Virtual planning in orthognathic surgery

Int J Oral Maxillofac Surg. 2014 Aug;43(8):957-65. doi: 10.1016/j.ijom.2014.03.011. Epub 2014 Apr 16.


Numerous publications regarding virtual surgical planning protocols have been published, most reporting only one or two case reports to emphasize the hands-on planning. None have systematically reviewed the data published from clinical trials. This systematic review analyzes the precision and accuracy of three-dimensional (3D) virtual surgical planning of orthognathic procedures compared with the actual surgical outcome following orthognathic surgery reported in clinical trials. A systematic search of the current literature was conducted to identify clinical trials with a sample size of more than five patients, comparing the virtual surgical plan with the actual surgical outcome. Search terms revealed a total of 428 titles, out of which only seven articles were included, with a combined sample size of 149 patients. Data were presented in three different ways: intra-class correlation coefficient, 3D surface area with a difference <2mm, and linear and angular differences in three dimensions. Success criteria were set at 2mm mean difference in six articles; 125 of the 133 patients included in these articles were regarded as having had a successful outcome. Due to differences in the presentation of data, meta-analysis was not possible. Virtual planning appears to be an accurate and reproducible method for orthognathic treatment planning. A more uniform presentation of the data is necessary to allow the performance of a meta-analysis. Currently, the software system most often used for 3D virtual planning in clinical trials is SimPlant (Materialise). More independent clinical trials are needed to further validate the precision of virtual planning.

Keywords: computer-assisted image processing; computer-assisted surgery; three-dimensional imaging; user–computer interface; virtual surgical planning.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Orthognathic Surgical Procedures*
  • Patient Care Planning*
  • Surgery, Computer-Assisted / methods*
  • User-Computer Interface*