The accuracy of soft tissue movement using virtual planning for non-syndromic facial asymmetry cases-a systematic review

Oral Maxillofac Surg. 2023 Jun;27(2):187-200. doi: 10.1007/s10006-022-01059-w. Epub 2022 Apr 18.


The 3D prediction of post-operative changes is an inevitable tool for the surgical correction of facial asymmetry. The objective is to execute an evidence-based review answering the following question. Does the 3D virtual prediction planning draw reliable and accurate results in the surgical outcome related to the soft tissues of the face in facial asymmetry? This systematic review of the literature is based on the 3D soft tissue prediction planning of facial asymmetry correction to draw conclusions on the reliability and accuracy of these methods in the surgical outcome related to the soft tissues of the face. PubMed, Web of Science, Cochrane, and Ovid databases were adopted for the literature search. Studies published between years 2000 and 2020, aimed at the assessment of soft tissue predictions using software prediction packages for facial asymmetry, were selected. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) was applied. Quadas-2 tool was used for the qualitative evaluation of selected studies. Initial search yielded 248 articles. Twenty articles fulfilled the inclusion and exclusion criteria and selected for qualitative analysis. Finally, 12 articles were selected for quantitative analysis. The results indicate 3D imaging prediction methods provided more accurate information with less distortion for soft tissue prediction regardless of various softwares currently available. The prediction of soft tissue accuracy in facial asymmetry was less accurate in lower face regardless of the type of surgery for facial asymmetry. The mean prediction error was less than 2 mm.

Keywords: Computer-aided orthognathic surgery; Facial dysmorphism; Orthognathic simulation; Soft tissue prediction; Virtual treatment planning.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Facial Asymmetry* / diagnostic imaging
  • Facial Asymmetry* / surgery
  • Humans
  • Imaging, Three-Dimensional / methods
  • Orthognathic Surgical Procedures* / methods
  • Reproducibility of Results
  • Software