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Background <p>Orthognathic surgery (OGS) planning remains a complex process that requires integration of clinical assessment, cephalometric analysis, and surgical decision-making. While virtual surgical planning (VSP) and three-dimensional (3D) digital workflows have improved surgical precision, there remains a need for structured clinical assessment protocols that guide initial diagnostic decision-making, particularly in resource-limited settings.</p> Objective <p>To develop and evaluate a structured clinical proforma integrating key clinical and cephalometric parameters for systematic OGS planning, derived from a 20-year single-surgeon retrospective case series.</p> Materials and Methods <p>A retrospective review of 131 OGS cases performed by a single surgeon was conducted. Clinical records, photographs, lateral cephalograms, and digital documentation were analysed. Recurrent diagnostic parameters were identified and tabulated into a structured proforma comprising 16 clinical and 11 cephalometric parameters. Postoperative outcomes were assessed using patient satisfaction scores (threshold ≥8/10) based on the Posnick and Wallace OGS Satisfaction Scoring system. Sixty-six patients with complete follow-up data and favourable outcomes were observed among respondents were included for outcome analysis.</p> Results <p>The proforma demonstrated consistent correlation between clinical findings and surgical treatment selection across all reviewed cases. Of the 66 respondents meeting the satisfaction threshold, the clinical and cephalometric parameters of the proforma corresponded with favourable postoperative satisfaction among responding patients. The proforma streamlined the diagnostic pathway by categorising presenting complaints into nine defined clinical categories (A–I) and mapping them to a limited surgical armamentarium (Le Fort I osteotomy, bilateral sagittal split osteotomy [BSSO], genioplasty, and anterior segmental osteotomies, singly or in combination).</p> Conclusion <p>The proposed structured proforma provides a reproducible, systematic structured clinical decision-support workflow derived from long-term orthognathic surgical experience for OGS planning that may reduce diagnostic complexity for less experienced surgeons. Prospective multicentric validation with standardised outcome measures is warranted.</p>

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Simplifying Orthognathic Planning-A Retrospective Planning Framework Derived from Experience of Orthognathic Surgery: Analysis of 131 Cases Over 20 Years

  • 期刊论文

  • 发表日期：

    2026年6月29日

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  • Srijon Mukherji,
  • Annuradha Dey,
  • Anurag Vats

摘要

Background

Orthognathic surgery (OGS) planning remains a complex process that requires integration of clinical assessment, cephalometric analysis, and surgical decision-making. While virtual surgical planning (VSP) and three-dimensional (3D) digital workflows have improved surgical precision, there remains a need for structured clinical assessment protocols that guide initial diagnostic decision-making, particularly in resource-limited settings.

Objective

To develop and evaluate a structured clinical proforma integrating key clinical and cephalometric parameters for systematic OGS planning, derived from a 20-year single-surgeon retrospective case series.

Materials and Methods

A retrospective review of 131 OGS cases performed by a single surgeon was conducted. Clinical records, photographs, lateral cephalograms, and digital documentation were analysed. Recurrent diagnostic parameters were identified and tabulated into a structured proforma comprising 16 clinical and 11 cephalometric parameters. Postoperative outcomes were assessed using patient satisfaction scores (threshold ≥8/10) based on the Posnick and Wallace OGS Satisfaction Scoring system. Sixty-six patients with complete follow-up data and favourable outcomes were observed among respondents were included for outcome analysis.

Results

The proforma demonstrated consistent correlation between clinical findings and surgical treatment selection across all reviewed cases. Of the 66 respondents meeting the satisfaction threshold, the clinical and cephalometric parameters of the proforma corresponded with favourable postoperative satisfaction among responding patients. The proforma streamlined the diagnostic pathway by categorising presenting complaints into nine defined clinical categories (A–I) and mapping them to a limited surgical armamentarium (Le Fort I osteotomy, bilateral sagittal split osteotomy [BSSO], genioplasty, and anterior segmental osteotomies, singly or in combination).

Conclusion

The proposed structured proforma provides a reproducible, systematic structured clinical decision-support workflow derived from long-term orthognathic surgical experience for OGS planning that may reduce diagnostic complexity for less experienced surgeons. Prospective multicentric validation with standardised outcome measures is warranted.