The untold history of planning in orthognathic surgery: a narrative review from the beginning to virtual surgical simulation - 20/04/22

Doi : 10.1016/j.jormas.2022.04.002

M.D.A. Barretto ^⁎ , F. Melhem-Elias, M.C.Z. Deboni
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, Sao Paulo, SP 05088-000, Brazil

^⁎Corresponding author.

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 20 April 2022
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Highlights

•	The first orthognathic surgery was reported in 1849, and it took more than a century for the development of the traditional orthognathic 2D planning.
•	Despite that, the orthognathic surgery was restricted to the mandible at the beginning of the XX century. The maxillary changes were restricted to transversal modifications through orthodontic expansion, when necessary
•	In 1948 the first cephalometric 2D analysis was developed by William Downs.
•	In 1965, Obwegeser published his article [30,31] reporting the first bimaxillary orthognathic surgery, and thus beginning of what we consider modern orthognathic surgery.
•	The cooperation between orthodontists and maxillofacial surgeons was only consolidated in the 1970s, by the development of the use of plaster models mounted in articulators and cephalometric analysis to the planning of orthognathic surgery.

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Abstract

We aimed to produce a narrative review of planning orthognathic surgery, chronologically. Also, to present flaws of methods and the future of orthognathic surgery planning. The search was carried out mainly in PubMed, SCOPUS, Embase, and Cochrane databases. Also was complemented by manual search in reference lists from identified studies and in grey literature. The first orthognathic surgery was reported in 1849, and it took more than a century for the development of the traditional orthognathic 2D planning. Besides the advances, surgeons observed failures and lacks on 2D method in representing with reliability the facial and maxillary tridimensional structure (3D). With technological developments in 90s and 2000s, methodological improvements were granted, and the 3D protocol was created. The CASS and Charlotte protocols were the earliest 3D planning protocols conceived. Since then, some steps were simplified, and new technologies are being developed and added to create a more reliable and precise way of planning orthognathic surgery.

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Keywords : Virtual surgery planning, Orthognathic surgery, Maxillofacial surgery, Realistic imaging, Diagnosis, Computerized tomography