**Author details**

more accurate osteotomies and graft placement. [7, 31] Use of manufactured pre-bent recon‐ structive plates can also significantly decrease the total operative time; total reconstructive

With regard to the current economic climate in healthcare, potential limitation of widespread incorporation of VSP-CAD/CAM technology is its added cost and the resultant financial burdens that may be placed on the patient and medical system.[8, 17, 28, 34] Given the economic healthcare constraints, the improved patient outcomes seen with VSP-CAD/CAM have to be balanced against the cost of the technology.[24, 39] Potential costs are further increased with the use of the manufactured pre-bent reconstruction plates. Given the qualita‐ tive nature of many benefits of VSP-CAD/CAM and the paucity of data currently available, the total value added and cost efficiency of VSP-CAD/CAM utilization has not been formally evaluated and still remains the subject of future studies.[24] As previously discussed, reduc‐ tions in ischemia and/or overall operative time is a potential source of cost reduction. Addi‐ tionally, the decreased complications and patient morbidity, and generalized improved outcomes seen signify cost savings that may offset the technological costs.[24] However, the clinical implications and economic benefits have yet to be formally analyzed with the added cost of VSP-CAD/CAM in the context of various expanding clinical applications including trauma, temporomandibular joint reconstruction, cancer, and skull base surgery.[6, 28, 35, 38] In head and neck cancer reconstruction, patient lifespan, risk for tumor recurrence and disease progression, and quality of life are additional factors that add complexity to the cost-

VSP-CAD/CAM is a novel technology that holds potential to consistently and predictably advance reconstructive outcomes, both aesthetically and functionally. This technology is suited for use in spatially complex reconstructive cases due to its ability to visualize and virtually manipulate 3D configurations of the craniomaxillofacial skeleton in a collaborative, synergistic fashion. Its applications are expanding for cases of varying levels of complexity that require precise millimeter precision particularly in trauma, orthognathic procedures and oncology to obtain optimized function and aesthetic outcomes. Implementation of VSP-CAD/ CAM into each stage of the reconstruction affords the opportunity to reduce human transla‐ tional error and facilitates intra-operative decision-making with expedition of the surgical phase.[1, 10, 11, 13, 21, 24] VSP- CAD/CAM technology is attaining acceptance across the multiple surgical disciplines as efforts towards validating its use are increasing, thereby holding promise as an mainstay, innovative solution in the management of challenging head

operative time was reported in one case to be less than 90 minutes.[3, 19, 31]

benefit evaluation of the technology in an oncologic setting.

**5. Disadvantages**

728 A Textbook of Advanced Oral and Maxillofacial Surgery Volume 2

**6. Summary**

and neck reconstruction cases.

Eric Zielinski1 , Ryan J. Jacobs1 , Eric Barker3 , Kate Rodby2 and Anuja K. Antony3\*

