Comparison of accuracy of maxilla between virtual surgical planning and conventional surgical planning in bimaxillary orthognathic surgery: a randomized controlled trial

Abstract Background Virtual surgical planning (VSP) improves accuracy in orthognathic surgery, but its differences from conventional surgical planning (CSP) remain unclear. This study compares VSP and CSP accuracy in maxillary repositioning. Methods A randomized controlled trial of 20 patients under...

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Main Authors: Loi Phuoc Nguyen, Chon Thanh Ho Nguyen, Tuan Van Nguyen, Hai Tien Do, Chanh Trung Le, Jun-Young Kim
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:Maxillofacial Plastic and Reconstructive Surgery
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Online Access:https://doi.org/10.1186/s40902-025-00469-6
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author Loi Phuoc Nguyen
Chon Thanh Ho Nguyen
Tuan Van Nguyen
Hai Tien Do
Chanh Trung Le
Jun-Young Kim
author_facet Loi Phuoc Nguyen
Chon Thanh Ho Nguyen
Tuan Van Nguyen
Hai Tien Do
Chanh Trung Le
Jun-Young Kim
author_sort Loi Phuoc Nguyen
collection DOAJ
description Abstract Background Virtual surgical planning (VSP) improves accuracy in orthognathic surgery, but its differences from conventional surgical planning (CSP) remain unclear. This study compares VSP and CSP accuracy in maxillary repositioning. Methods A randomized controlled trial of 20 patients undergoing bimaxillary surgery was conducted. Patients were assigned to VSP (3D planning, 3D-printed splints) or CSP (cast model surgery, conventional splints). Pre- and postoperative Computed Tomography (CT) scans were superimposed using voxel-based registration, measuring anteroposterior (Y), mediolateral (X), and vertical (Z) positional changes of A point, ANS, U1, U3, U6 landmarks. Results No significant differences in planned and actual surgical outcomes (p > 0.05). 2D planning (P2D) and 3D planning (P3D) showed significant differences in key maxillary landmarks, indicating that 3D planning provides additional refinements in skeletal positioning. However, VSP showed larger absolute discrepancies in U1L, U1R, U3L, U6L (p < 0.05), particularly in the anteroposterior (Y-axis) direction. Splint thickness and condylar simulation methods could also affect accuracy. Conclusions VSP and CSP provide comparable accuracy; however, VSP shows greater anterior–posterior discrepancies. Further studies should examine splint design and condylar modeling to optimize surgical precision.
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spelling doaj-art-848f57876c63463595f80eecafa63e2f2025-08-20T03:45:19ZengSpringerOpenMaxillofacial Plastic and Reconstructive Surgery2288-85862025-07-0147111310.1186/s40902-025-00469-6Comparison of accuracy of maxilla between virtual surgical planning and conventional surgical planning in bimaxillary orthognathic surgery: a randomized controlled trialLoi Phuoc Nguyen0Chon Thanh Ho Nguyen1Tuan Van Nguyen2Hai Tien Do3Chanh Trung Le4Jun-Young Kim5Department of Maxillofacial Surgery, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Maxillofacial Surgery, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh CityNational Hospital of Odonto-Stomatology in Ho Chi Minh CityNational Hospital of Odonto-Stomatology in Ho Chi Minh CityNational Hospital of Odonto-Stomatology in Ho Chi Minh CityDepartment of Oral & Maxillofacial Surgery, Yonsei University College of DentistryAbstract Background Virtual surgical planning (VSP) improves accuracy in orthognathic surgery, but its differences from conventional surgical planning (CSP) remain unclear. This study compares VSP and CSP accuracy in maxillary repositioning. Methods A randomized controlled trial of 20 patients undergoing bimaxillary surgery was conducted. Patients were assigned to VSP (3D planning, 3D-printed splints) or CSP (cast model surgery, conventional splints). Pre- and postoperative Computed Tomography (CT) scans were superimposed using voxel-based registration, measuring anteroposterior (Y), mediolateral (X), and vertical (Z) positional changes of A point, ANS, U1, U3, U6 landmarks. Results No significant differences in planned and actual surgical outcomes (p > 0.05). 2D planning (P2D) and 3D planning (P3D) showed significant differences in key maxillary landmarks, indicating that 3D planning provides additional refinements in skeletal positioning. However, VSP showed larger absolute discrepancies in U1L, U1R, U3L, U6L (p < 0.05), particularly in the anteroposterior (Y-axis) direction. Splint thickness and condylar simulation methods could also affect accuracy. Conclusions VSP and CSP provide comparable accuracy; however, VSP shows greater anterior–posterior discrepancies. Further studies should examine splint design and condylar modeling to optimize surgical precision.https://doi.org/10.1186/s40902-025-00469-6Virtual surgical planningOrthognathic surgeryMaxillary accuracy3D planningRandomized controlled trial
spellingShingle Loi Phuoc Nguyen
Chon Thanh Ho Nguyen
Tuan Van Nguyen
Hai Tien Do
Chanh Trung Le
Jun-Young Kim
Comparison of accuracy of maxilla between virtual surgical planning and conventional surgical planning in bimaxillary orthognathic surgery: a randomized controlled trial
Maxillofacial Plastic and Reconstructive Surgery
Virtual surgical planning
Orthognathic surgery
Maxillary accuracy
3D planning
Randomized controlled trial
title Comparison of accuracy of maxilla between virtual surgical planning and conventional surgical planning in bimaxillary orthognathic surgery: a randomized controlled trial
title_full Comparison of accuracy of maxilla between virtual surgical planning and conventional surgical planning in bimaxillary orthognathic surgery: a randomized controlled trial
title_fullStr Comparison of accuracy of maxilla between virtual surgical planning and conventional surgical planning in bimaxillary orthognathic surgery: a randomized controlled trial
title_full_unstemmed Comparison of accuracy of maxilla between virtual surgical planning and conventional surgical planning in bimaxillary orthognathic surgery: a randomized controlled trial
title_short Comparison of accuracy of maxilla between virtual surgical planning and conventional surgical planning in bimaxillary orthognathic surgery: a randomized controlled trial
title_sort comparison of accuracy of maxilla between virtual surgical planning and conventional surgical planning in bimaxillary orthognathic surgery a randomized controlled trial
topic Virtual surgical planning
Orthognathic surgery
Maxillary accuracy
3D planning
Randomized controlled trial
url https://doi.org/10.1186/s40902-025-00469-6
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