Is Virtual Surgical Planning in Orthognathic Surgery Faster Than Conventional Planning? A Time and Workflow Analysis of an Office-Based Workflow for Single- and Double-Jaw Surgery

Abstract

The purpose of this study was to measure and compare the working time for virtual surgical planning (VSP) in orthognathic surgery in a largely office-based workflow in comparison with conventional surgical planning (CSP) regarding the type of surgery, staff involved, and working location. This prospective cohort study included patients treated with orthognathic surgery from May to December 2016. For each patient, both CSP with manual splint fabrication and VSP with fabrication of computer-aided design-computer-aided manufacturing splints were performed. The predictor variables were planning method (CSP or VSP) and type of surgery (single or double jaw), and the outcome was time. Descriptive and analytic statistics, including analysis of variance for repeated measures, were computed. The sample was composed of 40 patients (25 female and 15 male patients; mean age, 24.6years) treated with single-jaw surgery (n=18) or double-jaw surgery (n=22). The mean times for planning single-jaw surgery were 145.5±11.5minutes for CSP and 109.3±10.8minutes for VSP, and those for planning double-jaw surgery were 224.1±11.2minutes and 149.6±15.3minutes, respectively. Besides the expected result that the working time was shorter for single-versus double-jaw surgery (P<.001), it was shown that VSP shortened the working time significantly versus CSP (P<.001). The reduction of time through VSP was relatively stronger for double-jaw surgery (P<.001 for interaction). All differences between CSP and VSP regarding profession (except for the surgeon's time investment) and location were statistically significant (P<.01). The surgeon's time to plan single-jaw surgery was 37.0minutes for CSP and 41.2minutes for VSP; for double-jaw surgery, it was 53.8minutes and 53.6minutes, respectively. Office-based VSP for orthognathic surgery was significantly faster for single- and double-jaw surgery. The time investment of the surgeon was equal for both methods, and all other steps of the workflow differed significantly compared with CSP.