Digital planning of orthognathic surgery with aligners - ortho-facial-driven - a viable protocol for surgery-first treatment

Sep 30, 2026

Traditionally, orthodontic-surgical correction proceeds through presurgical orthodontics, orthognathic surgery, and post-surgical orthodontics, which is predictable yet often requires prolonged treatment and can temporarily affect patient aesthetics. Early benefit surgery removes or reduces the initial orthodontic phase for earlier aesthetic and functional gains. The study presents a virtual diagnosis and planning protocol using CBCT and digital models for early benefit surgery with orthodontic aligners, evaluating accuracy via 30 cephalometric measurements.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages24

Reading Time1 h 0 min

AccessFree to download

Abstract

Introduction

Objective

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Volume 30-Number 5-Online | | | --- | | SPECIAL ARTICLE | | [https://doi.org/10.1590/2177-6709.30.5.e25spe5](https://doi.org/10.1590/2177-6709.30.5.e25spe5) | Digital planning oforthognathic surgery with aligners: ortho-facial-driven, a viable protocol for surgery-first treatment Bruno Nehme BARBO1 [https://orcid.org/0000-0002-7141-9867](https://orcid.org/0000-0002-7141-9867)[ ](https://orcid.org/0000-0002-7141-9867)Fabiane AZEREDO1 [https://orcid.org/0000-0002-5228-8718](https://orcid.org/0000-0002-5228-8718)[ ](https://orcid.org/0000-0002-5228-8718)Susana Maria Deon RIZZATTO1 [https://orcid.org/0009-0006-1853-8716](https://orcid.org/0009-0006-1853-8716)[ ](https://orcid.org/0009-0006-1853-8716)Guilherme Gehner FRITSCHER2 [https://orcid.org/0000-0003-1834-9115](https://orcid.org/0000-0003-1834-9115)[ ](https://orcid.org/0000-0003-1834-9115)Fernando ANDRIOLA2 [https://orcid.org/0000-0001-7345-2938](https://orcid.org/0000-0001-7345-2938)[ ](https://orcid.org/0000-0001-7345-2938)Luciane Macedo de MENEZES1 [https://orcid.org/0000-0002-8188-9803](https://orcid.org/0000-0002-8188-9803) Submitted: September 02, 2025 • Revised and accepted: October 30, 2025 [dr. menezes.ortho@gmail.com](dr. menezes.ortho@gmail.com) How to cite: Barbo BN, Azeredo F, Rizzatto SMD, Fritscher GG, Andriola F, Menezes LM. Digital planning of orthognathic surgery with aligners: ortho-facial-driven, a viable protocol for surgery-first treatment. Dental Press J Orthod. 2025;30(5):e25spe5 . Editor-in-Chief: Matheus Melo Pithon / Associate Editor: Cátia Cardoso Abdo Quintão (1) Pontifical Catholic University of Rio Grande do Sul, School of Health and Life Sciences, Department of Orthodontics (Porto Alegre/RS, Brazil) . (2) Pontifical Catholic University of Rio Grande do Sul, Department of Oral and Maxillofacial Surgery (Porto Alegre/ RS, Brazil) . Dental Press J Orthod. 2025;30(5):e25spe5 2 BarboorthogBnNat,hAiczeredosurgeryFw, Rizithzaalitto SgnerMs: Dor, tFhroits-facchi ealr-dGriG,veAn,ndriola viabaleFp, Merotoncezesol forLsMurg—erDy-ifgi tastlt prel annatmiengnt of ABSTRACT Introduction: Traditionally, orthodontic-surgical treatment is performed in three stages: presurgical orthodontics, orthognathic surgery and post-surgical orthodontics. Though predictable and stable, this protocol requires a long treatment time and can temporarily compromise the patient’s aesthetics. Early benefit surgery eliminates or reduces the initial stage of orthodontic treatment, providing more immediate aesthetic and functional improvement. Objective: To present a virtual diagnosis and planning protocol, combining cone beam computed tomography (CBCT) and digital models applied to early benefit surgeries using orthodontic aligners. Method: Ten patients with dentofacial deformities underwent the proposed protocol. The accuracy of virtual planning was assessed by comparing 30 planned cephalometric measurements with those achieved postoperatively, on the “x”(transverse),“y”(anteroposterior) and“z”(vertical) axes, using anatomical reference points. Results: Most measurements did not present statistically significant differences between planning and the surgical outcome. The exceptions were the incisive foramen on the z axis (mean difference = -1.79, P=0.045) and the left gonion on the x axis (mean difference = -1.52, P=0.029). Conclusion: The proposed early benefit surgery protocol with aligners proved to be a viable, safe and effective approach to conventional orthodontic-surgical treatment, with good clinical predictability rates. Keywords: Orthognathic surgery. Removable orthodontic appliances. Orthodontics. Dental Press J Orthod. 2025;30(5):e25spe5 3 BarboorthogBnNat,hAiczeredosurgeryFw, Rizithzaalitto SgnerMs: Dor, tFhroits-facchi ealr-dGriG,veAn,ndriola viabaleFp, Merotoncezesol forLsMurg—erDy-ifgi tastlt prel annatmiengnt of RESUMO Introdução: Tradicionalmente, otratamentoortodôntico-cirúrgico é realizado

FAQs

What treatment stages does the conventional orthodontic-surgical protocol involve?

It is performed in three stages: presurgical orthodontics, orthognathic surgery, and post-surgical orthodontics.

What is the objective of the proposed approach?

To present a virtual diagnosis and planning protocol that combines CBCT and digital models for early benefit surgeries using orthodontic aligners.

How was the accuracy of virtual planning evaluated?

The study compared 30 planned cephalometric measurements with postoperative results on x (transverse), y (anteroposterior), and z (vertical) axes using anatomical reference points.

Sep 30, 2026

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