title: Costs incurred by applying computer-aided design/computer-aided manufacturing techniques for the reconstruction of maxillofacial defects.
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.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Plastic Operations, Klinikum Bremen-Mitte, Medical School of the University of Göttingen, Bremen, Germany. Electronic address: janrustem@gmx.de.
authors.forename: Jan
authors.initials: J
authors.lastname: Rustemeyer
authors.affiliation: Department of Oral and Maxillofacial Surgery, Plastic Operations, Klinikum Bremen-Mitte, Medical School of the University of Göttingen, Bremen, Germany.
authors.forename: Alex
authors.initials: A
authors.lastname: Melenberg
authors.affiliation: Department of Oral and Maxillofacial Surgery, Plastic Operations, Klinikum Bremen-Mitte, Medical School of the University of Göttingen, Bremen, Germany.
authors.forename: Aynur
authors.initials: A
authors.lastname: Sari-Rieger
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000295:instrumentation / Q000379:methods; D017076:Computer-Aided Design / Q000191:economics*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003657:Decision Making; D005249:Fees and Charges; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D007348:Insurance, Health / Q000191:economics; D007571:Jaw Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000191:economics* / Q000295:instrumentation; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D010347:Patient Care Planning; D019651:Plastic Surgery Procedures / Q000191:economics* / Q000295:instrumentation; D012051:Reimbursement Mechanisms / Q000191:economics; D013524:Surgical Flaps / Q000637:transplantation; D036542:Tomography, Spiral Computed / Q000379:methods; D014584:User-Computer Interface
keywords: CAD/CAM; Costs; Devices; Maxillofacial reconstruction; Reimbursement; Virtual planning