Gupta Sumit
Department of Orthodontics, Healthpoint Hospital, Mubadala Health, M42, Abu Dhabi, ARE.
Cureus. 2025 Feb 15;17(2):e79033. doi: 10.7759/cureus.79033. eCollection 2025 Feb.
Orthognathic surgery, which corrects jaw deformities, requires meticulous planning to achieve optimal functional and aesthetic outcomes. Traditional surgical planning (TSP) relies on manual methods, whereas virtual surgical planning (VSP) uses computer-assisted simulations that may enhance accuracy and efficiency. Therefore, we conducted a systematic review to evaluate the effectiveness of VSP compared to TSP for orthognathic surgery. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered the protocol in the Prospective Register of Systematic Reviews (CRD42024618614). We searched electronic databases for studies comparing VSP and TSP. Two independent reviewers performed screening and data extraction. We assessed quality using the Cochrane Risk of Bias 2 (RoB 2) tool. We calculated the standardized mean difference (SMD) as the summary measure and used a random-effects model, considering p < 0.05 as statistically significant. We performed analyses using Review Manager (RevMan) version 5.3 (Cochrane Collaboration, London, UK). We included 10 qualitative synthesis and meta-analysis studies, evaluating data from 474 patients, of whom 244 underwent TSP and 230 underwent VSP. Included studies showed moderate to low risk of bias. We evaluated effectiveness in terms of planning time, surgical time, horizontal measurements, vertical measurements, and accuracy indicators for predicting outcomes. Meta-analysis revealed reduced planning time (SMD = 3.19 (-5.74 to 0.64)) and surgical time (SMD = -0.42 (-1.32 to 0.49)) with VSP, as well as differences in horizontal (SMD = -0.39 (-0.73 to 0.05)) and vertical measurements (SMD = -0.20 (-0.54 to 0.13)), and in accuracy indicators (SNA0: SMD = -0.15 (-0.46 to 0.16); SNB0: SMD = 0.53 (-0.82 to 1.87)). SNA0 represents the angle formed by sella (S), nasion (N), and point A (A), and SNB0 represents the angle formed by sella (S), nasion (N), and point B (B). The funnel plot showed no evidence of publication bias. VSP reduced planning and surgical times and predicted facial outcomes more accurately than TSP. These findings suggest that VSP can be an effective alternative to TSP in orthognathic surgeries.
正颌手术用于矫正颌骨畸形，需要精心规划以实现最佳的功能和美学效果。传统手术规划（TSP）依靠手工方法，而虚拟手术规划（VSP）则使用计算机辅助模拟，这可能会提高准确性和效率。因此，我们进行了一项系统评价，以评估在正颌手术中VSP与TSP相比的有效性。我们遵循系统评价和Meta分析的首选报告项目指南，并在系统评价前瞻性注册库（CRD42024618614）中注册了方案。我们在电子数据库中搜索比较VSP和TSP的研究。两名独立的评审员进行筛选和数据提取。我们使用Cochrane偏倚风险2（RoB 2）工具评估质量。我们计算标准化平均差（SMD）作为汇总指标，并使用随机效应模型，将p<0.05视为具有统计学意义。我们使用Review Manager（RevMan）5.3版（英国伦敦Cochrane协作网）进行分析。我们纳入了10项定性综合和Meta分析研究，评估了474例患者的数据，其中244例接受了TSP，230例接受了VSP。纳入的研究显示偏倚风险为中度至低度。我们从规划时间、手术时间、水平测量、垂直测量以及预测结果的准确性指标等方面评估有效性。Meta分析显示，VSP缩短了规划时间（SMD = 3.19（-5.74至0.64））和手术时间（SMD = -0.42（-1.32至0.49）），在水平测量（SMD = -0.39（-0.73至0.05））、垂直测量（SMD = -0.20（-0.54至0.13））以及准确性指标（SNA0：SMD = -0.15（-0.46至0.16）；SNB0：SMD = 0.53（-0.82至1.87））方面也存在差异。SNA0代表蝶鞍（S）、鼻根点（N）和A点（A）形成的角度，SNB0代表蝶鞍（S）、鼻根点（N）和B点（B）形成的角度。漏斗图未显示发表偏倚的证据。与TSP相比，VSP缩短了规划和手术时间，并能更准确地预测面部结果。这些发现表明，在正颌手术中，VSP可以成为TSP的有效替代方案。
