Do We Need Safety Nets for Outsourced Computer-Aided Orthognathic Planning? A Two-Center Analysis

Area of Science:

• Oral and Maxillofacial Surgery
• Medical Informatics
• Healthcare Management

Background:

• Computer-aided orthognathic surgical planning (CAOP) offers benefits in accuracy and efficiency.
• Logistical factors influencing outsourced CAOP (OS-CAOP) and their impact on patient care remain understudied.
• Understanding OS-CAOP limitations is vital for optimizing treatment workflows.

Purpose of the Study:

• To investigate the limitations of OS-CAOP.
• To assess the effect of these limitations on treatment planning workflow.
• To evaluate the influence on surgical outcomes.

Main Methods:

• Retrospective cross-sectional study across two international academic centers (South Korea and USA).
• Analysis of 642 subjects undergoing orthognathic surgery using CAOP over an 8-year period.
• Primary predictor: use of modifications/alternatives to OS-CAOP; Primary outcome: frequency of planning changes impacting outcomes.

Main Results:

• 5.8% of subjects required alternatives to OS-CAOP, with 78.4% of these due to outcome-affecting reasons.
• Identical frequency of OS-CAOP alternatives (5.8%) between centers, but reasons varied (plan-related vs. access/education-related).
• South Korean center utilized repeat OS-CAOP for alternatives (71.4%), while the US center used in-house CAOP (IH-CAOP).

Conclusions:

• A significant portion of OS-CAOP necessitated pre-surgical modifications or alternatives.
• Most modifications were for reasons potentially impacting patient outcomes.
• Need to establish adaptable "safety net" plans considering individual practice settings and healthcare systems.