Wellbeing Services County of Satakunta, Department of Oral and Maxillofacial Unit, Satahospital, Sairaalantie 3, FI-28500, Pori, Finland.
Department of Pediatric Dentistry and Orthodontics, Institute of Dentistry, University of Turku, FI-20014, Turku, Finland.
Eur J Orthod. 2023 Sep 18;45(5):558-564. doi: 10.1093/ejo/cjad051.
The aim was to analyse the costs and duration of orthodontic-surgical treatment with mandibular advancement in the public health care sector in Finland.
The study was conducted as a retrospective registry study in a public district hospital on all nonsyndromic patients that were ethnic Finns and treated with full fixed appliances and mandibular advancement surgery in 2016-2020.
The mean treatment duration of the included 45 patients was 28.1 months, including 18.9 months pre and 9.2 months postoperative orthodontics. The median number of visits was 27, including 17 visits before and 9 visits after surgery. The mean total treatment time was 14.5 h. The mean total direct costs per course of treatment were 7574 € to the municipality and 947 € to the patient. The costs positively correlated with the duration of the treatment (rho = 0.71, P = .000), but were not associated to gender or age of patient. The mean surgery time was 78 minutes, and significantly less with an experienced surgeon (P = .002). It was calculated that the mean minimum treatment costs would be 45% of the present total, achievable with a patient with optimum dental arches at the start of treatment.
The major limitation of the study is the relatively small number of study subjects.
A 55% share of the costs is influenced by case- and operator-dependent factors. This indicates that the complexity and performance of the orthodontic phases of treatment are important determinants in the cost structure.
分析在芬兰公共医疗保健系统中，采用下颌前伸术治疗的正畸-正颌联合治疗的成本和时间。
该研究是在一家公立地区医院进行的回顾性登记研究，共纳入了 2016 年至 2020 年间，所有非综合征的、采用全固定矫治器和下颌前伸术治疗的、芬兰裔患者。
45 名纳入患者的平均治疗时间为 28.1 个月，包括正畸前的 18.9 个月和术后的 9.2 个月。中位数就诊次数为 27 次，包括术前 17 次和术后 9 次。平均总治疗时间为 14.5 小时。每例治疗的平均总直接费用为市政当局 7574 欧元，患者 947 欧元。成本与治疗时间呈正相关（rho = 0.71，P =.000），但与患者的性别或年龄无关。平均手术时间为 78 分钟，具有丰富经验的外科医生手术时间显著更短（P =.002）。计算得出，平均最低治疗费用将为当前总费用的 45%，这在治疗开始时患者就具有理想牙弓的情况下是可以实现的。
该研究的主要局限性是研究对象相对较少。
55%的成本受病例和操作人员相关因素的影响。这表明治疗的正畸阶段的复杂性和表现是成本结构的重要决定因素。
