Important factors in the selection of orthognathic surgical procedures and treatment plan are the stability of the results, the predictability of hard and soft tissue changes and the patient’s response. The orthodontic and surgical changes must be described accurately prior to treatment in order to assess the treatment’s feasibility, optimize case management and increase patient understanding and acceptance of the recommended treatment.
Cephalometrics is a routine part of the diagnosis and treatment planning process and also allows the clinician to evaluate changes following combined orthodontic and surgical treatment. Traditionally cephalometry has been employed manually; nowadays computerized cephalometric systems are very popular. Cephalometric prediction in orthognathic surgery can be done manually or by computers, using several currently available software programs, alone or in combination with video images.
Retrospective studies of treated patients have provided the clinician with guidelines for estimating the effect of hard tissue surgery on the soft tissue. Forecasts must be based on known soft tissue changes that occur subsequent to dental and skeletal repositioning to be accurate. Accurate prediction is highly critical, because it is related to correct treatment decision making, appropriate treatment planning and the post treatment facial appearance anticipated by the patient. However, these predictions will always have limitations, because they are based on correlations between single cephalometric variables and cannot fully describe a three-dimensional biological phenomenon.
In this presentation the different methods of cephalometric prediction of the orthognathic surgery outcome will be reviewed and their limitations will be evaluated and discussed.