Patient-Specific Plates Cost Four Times More Without Cutting Operating Room Time

Edited by Dentaltown staff

Patient-specific implants used to stabilize Le Fort I osteotomies cost more than four times what stock plates cost and produced no reduction in operating room time, according to a retrospective cohort study published online Sept. 4 in the Journal of Oral and Maxillofacial Surgery.

Investigators reviewed patients who underwent Le Fort I osteotomy by a single surgeon at the University of North Carolina between 2016 and 2022. Of 49 patients evaluated and planned virtually for patient-specific implants, nine were excluded for cleft lip or palate, leaving 40 in the analysis. Twenty-two received stock plates and 18 received patient-specific implants.

Mean intraoperative surgical implant costs, covering plates, screws, and three-dimensional medical models, were $33,552.10 for patient-specific implants and $7,833.60 for stock plates, a significant difference at P less than .01.

Total operating room time did not differ. Cases using patient-specific implants averaged 219.2 minutes and cases using stock plates averaged 223.9 minutes, at P = .8.

The cohort had a mean age of 25.3 years, and 19 patients, or 48%, were male. No demographic variable differed significantly between the groups. Covariates included age, sex, Le Fort type, and concomitant mandibular surgery.

The authors concluded that patient-specific implants do not reduce operating room time and increase surgical costs relative to stock plates, and that there is no evidence the added cost is recovered through shorter operating room time.

Brennan Leininger, Derrick Nelson, Thomas Brader, Poolak Bhatt, Ceib Phillips, and Timothy A. Turvey conducted the study.

The design was retrospective and patients were not randomized, all cases came from one surgeon at one institution using a single implant company, and the analysis measured cost and operative time only. It does not address surgical accuracy, stability, or other outcomes that might justify patient-specific hardware in selected cases. The article is a journal pre-proof.

Sources:
Journal of Oral and Maxillofacial Surgery, “Stock Plates vs Patient-Specific Implants For Virtually Planned Orthognathic Surgery: Analysis Involving Cost and Duration of Surgery,” available online Sept. 4, 2026: sciencedirect.com/science/article/abs/pii/S0278239126009225
DOI: doi.org/10.1016/j.joms.2026.08.025