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Evaluating the Impact of Virtual Surgical Planning on National Trends in Orthognathic Surgery
Yida Cai BA, Samuel Boas BS, Arvin Smith BS, Lesley Summerville BS, Michael Wells BS, Stephen B Baker MD, DDS, Anand Kumar MD
Case Western Reserve University School of Medicine
2020-01-31
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 abstract represents the medical students and residents' 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 the treatment of dentofacial conditions by eliminating the need for dental labs. We hypothesize that the introduction of VSP in 2010 significantly reversed a decrease of procedural volume in the prior decade. The aim of this study is to evaluate orthognathic surgical trends in volume using the National Inpatient Sample (NIS).
Methods: The NIS was analyzed from January 2007 to December 2014. All patients who were diagnosed with dentofacial and malocclusion conditions and subsequently underwent orthognathic surgery were included. Regression discontinuity design (RDD) was used to analyze the effect of VSP on procedure volume in the years following.
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 = 0.01) increase in procedure volume by 26.9 percentage points (95% CI: 13.2 to 40.5%). The regression additionally identified a slight decreasing trend in procedure volume from January 2007 to January 2010 (Coefficient = -161.8, p = 0.075).
Conclusions: Our study demonstrated a significant increase in orthognathic surgery that was correlated with adoption of VSP. This increased volume of procedures is a interruption of a decreasing trend in the prior decade. Further studies will evaluate the impact of VSP on cost and hospital length of stay.
