS correlated with adoption of VSP. Additionally, although the adoption of VSP had no sharp effect on charges, they have risen significantly. This increase cannot be accounted for by the increased costs associated with VSP alone. Future studies will better identify factors influencing hospitalization charges associated with orthognathic surgery.
