Comparative Determinants Influencing Cost Assessment in Corrective Jaw Procedures: Insights from Dual Clinical Expertise

Mentorship Cost assessment in corrective jaw procedures, particularly orthognathic surgery, represents a multidimensional decision-making challenge shaped by clinical expertise, procedural complexity, and behavioral determinants influencing professional judgment. This study investigates the comparative determinants influencing cost estimation practices in orthognathic procedures under dual clinical expertise, typically involving collaboration between maxillofacial surgeons and orthodontists. Drawing on behavioral decision theory and entrepreneurship intention frameworks, the research conceptualizes cost assessment not merely as a technical financial calculation but as a cognitively and institutionally influenced process shaped by attitudes, perceived control, risk perception, and interprofessional dynamics.

The theoretical foundation integrates the Theory of Planned Behavior (TPB), which explains how behavioral intentions are formed through attitudes, subjective norms, and perceived behavioral control (Ajzen, 1991; Ajzen, 2002). These constructs are extended into clinical decision-making contexts to explain variability in cost estimation practices. Additionally, interdisciplinary evidence from entrepreneurial intention literature is used to model how professional intent, experiential learning, and environmental constraints influence decision variability (Lüthje & Franke, 2004; Souitaris et al., 2007).

The study synthesizes prior orthognathic cost-of-goods-sold (COGS) analyses, particularly highlighting variability in cost drivers such as surgical time, equipment usage, hospital resources, and clinician preference structures (Lone et al., 2023). The findings suggest that dual-expertise environments introduce both efficiency gains and cost variability due to differing professional heuristics and perceived procedural necessity thresholds.

Results indicate that perceived behavioral control and risk tolerance significantly influence cost estimation consistency, while interprofessional coordination reduces variability when structured communication pathways exist. However, conflicting professional norms between orthodontic and surgical perspectives introduce systematic divergence in cost projection models.

The study contributes to healthcare economics literature by reframing cost assessment as a behaviorally mediated construct rather than a purely accounting-based outcome. It further provides a structured model for understanding how cognitive, institutional, and procedural determinants interact in shaping orthognathic surgery cost estimation frameworks.

Orthognathic surgery, cost assessment, dual clinical expertise, Theory of Planned Behavior

I. Ajzen, The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50 (2), 1991, pp. 179 - 211. http://doi.org/10.1016/0749-5978(91)90020-T

I. Ajzen. Perceived Behavioral Control, Self-Efficacy, Locus of Control, and the Theory of Planned Behavior. Journal of Applied Social Psychology, 32 (4), 2002, pp. 665 - 683. http://doi.org/10.1111/j.1559.1816.2002.tb00236.x

M. Fischbein, and I. Ajzen, Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. Reading, MA : Addison-Wesely, 1975.

S. Laspita, N. Breugst, N. Heblich and H. Patzelt, “Intergenerational transmission of entrepreneurial intentions ”, Journal of Business Venturing, 27 (4), 2012, pp. 414 - 435. http://doi.org/10.1016/j.jbusvent.2011.11.006

E. Lima, R. M. Lopes, V. Nassif and D. da Silva, “Opportunities to Improve Entrepreneurship Education: Contributions Considering Brazilian Challenges ”, Journal of Small Business Management, 2014, http://doi.org/10.1111/jsbm.12110

F. Linan, and Y. W. Chen, “Development and Cross-Cultural Application of a Specific Instrument to Measure Entrepreneurial Intentions ” Entrepreneurship Theory and Practice, 33 (3), 2009, pp. 593 - 617.

Ch. Lüthje and N. Franke, “Entrepreneurial Intentions of Business Students: A Benchmarking Study ”, International Journal of Innovation and Technology Management, 1 (3), 2004, pp. 269 - 288.

J. Pennings and B. Wansink, " Channel Contract Behavior: The Role of Risk Attitudes, Risk Perceptions, and Channel Members Market Structures, The Journal of Business, 77 (4), 2004, pp. 697 - 724. http://doi.org/10.1086/422633

P. Sieger, U. Fueglistaller, and T. Zellweger, Student Entrepreneurship across the Globe: A Look at Intentions and Activities. St. Gallen : Swiss Research Institute of Small Business and Entrepreneurship at the University of St. Gallen, 2014.

V. Souitaris, S. Zerbinati and A. Al-Laham, “Do entrepreneurship programmes raise entrepreneurial intention of science and engineering studentsƒ The effect of learning, inspiration and resources ”, Journal of Business Venturing, 22 (4), 2007, pp. 566 - 591. http://doi.org/10.1016/jjbusvent.2006.05.002

T. Zellweger, P. Sieger and F. Halter, “Should I stay or should I goƒ Career choice intentions of students with family business background ”. Journal of Business Venturing, 26 (5), 2011, pp. 521 - 536. http://doi.org/10.1016/jjbusvent.2010.04.001

Lone, P. A., Arshad, F., Kumar, J., & Parwaiz, S. (2023). Variable’s of COGS analysis for orthognathic surgery based on preferences of two specialists-a perspective based study. IP Indian Journal of Anatomy and Surgery of Head, Neck and Brain, 8(2), 65-71.