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Comparison of soft tissue simulations between two planning software programs for orthognathic surgery.

Ali Modabber¹, Tanja Baron¹, Florian Peters¹

¹Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.

Scientific Reports

|March 24, 2022

Summary

Two software programs for predicting soft tissue changes in orthognathic surgery showed different results, particularly for specific surgical techniques. While differences were statistically significant, they were often below clinically relevant levels, suggesting critical evaluation of prediction accuracy.

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Area of Science:

Orthognathic surgery
Craniofacial soft tissue analysis
Surgical planning software

Background:

Accurate prediction of soft tissue changes is crucial for successful orthognathic surgery outcomes.
Established software programs are used to simulate these changes, aiding in surgical planning.
The reliability of these predictions can vary depending on the surgical technique and magnitude of skeletal displacement.

Purpose of the Study:

To compare the soft tissue predictive accuracy of two leading software programs: Dolphin (D) and ProPlan (PP).
To evaluate prediction differences based on various orthognathic surgical techniques and displacement amounts.
To assess the clinical relevance of observed discrepancies in soft tissue predictions.

Main Methods:

Fifty computed tomography (CT) datasets were used to simulate 11 orthognathic surgical procedures.
Simulations included maxillary advancement (MxA), maxillary impaction (MxI), mandibular setback (MnS), mandibular advancement (MnA), and bimaxillary (MxA/MnS) displacements.
Eight linear and two angular measurements of soft tissue changes were performed and compared between Dolphin and ProPlan predictions.

Main Results:

Maxillary impaction simulations showed similar soft tissue behavior between Dolphin and ProPlan.
Significant differences were observed for other procedures, notably in the nasolabial angle and mentolabial angle, and the inferior lip's distance to the aesthetic E-line.
While statistically significant, many observed differences between the programs were below a clinically relevant threshold.

Conclusions:

The tested software programs exhibit divergent soft tissue prediction outcomes for various orthognathic surgical procedures.
The clinical significance of these differences is often minimal, necessitating a critical approach to interpreting prediction results.
Further clarification is needed regarding the actual clinical benefit and reliability of current soft tissue prediction software in orthognathic surgery.