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Review
. 2025 Mar 19;17(3):e80858.
doi: 10.7759/cureus.80858. eCollection 2025 Mar.

Analog to Digital Diagnosis and Planning in Orthognathic Surgery: A Narrative Review

Sujeeth K Shetty  1 , Rishabh Kasrija  1
Affiliations
Review

Analog to Digital Diagnosis and Planning in Orthognathic Surgery: A Narrative Review

Sujeeth K Shetty et al. Cureus. .

Abstract

Orthognathic surgery is a transformative procedure for correcting skeletal and dental discrepancies and enhancing facial aesthetics, functionality, and quality of life. Patients with dentofacial deformities often experience mastication, speech, and respiration challenges. Advances in diagnostic tools, treatment planning, and surgical methodologies have significantly improved surgical precision and predictability. Accurate diagnosis relies on clinical assessments, cephalometric analysis, and advanced imaging techniques such as cone beam computed tomography and three-dimensional facial scanning. Traditional surgical planning using two-dimensional cephalometry and plaster models has been largely replaced by virtual surgical planning, which enables precise simulations, computer-aided design/computer-aided manufacturing-assisted surgical splint fabrication, and improved postoperative stability. Achieving a balance between function and aesthetics is crucial. Contemporary approaches emphasize both skeletal correction and soft tissue response, with airway management being a key consideration, particularly in cases of obstructive sleep apnea. The treatment pathway includes presurgical orthodontics, maxillary or mandibular repositioning, and postoperative rehabilitation. Artificial intelligence and augmented reality-assisted surgery drive future innovations to enhance surgical accuracy and treatment customization. Despite these advancements, challenges such as treatment duration, patient compliance, psychological readiness, and costs remain. Predicting soft tissue behavior and ensuring long-term stability require further research. This review aims to provide a comprehensive overview of advancements in orthognathic surgery, from diagnostic innovations to modern treatment planning and emerging technologies, highlighting their impact on surgical precision, efficiency, and patient outcomes. With continuous technological progress and interdisciplinary collaboration, orthognathic surgery is moving toward greater precision, efficiency, and improved patient outcomes.

Keywords: diagnosis; digital planning; maxillofacial imaging; orthognathic surgery; treatment plan.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Psychological assessment in orthognathic surgery
The image is the property of the authors and is relevant to the content of the study.
Figure 2
Figure 2. Changing parameters of traditional orthognathic surgery to VSP
2D: two dimensional, 3D: three dimensional, VSP: virtual surgical planning, AI: artificial intelligence The image is the property of the authors and is relevant to the content of the study.
Figure 3
Figure 3. Future of orthognathic surgery with integration of AI
AI: artificial intelligence, AR: augmented reality, VSP: virtual surgical planning, 3D: three dimensional, CAD/CAM: computer-aided design and manufacturing The image is the property of the authors and is relevant to the content of the study.
See this image and copyright information in PMC

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