From Virtual Planning to Precision Surgery: An Evidence-Based Narrative Review of Digital Innovations in Orthognathic Surgery

Orthognathic surgery has undergone a profound transformation with the integration of digital technologies that have enhanced diagnosis, treatment planning, surgical execution, and postoperative assessment. Conventional planning methods, largely dependent on two-dimensional cephalometric analysis, facebow transfer, and manual model surgery, are increasingly being replaced by comprehensive digital workflows incorporating cone-beam computed tomography (CBCT), intraoral scanning, computer-aided design/computer-aided manufacturing (CAD/CAM), virtual surgical planning (VSP), additive manufacturing, and artificial intelligence (AI). These technologies have substantially improved the precision of skeletal repositioning while facilitating personalized surgical planning and reducing cumulative procedural errors. Furthermore, recent innovations such as patient-specific implants, surgical navigation, augmented reality, and machine learning are redefining the standards of precision in orthognathic surgery. Despite these advances, challenges remain regarding cost, accessibility, validation, and long-term clinical outcomes. This review critically examines the contemporary digital workflow in orthognathic surgery, emphasizing the evidence supporting its clinical accuracy, current limitations, and future directions toward precision surgery.