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

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.