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Outcomes of conventional versus virtual surgical planning of orthognathic surgery using surgery-first approach for class III asymmetry

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Abstract

Objectives

To determine if patient outcome variables differ between conventional and virtual surgical planning of orthognathic surgery for class III asymmetry.

Material and methods

This retrospective case-control study examined 95 patients with class III asymmetry who had been consecutively treated with at least a Le Fort I osteotomy and a bilateral sagittal split osteotomy with a surgery-first approach. Two groups were examined: 51 patients treated with conventional surgical planning and 44 with virtual surgical planning. After treatment, quantitative assessment was determined with measurements of midline symmetry, contour symmetry, and overall facial symmetry using standardized frontal photographs. Subject assessments were analyzed with questionnaires regarding self-perception of overall appearance, satisfaction with appearance, and quality of life.

Results

Conventional and virtual surgical planning resulted in significant improvements in outcomes for all patients. However, facial midline and overall facial symmetry were significantly greater for the virtual compared with the conventional group. There were no significant differences in subjective measures of appearance, satisfaction with appearance, and quality of life for patients treated with conventional or virtual surgical planning; measures were high for both groups.

Conclusions

Conventional and virtual surgical planning of surgery-first bimaxillary orthognathic surgery resulted in quantitative and qualitative improvements in facial symmetry. Although patient satisfaction was similar for both approaches, virtual surgical planning was superior to conventional surgical planning for the improvement of midline and overall asymmetry.

Clinical relevance

Improvements with virtual surgical planning in facial midline, facial contour, and overall facial symmetry are as good as or better than conventional surgical planning.

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Funding

The work was supported by the Chang Gung Memorial Hospital, Taiwan (CMRPG5F0051, CMRPG5F0061, CMRPG5G0021).

Author information

Authors and Affiliations

  1. Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, No. 123, Dinghu Road, Gueishan Township, Taoyuan, 333, Taiwan

    Yu-Fang Liao

  2. Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Yu-Fang Liao, Ying-An Chen & Yu-Ray Chen

  3. Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan

    Yu-Fang Liao, Ying-An Chen & Yu-Ray Chen

  4. Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan

    Yu-Fang Liao & Yu-Ray Chen

  5. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan

    Ying-An Chen & Yu-Ray Chen

  6. Chicing Plastic Surgery, Taipei, Taiwan

    Yi-Chieh Chen

Authors
  1. Yu-Fang Liao
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  2. Ying-An Chen
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Corresponding author

Correspondence to Yu-Fang Liao.

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All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was not needed due to the retrospective design of the study.

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Liao, YF., Chen, YA., Chen, YC. et al. Outcomes of conventional versus virtual surgical planning of orthognathic surgery using surgery-first approach for class III asymmetry. Clin Oral Invest 24, 1509–1516 (2020). https://doi.org/10.1007/s00784-020-03241-4

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  • DOI: https://doi.org/10.1007/s00784-020-03241-4

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