Radiographic Imaging Multidisciplinary Approach to Orthognathic Surgery: Integrating Orthodontic Planning, Oral Surgical Intervention, and Radiological Assessment

Abstract

Background:
Orthognathic surgery requires accurate assessment of dentofacial skeletal discrepancies and precise coordination between orthodontic and surgical treatment objectives. Advances in three-dimensional (3D) imaging and virtual surgical planning (VSP) have provided improved opportunities for individualized treatment planning and prediction of postoperative skeletal outcomes.
Aim:
The present study aimed to evaluate the effectiveness and accuracy of integrated radiographic assessment and 3D VSP in patients undergoing orthognathic surgery.
Materials and Methods:
This observational study included 60 patients undergoing orthognathic surgical treatment. Comprehensive radiographic assessment was performed using panoramic radiographs, lateral and posteroanterior (PA) cephalograms, and cone-beam computed tomography (CBCT), as indicated. 3D VSP was used to determine the proposed skeletal movements and assist in multidisciplinary treatment planning. Presurgical cephalometric parameters were assessed before orthodontic treatment and immediately before surgery. Planned skeletal movements were subsequently compared with postoperative measurements. Clinical and radiological outcomes, treatment-plan modifications, multidisciplinary agreement, and planning confidence were also evaluated. Statistical analysis was performed using appropriate descriptive, comparative, and correlation-based methods.
Results:
Presurgical orthodontic preparation resulted in significant changes in the assessed skeletal and dental cephalometric parameters. Bimaxillary surgery was the most frequently performed surgical approach. Comparison of planned and postoperative skeletal movements demonstrated close correspondence across the evaluated maxillary and mandibular dimensions. Strong positive correlations were observed between virtually planned and postoperative skeletal movements. Postoperative assessment demonstrated generally favorable skeletal, occlusal, facial, and radiological outcomes, with stable positioning of the operated skeletal segments in most patients. Integration of orthodontic, surgical, and radiological assessments resulted in treatment-plan refinement in a proportion of cases and was associated with high multidisciplinary agreement and confidence in the finalized surgical plan.
Conclusion:
Integrated radiographic assessment combined with 3D VSP provides an effective and reliable approach to orthognathic surgical management. The multidisciplinary workflow facilitates comprehensive diagnosis, individualized treatment planning, accurate prediction of skeletal movements, and improved coordination between orthodontic and surgical objectives. This approach may enhance the precision, predictability, and overall quality of orthognathic surgical treatment.