Stock Plates Versus Patient-Specific Implants for Virtually Planned Orthognathic Surgery: Analysis Involving Cost and Duration of Surgery.

BACKGROUND: Patient-specific implants (PSIs) are prefabricated using virtual treatment planning to achieve the desired final orthognathic position. Although PSIs are associated with increased cost, that cost may be offset by decreased operating room times compared with stock plates (SPs). PURPOSE: The purpose was to measure and compare the operative time and expense of using PSIs versus SPs for stabilizing LeFort I osteotomies. STUDY DESIGN, SETTING, AND SAMPLE: This retrospective cohort study was composed of patients who underwent LeFort I osteotomy at the University of North Carolina between 2016 and 2022. Patients with craniofacial syndromes were excluded. PREDICTOR VARIABLE: The primary predictor variable was plate type (PSI vs SP). MAIN OUTCOME VARIABLES: The primary outcome was total operating room time. Secondary outcomes included intraoperative surgical implant costs (plates, screws, 3-dimensional medical models). COVARIATES: Covariates included age, sex, Lefort type, and concomitant mandibular surgery. ANALYSES: Operating room time and cost were compared using unpaired t tests. Demographic variables were analyzed using χ2 or Fisher exact tests. Statistical significance was set at P < .05. RESULTS: The sample was composed of 40 subjects who met inclusion/exclusion. Sample had a mean age of 25.3 ± 9.3 and 19 (48%) were male; no statistically significant demographic variables between the different groups. PSIs were statistically significantly more expensive than SPs ($33,552.1 ± 1,346.0 vs $$7,833.6 ± 4,231.7; P < .01). Operating room time did not differ significantly (219.2 ± 17.8 minutes vs 223.9 ± 17.1 minutes; P = .8). CONCLUSIONS: PSIs do not reduce operating room time and result in increased surgical costs compared to SPs. There is no evidence that this increased cost results in cost savings in the form of decreased operating room time.