Postoperative outcomes of two- and three-dimensional planning in orthognathic surgery: A comparative study

Objective: Compared with conventional two-dimensional (2D) planning, three-dimensional (3D) planning in orthognathic surgery yields more accurate anatomical information and enables the precise positioning of maxillary and mandibular segments, particularly for patients with facial asymmetry. Accordingly, surgical outcomes achieved using 3D planning should be superior. This study determined the differences between the 2D and 3D planning techniques by comparing their surgical outcomes. Materials and methods: In this retrospective study, patients who underwent surgery following the traditional 2D planning technique were classified into the 2D planning group. Patients in whom the 2D plan was transferred to a 3D system after surgical simulation were classified into the 3D planning group. Surgical outcomes were compared using cephalometric measurements and patient perception of the results. Results: In the 3D planning group, more favorable results were observed in frontal symmetry, change in the angle between the orbital and occlusal lines, frontal ramus inclination, and the distances from the mandibular central incisor and menton to the midsagittal line. No significant differences were observed in the lateral profiles (SNA, SNB, ANB, and angle convexity) of the two groups. Patient satisfaction was favorable in the two groups, but more patients in the 3D planning group reported being very satisfied. Conclusion: The 3D planning technique provided superior overall outcomes. The study findings can be used to augment clinical planning and surgical execution when using a conventional approach. (C) 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.