Table 4 Issues discussed in the interviews and issues raised in the literature

1

Useful tool in planning and exploring other options.

(8,9)

2

Helps with teaching and learning for students and patients.

(8,10)

3

Accuracy, efficiency, quality are all potential advantages.

(11,12,12-14)

4

Potential for improved functional outcome: planning for dental implants, dental rehabilitation, better occlusion, less TMJ dysfunction and improved mandibular strength and cosmetic outcome.

(14,15)

5

Potential for reducing Operating Room time.

(16,17)

6

Communication between team members can be facilitated by the technology.

(9)

7

Increase in surgeon confidence.

(17)

8

Initial cost of the setup of the technology is a disadvantage but can be outweighed by the longterm benefits.

(18)(19)

9

Accessibility and availability of the resource is a disadvantage.

(17)

10

Time constraint is a disadvantage which includes time to learn the technology, collaborate and plan each case and turnaround and production time between initial case planning and scheduled surgery.

(18)

11

There is minimal quantitative research available to prove the accuracy, benefits and functional outcome of the patients when digital surgical design and simulation is used. There is also a need for a cost-benefit analysis.

(20)

12

Surgical design and simulation can bring more of a team approach.

(17)

13

Surgical design and simulation is not included in medical student training.

14

There is cultural resistance to the surgical design and simulation technology.

15

The field of surgical design and simulation is a work in progress.