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Virtual Surgical Planning in Orthognathic Surgery: Wafer-Only Versus Customized Guide-Plate System.

Jung-Hwan Bae1, Kyu-Bum Kim, Jihye Ryu

  • 1Department of Oral and Maxillofacial Surgery, Dental and Life Science Institute and Dental Research Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea.

The Journal of Craniofacial Surgery
|September 12, 2025
PubMed
Summary

The customized guide-plate system significantly improves maxillary positioning accuracy in bimaxillary orthognathic surgery compared to the wafer-only method. Both approaches show similar long-term skeletal stability after surgery.

Keywords:
Cost-effectivenessguide-plate systemorthognathic surgerysurgical accuracyvirtual surgical planning

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthodontics
  • Surgical Planning

Background:

  • Bimaxillary orthognathic surgery corrects complex dentofacial deformities.
  • Accurate maxillary positioning is crucial for functional and aesthetic outcomes.
  • Virtual surgical planning (VSP) aids in pre-operative simulation and execution.

Purpose of the Study:

  • To compare the clinical accuracy of maxillary positioning in bimaxillary orthognathic surgery.
  • To evaluate two VSP implementation methods: wafer-only versus a customized guide-plate system.

Main Methods:

  • Retrospective analysis of 34 patients undergoing bimaxillary orthognathic surgery.
  • Division into a control group (wafer-only) and a study group (wafer+guide+plate).
  • Quantitative 3D analysis of 5 maxillary landmarks comparing virtual plan to postoperative cone-beam computed tomography (CBCT).

Main Results:

  • The guide-plate system demonstrated significantly higher accuracy in transverse and anterior vertical dimensions.
  • Both groups faced challenges with posterior vertical and sagittal accuracy.
  • No significant differences in 6-month skeletal stability were observed between the groups.

Conclusions:

  • The customized guide-plate system provides a clinically significant improvement in maxillary positioning accuracy.
  • Enhanced initial accuracy with the guide-plate system does not compromise long-term skeletal stability.
  • The guide-plate system is particularly beneficial for complex cases demanding high precision.