I once watched an oral surgeon pull up a jaw on his laptop, rotate it with two fingers, and cut a virtual bone segment before he ever touched a scalpel. He first rehearsed the entire surgery on screen, then used a dental 3D printing service in the next room to print a surgical guide he would use the next morning. If this were ten years ago, that same planning would have happened on plaster models and tracing paper.
Orthognathic surgery, or surgery that corrects jaw misalignment, used to rely on physical casts, hand-drawn cephalometric tracings, and a technique called model surgery, in which the surgeon literally sawed apart a plaster cast of the patient’s teeth to simulate bone movements. It worked. It also left a lot of room for error because a plaster model can’t show you an airway, a nerve canal, or how soft tissue will drape over a repositioned jaw.
3D technology changed the starting point of the conversation. Surgeons stopped planning on approximations and started planning on the patient’s actual anatomy.
From Flat Images to a Working Model of the Face
Traditional orthognathic workups leaned on two-dimensional X-rays and photographs. Flat images ask a surgeon to imagine depth that isn’t there.
Cone beam computed tomography, or CBCT, solved a big part of that problem. It gives a full 3D reconstruction of the skull, jaws, and airway from a single scan. Combine that with 3D facial photography, and you get a model that captures both the hard structure underneath and the soft tissue on top.
In a review published by Cao and colleagues, 3D technology is divided into four stages: diagnosis, surgical planning, the surgery itself, and postoperative evaluation (1). 3D imaging, virtual planning software, 3D printing, and computer-aided design and manufacturing (CAD/CAM) each play a role somewhere in that chain, and the review found evidence that using them together shortens operative time and hospital stays compared to the older 2D workflow (1). That older workflow earns the “2D” label because it relied on flat representations of a three-dimensional structure, plaster casts physically sawed apart to simulate bone movement, hand-drawn cephalometric tracings, and two-dimensional X-rays and photographs. None of these tools could capture depth, so a surgeon had to mentally reconstruct a 3D model of the jaw, airway, and soft tissues from flat images and physical approximations. The shift to CBCT and 3D facial photography replaced that guesswork with an actual volumetric model of the patient’s anatomy.
Rehearsing the Surgery Before the Surgery
Here’s where it gets interesting. Once a surgeon has a 3D model of a patient’s skull, that model becomes a rehearsal space.
Virtual surgical planning lets the surgical team cut, move, and reposition bone segments on screen, checking how the bite comes together and how the jaw will sit in relation to the skull base before making a single incision. This virtual plan then gets translated into something physical: 3D-printed cutting guides, splints, and, increasingly, patient-specific implants built to the exact geometry of that person’s bone.
The review describes this as a shift toward point-of-care manufacturing, where hospitals design and print surgical tools in-house rather than ordering generic, one-size-fits-most hardware (2). A plate made for one specific jaw fits differently than a plate bent by hand in the operating room to approximate a fit.
The same review also looks ahead to four-dimensional, or 4D, printing, materials engineered to change shape over time after implantation. It’s still early, but the direction is clear: implants that don’t just match anatomy initially but adapt to it afterward (2).
Can a Computer Predict the Outcome?
The newest layer on top of all this is prediction. If an accurate 3D model of a patient’s face and jaw can be built, can software predict what the face will look like after surgery?
A systematic review by Hasanzade and colleagues in the Galen Medical Journal looked at exactly that question, screening 42 studies published between 2020 and 2025 and narrowing them to 12 that used machine learning or deep learning to predict orthognathic surgery outcomes from 3D data (3). The techniques varied, including deep neural networks, random forest models, and graph-based approaches, but the common thread was training software on 3D facial scans or CBCT images to forecast postoperative results.
The review’s conclusion lands somewhere between promising and premature. Digital technology, 3D modeling, and machine learning are playing a growing role in maxillofacial and cosmetic surgical planning, but the field is still young, with 12 eligible studies out of 42 screened over five years (3). That’s not a mature body of evidence yet; it’s an emerging one.
So a Computer Can Plan Your Jaw Surgery. Does That Make It Better?
Not automatically, and that distinction matters.
An editorial by Hwang in the Journal of the Korean Association of Oral and Maxillofacial Surgeons makes a point worth sitting with: the 3D approach has become an essential method in orthognathic surgery, and it represents a genuine milestone, but nobody is entirely sure what comes next, and the technology still requires a surgeon who knows how to use it well (4). A 3D-printed splint built from a flawed virtual plan is still a flawed splint. The software plans the surgery. It doesn’t perform it.
That’s the honest caveat running through all four of these sources. The reviews consistently find that 3D technology adds precision, reduces guesswork, and can shorten time in the operating room (1)(2). What they don’t claim is that it replaces surgical judgment, and machine learning research in particular is still working out which prediction models actually hold up outside a research setting (3).
What Now? So does 3D technology actually improve oral and maxillofacial surgery?
Yes, and by a meaningful margin.
Going from plaster models and flat X-rays to a full 3D reconstruction of a patient’s skull changes what a surgical team can see and plan for before they ever pick up an instrument. CBCT imaging, virtual surgical planning, 3D-printed guides and implants, and now early machine learning models all point toward the same trend: more of the surgery gets solved on a screen, and less of it gets figured out as surgery is happening on a patient.
3D technology, however, is not a finished product. The evidence base for predictive 3D modeling remains limited. Point-of-care manufacturing is still new enough that most hospitals don’t have it in-house, and every one of these tools is only as good as the person running it.
If you’re heading into orthognathic surgery, ask your surgical team whether they use virtual surgical planning and 3D-printed guides. It’s a fair question, and a good surgeon will be glad you asked it.
Check Out Our Other Blogs
Did you enjoy our article? We have more great content (links below)!
- Curodont: A New Way to Treat Cavities Without the Drill
- Dental Bioprinting: The Future of Dentistry?
- Salivary Glands: The Unsung Heroes of Oral Health
- The Teeth Whitening Powder! Future of Whitening?
- How Dental Biologics Are Shaping the Future of Dentistry?
- Gum Disease and The Heart… It’s Not A Loving Relationship
- Enamel Regeneration: A Dental Revolution on the Horizon
- Ozempic Teeth: From Waist Line To Gum Line
- Unveiling the Truth: Debunking Myths about Fluoride
- Be Wary of PRIME… It Could Ruin Your Teeth
- Hydrogen Peroxide Teeth Experiment: Be Careful With Whitening
- Dental Science Experiments: Hydrochloric Acid and Teeth
- Medium: What It Means To Be A Tooth Engineer
Follow Us!
If you liked this article, then please subscribe to our YouTube Channel and Medium Blog for more Tooth Engineers content. You can also find us on TikTok, Instagram and Facebook.References
- Cao RK, Li LS, Cao YJ. Application of three-dimensional technology in orthognathic surgery: a narrative review. Eur Rev Med Pharmacol Sci. 2022 Nov;26(21):7858-7865. https://doi.org/10.26355/eurrev_202211_30137
- Saxena V, Krishnan VG, Rangarajan H. Virtual 3D planning in Maxillofacial surgery: The journey so far and the way ahead. Med J Armed Forces India. 2024 Jul-Aug;80(4):392-398. https://doi.org/10.1016/j.mjafi.2024.05.008
- Hasanzade M, Yousefbeigi A, Jafari S, Veshveshadi O, Soleimani M, Mohammadikhah M, Mirmohammadi SMM. Predictive 3D Modeling of Orthognathic Surgery Outcomes Using Machine Learning Algorithms: A Systematic Review. Galen Med J. 2025 Nov 8;14(S Pt 1):e4014. https://doi.org/10.31661/gmj.vi.4014
- Hwang DS. Practical utility of the three-dimensional approach in orthognathic surgery. J Korean Assoc Oral Maxillofac Surg. 2021 Aug 31;47(4):337-338. https://doi.org/10.5125/jkaoms.2021.47.4.337
- xAI. (2026). AI-generated illustration of futuristic 3D virtual surgical planning and patient-specific jaw reconstruction using holographic models and 3D-printed implants [AI-generated image]. Grok.
