Functional and aesthetic outcomes in complex cases of dentofacial deformities through the integration of 3D digital planning: a narrative review

Abstract

Dentofacial deformities involve significant skeletal and dental discrepancies that impair occlusion, oral function, airway, and facial aesthetics. Accurate diagnosis and precise treatment planning are critical for restoring function and achieving desirable aesthetic outcomes. In recent years, three-dimensional (3D) digital planning—including virtual surgical planning (VSP), cone-beam CT imaging, CAD/CAM workflows, and 3D printing—has emerged as a transformative approach in orthognathic surgery. This narrative review aims to evaluate how 3D digital planning integration affects functional and aesthetic outcomes in complex dentofacial deformity cases, highlighting the advantages, limitations, and potential future directions. A systematic search of PubMed, Cochrane library, and Google Scholar was conducted for studies published between 2015–2025. Keywords included “3D digital planning,” “virtual surgical planning,” “orthognathic surgery,” “functional outcomes,” and “aesthetic outcomes.” Studies reporting quantitative or qualitative human clinical outcomes were included, while animal studies, case reports without outcomes, or non-digital workflows were excluded. Evidence was synthesized into three thematic areas: technological integration, functional outcomes, and aesthetic outcomes. Studies indicate that 3D digital planning enhances surgical precision and predictability. Mean linear discrepancies between planned and actual outcomes ranged from 0.04–0.25 mm with VSP versus 0.29–1.33 mm using conventional methods. AI-assisted soft-tissue simulations achieved mean predictive errors of 1.17 ± 0.49 mm. Functional improvements included enhanced mastication, occlusal stability, TMJ alignment, and airway optimization, while aesthetic gains comprised improved facial symmetry and patient-reported satisfaction. Fully digital workflows, including automated dental registration, 3D-printed splints, and interdisciplinary planning, reduced intraoperative variability and operative time. 3D digital planning significantly improves functional and aesthetic outcomes in complex dentofacial deformities. Future research should prioritize long-term comparative studies, standardized outcome metrics, and integration of emerging technologies such as AI, machine learning, and augmented reality to further optimize orthognathic surgical planning and execution.