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Published on: May 23, 2020
Three-dimensional virtual planning reduces operative time in orthognathic surgery: a procedure-specific retrospective
Yuki Kunisada1, Norie Yoshioka2, Akiyoshi Nishiyama2,3,4
1Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan. de16013@s.okadai.jp.
Purpose:
Three-dimensional virtual surgical planning (3D-VSP) is increasingly used in orthognathic surgery; however, procedure-specific evidence regarding its real-world impact on operative efficiency and intraoperative blood loss remains limited. This study evaluated the association between 3D-VSP implementation and operative time, and intraoperative blood loss across different orthognathic procedures.
Methods:
This retrospective cohort study included consecutive patients who underwent orthognathic surgery at a single academic institution before (2019-2020) and after (2023-2024) the full implementation of 3D-VSP integrated with in-house additive manufacturing (n = 344). Procedure-specific multivariable linear regression analyses were performed, adjusting for age, sex, and surgeon experience.
Results:
After 3D-VSP implementation, operative time was reduced by approximately 36 min in sagittal split ramus osteotomy (SSRO), 50 min in Le Fort I (LF1) combined with SSRO, and 42 min in segmental LF1 combined with SSRO, representing a 15-20% reduction in total operative time. No meaningful reduction was observed in intraoral vertical ramus osteotomy (IVRO)-based procedures. A statistically significant, but modest, reduction in intraoperative blood loss was observed only in SSRO. The time-saving effect was independent of surgeon experience.
Conclusion:
The clinical benefit of 3D-VSP in orthognathic surgery is procedure-dependent and most evident in geometrically complex SSRO-based operations. These findings support the targeted implementation of digital planning and additive manufacturing workflows to improve operative efficiency in routine practice.
