A comparative study of new Barcelona line and traditional method for 3D planning of orthognathic surgery.

Background: This retrospective study aims to compare the postoperative facial profiles of Class III orthognathic surgery patients planned according to the true vertical line (TVL) by comparing their positions with the Barcelona line (BL) reference specifically focusing on Class III patients with maxillary retrognathism and mandibular prognathism.

Methods: A retrospective analysis was conducted on 43 skeletal Class III patients undergoing isolated maxillary LeFort I or bimaxillary surgery. Digital planning data were used for preoperative and postoperative (6 months) upper incisor (UI)-BL measurements. Patients were categorized into four groups based on the maxillary incisor position relative to BL: Group 1 (UI > 4 mm behind BL), Group 2 (UI 0-4 mm behind BL), Group 3 (UI 0-4 mm ahead of BL), and Group 4 (UI > 4 mm ahead of BL).

Results: In total of 43 patients, those with maxillary retrognathia showed significant postoperative transitions towards a more protrusive position, while those with mandibular prognathism exhibited greater stability. (p = 0.001) CONCLUSION: BL is a reliable reference in digital planning for skeletal Class III patients, particularly in cases of maxillary retrusion, leading to outcomes more aligned with contemporary aesthetic standards. These findings support incorporating BL into orthognathic surgery planning to optimize sagittal positioning and facial harmony.

Trial registration: Baskent University Institutional Review Board approved this study (D-KA24/16). All participants provided informed consent prior to inclusion.