title: Three-dimensional virtual planning in orthognathic surgery enhances the accuracy of soft tissue prediction.
abstract: BACKGROUND
  Throughout the history of computing, shortening the gap between the physical and digital world behind the screen has always been strived for. Recent advances in three-dimensional (3D) virtual surgery programs have reduced this gap significantly. Although 3D assisted surgery is now widely available for orthognathic surgery, one might still argue whether a 3D virtual planning approach is a better alternative to a conventional two-dimensional (2D) planning technique. The purpose of this study was to compare the accuracy of a traditional 2D technique and a 3D computer-aided prediction method.
  
  
  METHODS
  A double blind randomised prospective study was performed to compare the prediction accuracy of a traditional 2D planning technique versus a 3D computer-aided planning approach. The accuracy of the hard and soft tissue profile predictions using both planning methods was investigated.
  
  
  RESULTS
  There was a statistically significant difference between 2D and 3D soft tissue planning (p < 0.05). The statistically significant difference found between 2D and 3D planning and the actual soft tissue outcome was not confirmed by a statistically significant difference between methods.
  
  
  CONCLUSIONS
  The 3D planning approach provides more accurate soft tissue planning. However, the 2D orthognathic planning is comparable to 3D planning when it comes to hard tissue planning. This study provides relevant results for choosing between 3D and 2D planning in clinical practice.
authors.affiliation: Department of Cranio-Maxillofacial Surgery, University of Antwerp, AZ MONICA Antwerp, Harmoniestraat 68, 2018 Antwerp, Belgium.
authors.forename: Geert
authors.initials: G
authors.lastname: Van Hemelen
authors.affiliation: Department of Cranio-Maxillofacial Surgery, University of Antwerp, AZ MONICA Antwerp, Harmoniestraat 68, 2018 Antwerp, Belgium.
authors.forename: Maarten
authors.initials: M
authors.lastname: Van Genechten
authors.affiliation: Department of Cranio-Maxillofacial Surgery, University of Antwerp, AZ MONICA Antwerp, Harmoniestraat 68, 2018 Antwerp, Belgium.
authors.forename: Lieven
authors.initials: L
authors.lastname: Renier
authors.affiliation: Department of Mund-, Kiefer- und Gesichtschirurgie, Fachklinik Hornheide, Dorbaumstraße 300, 48157 Münster, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Desmedt
authors.affiliation: Department of Medical Informatics, Military Hospital Queen Astrid, Bruynstraat 1, 1120 Brussels, Belgium.
authors.forename: Elric
authors.initials: E
authors.lastname: Verbruggen
authors.affiliation: Department of Cranio-Maxillofacial Surgery, University of Antwerp, AZ MONICA Antwerp, Harmoniestraat 68, 2018 Antwerp, Belgium. Electronic address: nasser@nadjmi.com.
authors.forename: Nasser
authors.initials: N
authors.lastname: Nadjmi
mesh_terms: D002508:Cephalometry / Q000379:methods; D004311:Double-Blind Method; D005145:Face / Q000033:anatomy & histology*; D005147:Facial Bones / Q000033:anatomy & histology; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D063172:Genioplasty / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008313:Malocclusion, Angle Class III / Q000601:surgery; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods; D010347:Patient Care Planning; D017060:Patient Satisfaction; D011446:Prospective Studies; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome; D014584:User-Computer Interface; D055815:Young Adult
keywords: 2D planning; 3D planning; Orthognathic surgery; Soft tissue prediction; Virtual surgery