Recent Advances in Surgical Orthodontics: A Narrative Review
Keywords:
Orthognathic surgery, surgical orthodontics, digital planning, aligners, patient-specific implants, ERAS, airwayAbstract
Surgical orthodontics has witnessed significant advancements over the last decade, with innovations spanning diagnostic imaging, virtual surgical planning (VSP), additive manufacturing, patient-specific implants (PSIs), navigation and augmented reality (AR), the surgery-first approach (SFA), aligner integration, airway-centered planning, and perioperative management strategies such as enhanced recovery after surgery (ERAS) and tranexamic acid (TXA). These developments collectively improve surgical accuracy, efficiency, stability, and patient-centered outcomes. This review synthesizes the current literature on seven key advances in surgical orthodontics, highlighting their clinical applications, limitations, and future research priorities.
Downloads
Metrics
References
Proffit WR, Fields HW, Larson BE, Sarver DM. Contemporary Orthodontics. 6th ed. St. Louis: Elsevier; 2018.
Proffit WR, White RP, Sarver DM. Contemporary Treatment of Dentofacial Deformity. St. Louis: Mosby; 2003.
Alkhayer A, Piffkó J, Lippold C, Segatto E. Accuracy of virtual planning in orthognathic surgery: a systematic review. Head Face Med. 2020;16(1):34.
Chen S, Lei J, Wang X, Song X, Ji P, Zhang C, et al. Outcome assessment of computer-aided versus conventional orthognathic surgery: A systematic review and meta-analysis. Int J Surg. 2021;89:105947.
Kim JW, Kim JC, Hwang JH, Kim HK. Accuracy of patient-specific titanium plates in orthognathic surgery. J Craniomaxillofac Surg. 2023;51(4):344–352.
Buchholzer S, Rustemeyer J. Three-dimensional analysis of accuracy and stability using patient-specific implants in orthognathic surgery. J Oral Maxillofac Surg. 2025;83(1):42–50.
Tsokkou M, Ayoub AF, Rossi E, et al. Augmented reality in orthognathic surgery: a systematic review. Br J Oral Maxillofac Surg. 2025;63(1):45–54.
Oillic N, Haq J, Leiggener C, et al. Dynamic navigation in orthognathic surgery: current evidence. Int J Oral Maxillofac Surg. 2023;52(7):900–909.
Seo YJ, Chung KR, Kim YH, Nelson G. Surgery-first approach in orthognathic surgery: a review. Korean J Orthod. 2021;51(6):383–397.
Zammit P, Goonewardene MS, Battagel J. Surgery-first orthognathic approach: current evidence and future directions. Prog Orthod. 2023;24(1):16.
Liou EJ, Chen PH, Wang YC, Yu CC, Huang CS, Chen YR. Surgery-first approach with aligner orthodontics: a paradigm shift. Am J Orthod Dentofacial Orthop. 2024;166(3):235–246.
Cunha LM, Pithon MM, et al. Clear aligners in orthognathic surgery patients: outcomes and limitations. Angle Orthod. 2025;95(2):178–185.
Trindade R, Paiva R, Santos C, et al. Maxillomandibular advancement for obstructive sleep apnea: A systematic review and meta-analysis. Sleep Med Rev. 2023;67:101737.
Walker RJ, Holty JEC, et al. Long-term outcomes after maxillomandibular advancement in obstructive sleep apnea. Chest. 2024;165(4):925–934.
Cascino F, Vicini C, D’Agostino G, et al. Piezosurgery in orthognathic procedures: systematic review. J Craniomaxillofac Surg. 2021;49(8):728–735.
Amaral MB, Oliveira A, et al. Comparative analysis of piezoelectric versus conventional osteotomy in orthognathics. Oral Surg Oral Med Oral Pathol Oral Radiol. 2022;133(1):72–80.
Stratton C, Smith D, et al. Enhanced recovery after surgery in orthognathic patients: a systematic review. Int J Oral Maxillofac Surg. 2022;51(9):1134–1142.
Joachim S, Wahlstrom S, et al. Enhanced recovery pathways in pediatric and adult orthognathics: multicenter analysis. Br J Oral Maxillofac Surg. 2025;63(2):110–118.
Baghaie F, Thompson C, et al. Tranexamic acid in orthognathic surgery: updated systematic review and meta-analysis. J Oral Maxillofac Surg. 2025;83(2):223–231.
Shafaee H, Khosravi R, et al. Stability of surgery-first versus conventional sequencing: systematic review. J World Fed Orthod. 2025;14(1):35–44.
Kunz F, Dulla M, et al. Patient-reported outcomes after aligner-assisted orthognathic therapy. Eur J Orthod. 2024;46(3):340–348.
Ali M, Nanu A, et al. Ethnicity-based outcomes in MMA for OSA. Sleep Breath. 2025;29(1):99–108.
Kesmez O, Aksu M, et al. Long-term stability of patient-specific implants in orthognathic surgery. J Stomatol Oral Maxillofac Surg. 2022;123(5):e563–e569.
Raj T, Sharma P, et al. Piezoelectric versus rotary osteotomy in mandibular surgery: a randomized trial. Int J Oral Maxillofac Surg. 2022;51(11):1375–1382.
Nanu A, Gupta V, et al. Impact of MMA on cardiovascular parameters in OSA patients. J Clin Sleep Med. 2024;20(1):55–62.
Ölmez H, Çakan DG. Clear aligners versus fixed appliances: systematic review. Orthod Craniofac Res. 2023;26(3):274–283.
Singh A, Gupta R, et al. Digital workflows and accuracy metrics in orthognathic surgery: a systematic review. Clin Oral Investig. 2025;29(1):23–35.
Martis CS, et al. AI-assisted surgical prediction in orthognathics: current evidence. J Dent Res. 2025;104(4):445–454.
Żelechowski A, et al. Mixed reality in craniofacial surgery: technical update. Front Surg. 2024;11:1448379.
Wei H, et al. Long-term stability of surgery-first orthognathic protocols: systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(6):495–503.
Cunha-Cruz J, et al. Patient-centered outcomes in orthognathic surgery: scoping review. Community Dent Oral Epidemiol. 2025;53(1):23–36.
Gupta A, et al. Cost-effectiveness of digital workflows in orthognathics: pilot analysis. Health Econ Rev. 2025;15(1):10.
Tsou E, et al. Robotics in maxillofacial surgery: emerging applications. J Craniomaxillofac Surg. 2025;53(3):245–254.
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.