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Factors Associated With Treatment Time of Conventional Orthodontic-Orthognathic Surgery Patients in a University
Catherine Florentine1, Vivian Van2, Mohammed Shreiteh2
1Resident, Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University of Connecticut Health, Farmington, CT.
Background:
Conventional orthodontic-orthognathic surgery (COS) treatment often involves prolonged treatment times, particularly in postgraduate training institutions.
Purpose:
The objective of this study was to identify treatment-related variables associated with treatment duration in patients undergoing COS treatment.
Study Design, Setting, Sample:
A retrospective cohort study of COS patients treated at UConn Health between January 2013 and May 2020 was performed. Patients treated using the surgery-first approach, those with craniofacial anomalies, prior prosthodontic treatment, faculty practice treatment, or incomplete records were excluded.
Independent Variables:
Predictor variables were grouped into 4 main categories: baseline clinical characteristics, patient-related, provider and health system, and treatment course factors.
Outcome Variables:
The primary outcome variable was total treatment time. Surgical readiness-to-surgery and postsurgical treatment times were secondarily assessed.
Covariates:
No demographic or clinical covariates were included in the regression analyses.
Analyses:
For each binary predictor variable, treatment times were compared between groups using the Wilcoxon rank-sum test to account for non-normal outcome distributions. Predictors that were statistically significant at the 5% level were subsequently included in the corresponding multivariable linear regression model.
Results:
Sixty-five subjects were evaluated, and 52 met the inclusion criteria (mean age 23.0 (7.4) years; 25 (48.1%) females). The median duration of the total treatment was 34.66 (23.44) months, including 8.90 (14.29) from surgical readiness-to-surgery and 9.18 (8.83) months for the postsurgical orthodontic phase. Reduced total treatment time was associated with prior orthodontic treatment (16.42 months; 95% CI -24.20, -8.63, P < .001) and surgical planning initiated at treatment onset (15.38 months; 95% CI -25.40, -5.36, P = .004).
Conclusion:
Prior orthodontic treatment and earlier surgical planning were associated with shorter total COS treatment times in a university training program. By quantifying the impact of these and other clinically relevant factors, this study provides a practical framework for anticipating potential delays and identifying opportunities to improve treatment efficiency in training-based programs.
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