Comparison of sliding genioplasty use between virtual surgical planning and model surgery in patients with facial asymmetry.

Abstract

This retrospective comparative study evaluated whether the adoption of virtual surgical planning (VSP) was associated with changes in adjunctive sliding genioplasty use in patients undergoing bimaxillary orthognathic surgery for facial asymmetry. A total of 117 patients were classified into a model surgery (MS) group (n = 32) and a VSP group (n = 85). Sliding genioplasty frequency was compared between groups, and subgroup analysis was performed according to preoperative menton deviation. In patients with severe menton deviation (≥4 mm), postoperative transverse skeletal and soft-tissue symmetry was additionally assessed using cone-beam computed tomography. Overall, there was slight evidence that adjunctive sliding genioplasty was performed less frequently in the VSP group than in the MS group (18% vs 34%, P = 0.079). In patients with severe menton deviation, the frequency was significantly lower in the VSP group (27% vs 82%, P = 0.003). In this subgroup, both VSP and MS groups showed significant postoperative improvement in transverse facial symmetry, with no significant intergroup differences in postoperative menton deviation (P = 0.17), soft-tissue pogonion deviation (P = 0.099), transverse surgical change at the bony menton (P = 0.52) or soft-tissue pogonion (P = 0.86), or the soft-to-hard tissue movement ratio (P = 0.20). VSP was associated with less frequent adjunctive sliding genioplasty in patients with severe preoperative menton deviation, while postoperative cone-beam computed tomography-based transverse skeletal and soft-tissue symmetry remained comparable between groups. These findings suggest a potential clinical role for VSP in treatment planning for patients with severe facial asymmetry.