An Enhanced Digital Surgical Planning Approach for Long-Curve Mandibular Angle Osteotomy

This study presents a digital surgical planning method for long-curve mandibular angle osteotomy based on three-dimensional (3D) symmetry principles. The authors retrospectively analyzed 30 patients with mandibular angle hypertrophy who had previously undergone conventional long-curve osteotomy. Many reported postoperative dissatisfaction due to visible bilateral mandibular margin asymmetry from the submental view. Preoperative CT data were reconstructed into 3D models, to which a symmetry-guided osteotomy protocol was applied. By integrating sagittal, coronal, and axial planes with dynamic bilateral point adjustments, the protocol identified asymmetries often overlooked by traditional methods. Quantitative analyses confirmed these discrepancies. The proposed approach achieved bilateral mandibular margin symmetry in frontal, lateral, and submental views. This reproducible and clinically applicable 3D planning method may reduce revision rates and improve patient satisfaction, particularly among populations with aesthetic preferences for a slender V-line contour.