The Role of Artificial Intelligence in Orthognathic Surgery: A Scoping Review

Background/Objectives: Artificial intelligence (AI) has gained growing interest in the field of orthognathic surgery due to its potential to improve diagnostic accuracy, surgical planning, and treatment outcomes. This scoping review maps literature from 2017 to May 2025 to identify AI applications in orthognathic surgery, assess their clinical relevance, and discuss the associated ethical, legal, and technical limitations. Methods: This scoping review further examines the stages of the orthognathic surgical workflow at which AI applications have been prospectively validated, the artificial intelligence methodologies applied to virtual surgical planning and outcome prediction, and the main methodological, ethical, and legal factors that may constrain broader clinical adoption. Results: A total of 62 studies were included, covering AI use in cephalometric analysis, virtual surgical planning (VSP), outcome prediction, and intraoperative support. While AI demonstrates remarkable potential in orthognathic planning, current approaches are often limited by heterogeneous methodologies and retrospective validation. Conclusions: Future studies should prioritize prospective, multicentre designs integrating AI-assisted decision-making directly into the clinical workflow, with emphasis on model interpretability, patient-specific accuracy, and ethical transparency. These questions extend beyond mapping applications by emphasizing clinical validation, methodological rigor, and ethical accountability-dimensions insufficiently explored in prior reviews.