Orthodontic-orthognathic combined case management in postgraduate orthodontic and oral maxillofacial surgery programs

Objectives: With the development of three-dimensional (3D) image, the 3D virtual surgical planning (VSP) system has been broadly used in the treatment planning of orthodontic-orthognathic cases. This study aimed to understand the current education status regarding the use of orthodontic-orthognathic surgical planning tools in the postgraduate orthodontic and oral and maxillofacial surgery (OMFS) programs in North America.

Methods: An electronic multiple-choice survey was sent via email with 2-week and 1-month follow-ups, requesting anonymous participation of program directors/department chairs from all postgraduate orthodontic and OMFS programs in North America. Responses were collected directly on Qualtrics for analysis.

Results: The response rate was 25.68% for orthodontic and 34.34% for OMFS programs. Two-dimensional traditional surgical planning (TSP) at initial treatment planning and 3D VSP right before surgery were most commonly utilized in both specialty programs. All responded postgraduate OMFS programs utilized VSP, yet 26.32% of responded orthodontic programs did not utilize VSP. For the surgical outcomes, fewer orthodontic programs were highly satisfied than OMFS programs. More orthodontic programs warranted secondary surgery at a higher rate due to the unsatisfied outcome. Additionally, the orthodontic programs that did not use VSP showed higher unsatisfied surgical outcomes than the programs that used VSP. Moreover, there were discrepancies between orthodontic and OMFS programs regarding the perceived level of collaboration of each other on the surgical planning for the patients.

Conclusion: There were discrepancies between orthodontic and OMFS programs regarding the utilization of VSP, treatment outcomes satisfaction, and perceived level of collaboration on surgical planning for the patients.