Costs incurred by applying computer-aided design/computer-aided manufacturing techniques for the reconstruction of maxillofacial defects

J Craniomaxillofac Surg. 2014 Dec;42(8):2049-55. doi: 10.1016/j.jcms.2014.09.014. Epub 2014 Oct 7.

Abstract

This study aims to evaluate the additional costs incurred by using a computer-aided design/computer-aided manufacturing (CAD/CAM) technique for reconstructing maxillofacial defects by analyzing typical cases. The medical charts of 11 consecutive patients who were subjected to the CAD/CAM technique were considered, and invoices from the companies providing the CAD/CAM devices were reviewed for every case. The number of devices used was significantly correlated with cost (r = 0.880; p < 0.001). Significant differences in mean costs were found between cases in which prebent reconstruction plates were used (€3346.00 ± €29.00) and cases in which they were not (€2534.22 ± €264.48; p < 0.001). Significant differences were also obtained between the costs of two, three and four devices, even when ignoring the cost of reconstruction plates. Additional fees provided by statutory health insurance covered a mean of 171.5% ± 25.6% of the cost of the CAD/CAM devices. Since the additional fees provide financial compensation, we believe that the CAD/CAM technique is suited for wide application and not restricted to complex cases. Where additional fees/funds are not available, the CAD/CAM technique might be unprofitable, so the decision whether or not to use it remains a case-to-case decision with respect to cost versus benefit.

Keywords: CAD/CAM; Costs; Devices; Maxillofacial reconstruction; Reimbursement; Virtual planning.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Bone Transplantation / instrumentation
  • Bone Transplantation / methods
  • Computer-Aided Design / economics*
  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Decision Making
  • Fees and Charges
  • Female
  • Humans
  • Insurance Coverage / economics
  • Insurance, Health / economics
  • Jaw Diseases / surgery
  • Male
  • Middle Aged
  • Oral Surgical Procedures / economics*
  • Oral Surgical Procedures / instrumentation
  • Osteotomy / instrumentation
  • Osteotomy / methods
  • Patient Care Planning
  • Plastic Surgery Procedures / economics*
  • Plastic Surgery Procedures / instrumentation
  • Reimbursement Mechanisms / economics
  • Surgical Flaps / transplantation
  • Tomography, Spiral Computed / methods
  • User-Computer Interface