Case Volume and Plan Change After Virtual Surgical Planning: An Exploratory Survey Using a Standardized Class III Case
Daiven S. Sharma, Iris Y. Brammer, Eric Zeng, Mario S. Blondin Fernandez, Robin Yang, Christopher M. RunyanBackground:
Virtual surgical planning (VSP) enables 3-dimensional modeling of orthognathic outcomes, but whether it changes the operative plan a surgeon selects, and for which surgeons, remains unclear.
Objective:
To determine whether review of a patient-specific VSP simulation altered the selected operative plan, and whether change was associated with case volume or years in practice.
Methods:
In this exploratory multi-institutional cross-sectional survey (May-July 2025), attending oral and maxillofacial and plastic surgeons planned one standardized skeletal Class III case. Participants requested clinical and imaging data, recorded an initial plan, and rated confidence in VSP (1-10). Each plan was rendered in 3 dimensions; participants reviewed their simulation and the same 5 VSP-generated alternatives and indicated whether they preferred an alternative. The primary outcome was preference for an alternative plan.
Results:
Of 43 surgeons invited, 18 responded (41.9%); respondents and nonrespondents differed only in training background (
Conclusions:
In this exploratory single-case survey, plan change occurred only among surgeons performing ≤10 cases annually, and those who changed converged from 4 different plans onto 1 configuration. These preliminary findings are based on 5 plan changes and do not indicate which surgeons should use VSP.