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Purpose <p>Three-dimensional virtual surgical planning (3D-VSP) is increasingly used in orthognathic surgery; however, procedure-specific evidence regarding its real-world impact on operative efficiency and intraoperative blood loss remains limited. This study evaluated the association between 3D-VSP implementation and operative time, and intraoperative blood loss across different orthognathic procedures.</p> Methods <p>This retrospective cohort study included consecutive patients who underwent orthognathic surgery at a single academic institution before (2019–2020) and after (2023–2024) the full implementation of 3D-VSP integrated with in-house additive manufacturing (<i>n</i> = 344). Procedure-specific multivariable linear regression analyses were performed, adjusting for age, sex, and surgeon experience.</p> Results <p>After 3D-VSP implementation, operative time was reduced by approximately 36&#xa0;min in sagittal split ramus osteotomy (SSRO), 50&#xa0;min in Le Fort I (LF1) combined with SSRO, and 42&#xa0;min in segmental LF1 combined with SSRO, representing a 15–20% reduction in total operative time. No meaningful reduction was observed in intraoral vertical ramus osteotomy (IVRO)-based procedures. A statistically significant, but modest, reduction in intraoperative blood loss was observed only in SSRO. The time-saving effect was independent of surgeon experience.</p> Conclusion <p>The clinical benefit of 3D-VSP in orthognathic surgery is procedure-dependent and most evident in geometrically complex SSRO-based operations. These findings support the targeted implementation of digital planning and additive manufacturing workflows to improve operative efficiency in routine practice.</p>

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Three-dimensional virtual planning reduces operative time in orthognathic surgery: a procedure-specific retrospective study incorporating additive manufacturing

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月30日

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  • Yuki Kunisada,
  • Norie Yoshioka,
  • Akiyoshi Nishiyama,
  • Masanori Masui,
  • Koichi Kadoya,
  • Hiroaki Takakura,
  • Kyoichi Obata,
  • Kisho Ono,
  • Koki Umemori,
  • Soichiro Ibaragi

摘要

Purpose

Three-dimensional virtual surgical planning (3D-VSP) is increasingly used in orthognathic surgery; however, procedure-specific evidence regarding its real-world impact on operative efficiency and intraoperative blood loss remains limited. This study evaluated the association between 3D-VSP implementation and operative time, and intraoperative blood loss across different orthognathic procedures.

Methods

This retrospective cohort study included consecutive patients who underwent orthognathic surgery at a single academic institution before (2019–2020) and after (2023–2024) the full implementation of 3D-VSP integrated with in-house additive manufacturing (n = 344). Procedure-specific multivariable linear regression analyses were performed, adjusting for age, sex, and surgeon experience.

Results

After 3D-VSP implementation, operative time was reduced by approximately 36 min in sagittal split ramus osteotomy (SSRO), 50 min in Le Fort I (LF1) combined with SSRO, and 42 min in segmental LF1 combined with SSRO, representing a 15–20% reduction in total operative time. No meaningful reduction was observed in intraoral vertical ramus osteotomy (IVRO)-based procedures. A statistically significant, but modest, reduction in intraoperative blood loss was observed only in SSRO. The time-saving effect was independent of surgeon experience.

Conclusion

The clinical benefit of 3D-VSP in orthognathic surgery is procedure-dependent and most evident in geometrically complex SSRO-based operations. These findings support the targeted implementation of digital planning and additive manufacturing workflows to improve operative efficiency in routine practice.