Table 2. Data extraction sheet .
ANB: A point-Nasion-B point angle; CAD: Computer-aided design; CAD/CAM: Computer-aided design/computer-aided manufacturing; CSP: Conventional surgical planning; FFF: Fibula free flap; IS-VSP: Integrated surgical virtual surgical planning; LOS: Length of stay; MAO: Mandibular angle osteotomy; P-VSP: Patient-specific virtual surgical planning; PEEK-PSI: Polyether ether ketone patient-specific implants; SNA: Sella-Nasion-A point angle; SNB: Sella-Nasion-B point angle; TMJ: Temporomandibular joint; UHMWPE: Ultra-high molecular weight polyethylene; VSP: Virtual surgical planning.
| Study | Population | Type of study | Mean age of patients | Parameters checked | Intervention | Comparison | Outcome | Time period |
| Efanov JI et al., 2018 [18] | 54 patients | Retrospective review | Not specified | Adherence to virtual surgical plans (complete, partial, abandoned) | Virtual Surgical Planning (VSP) | Not specified | 85% complete adherence, 9% partially adhered, 4% abandoned | July 2012 - October 2016 |
| Yang WF et al., 2018 [19] | 10 patients with head and neck tumors | Open-label, prospective, single-arm, single-center clinical trial | 52.6 years | Intraoperative success rate, adaptation of surgical plates, postoperative adverse events, accuracy of reconstruction | 3D-printed patient-specific surgical plates | Conventional plates (contingency plan) | Primary: 100% intraoperative success rate; Secondary: No major or minor complications; Mean absolute distance deviation: 1.40 ± 0.63 mm | December 2016 to October 2017 |
| Sun et al., 2013 [20] | 15 patients undergoing bimaxillary surgery (excluding cleft lip and palate) | Clinical validation study | Not provided | Accuracy of occlusal fit, surgical movement | Use of CAD-designed registration block (CAD_WR) and digital intermediate splint for bimaxillary surgery | Planned vs. Actual Surgical Movement | No significant difference between planned and actual surgical movements in sagittal, vertical, and horizontal directions | October 2010 to April 2012 |
| Liu YF et al., 2014 [21] | 15 cases (8 males, 7 females) | Clinical case series | 39.8 years (range: 15–63 years) | Tumor type (ameloblastoma, fibroma, gingival carcinoma), defect size (3 cm × 3 cm - 10 cm × 5 cm), flap size (9.5 cm - 17 cm) | Fibular free flap reconstruction with template guidance | Conventional free-hand operation | Reduced surgical time by 20%, improved accuracy in resection and graft shaping, good postoperative functional recovery | December 2011 - December 2013 |
| Soleman J et al., 2015 [22] | Infants with craniosynostosis | Observational study | 8 months | Cranial morphology, symmetry, soft-tissue changes, operative outcomes | 3D printed surgical templates for frontoorbital advancement | Standard procedures without 3D templates | Excellent accuracy in cranial modeling, improved reconstruction speed, minimal swelling, good scar healing, no neurological deficits | Postoperative follow-up: 3 weeks; Additional follow-up planned: 6 months |
| Ye N et al., 2015 [23] | Nine patients with prominent mandibular angles (8 women, 1 man) | Observational study | 26 years | Accuracy of osteotomy, post-operative symmetry, deviation from simulation | Mandibular angle osteotomy (MAO) with 3D printed surgical templates | Standard MAO without 3D templates | High accuracy in osteotomy, minimal shell-to-shell deviations (2.02 ± 0.32 mm on right, 1.97 ± 0.41 mm on left), no nerve injury, good cosmetic outcomes | July 2013 to February 2014 |
| Scolozzi P et al., 2015 [24] | Ten consecutive patients with dentofacial deformities (6 men, 4 women) | Retrospective study | 21.3 years | Age, gender, dentofacial deformity, surgical procedure, postoperative complications | CAD/CAM surgical splints, cutting guides, customized internal distractors, and PEEK-PSI implants | Standard procedures without CAD/CAM | No intraoperative complications, stable cosmetic and dimensional results at 1-year follow-up | 1 year follow up |
| Sembronio S et al., 2019 [25] | 10 patients, 11 TMJ reconstructions (including bilateral) | Retrospective | Not specified | Prosthesis positioning accuracy, preoperative vs. postoperative measurements | Preoperative virtual planning and customized prostheses (titanium alloy and UHMWPE), surgical guides for bone resection and prosthesis placement | Preoperative vs. postoperative measurements | Lin concordance correlation coefficient: 0.999, 95% CI: 0.999–0.999, 99% CI: 0.999–1.000; 95% limits of agreement: -1.608 mm to 1.598 mm; 79.02% of differences <1 mm; no significant difference (p = 0.83) | 2016-2017 |
| Schneider D et al., 2019 [26] | 21 patients with retrognathism | Prospective | 31.1 years (median 32.6 years) | Angular differences for maxilla and mandible (SNA, SNB, ANB); accuracy of splints; surgical time; cost | Virtual Planning (VSP) vs. Conventional Planning (CSP) | Virtual Planning vs. Conventional Planning | Significant differences in angular measurements (SNA, SNB, ANB); fewer modifications needed for VSP splints; reduced surgical time with VSP; cost analysis showed VSP was similar to CSP without models | 2014 to 2017 |
| Smithers FAE et al., 2018 [27] | 6 patients undergoing mandible or maxillary reconstruction | Prospective | Age range 44–78 years | Operative time, length of hospital stay, flap failures, wound infections, recovery complications | IS-VSP (Integrated Surgical Virtual Surgical Planning) process for fibula free flap (FFF) reconstructions | Conventional VSP | Median operative time: 7h 46min; Median length of stay: 13 days; No flap failures; One major complication (wound infection) | August 2016 to February 2017 |
| Swendseid BP et al., 2020 [28] | 23 patients with midface defects requiring scapula reconstruction | Retrospective cohort | Median age: 67 (range 22–88) | Subunit resection and reconstruction, anatomic position of bone segments, bone segment apposition, postoperative projection symmetry, shoulder dysfunction, quality of life | Virtual Surgical Planning (VSP) vs. non-VSP (conventional planning) | VSP vs. non-VSP | VSP group restored more subunits, achieved better anatomic positioning of bone segments, higher contact between bone segments, comparable operative times and quality of life | 2015 to 2019 |
| Sozzi D et al., 2022 [29] | 21 patients (9 female, 12 male), mean age 45.9 ± 15.0 years (range 17–65) | Retrospective Study | 45.9 ± 15.0 years | Pre-operative and post-operative positional accuracy of mandibular markers (e.g., condyles, midline, angles) | Virtual planning and surgical navigation, including hemi-mandibulectomy and free fibula flap reconstruction | Comparison of accuracy between right and left-hand sides | Overall discrepancy in mandibular positioning with higher error in mandibular angles; discrepancies analyzed by side | January 2010 – September 2018 |
| Mazzola F et al., 2020 [30] | 138 patients | Retrospective analysis | 62.5 years (median) | Intensive monitoring days, ward length of stay, length of procedure, postoperative complications, bone segments used, screws, plates, ablative surgery details, donor site, complexity score, costs. | Non-VSP, P-VSP | Non-VSP vs P-VSP | P-VSP group had shorter median LOS, lower median ward costs, and operating costs despite higher material costs; no difference in complication rates. | January 2010 to March 2018 |
| Kalmar CL et al., 2020 [31] | 1131 consecutive craniofacial index procedures | Retrospective chart review | Varies by procedure | Gender, age at surgery, diagnosis, procedure type, VSP usage | Virtual Surgical Planning (VSP) vs. Traditional modalities | VSP vs. non-VSP | Increased VSP usage in certain procedures; variation in component utilization; trend towards higher VSP use over time | January 2011 - December 2018 |
| Barrera JE et al., 2014 [32] | 4 cases of obstructive sleep apnea (OSA) patients undergoing maxillomandibular advancement (MMA) surgery | Case series with analysis of surgical outcomes | 40, 52, 48, 53 years | Airway measurements (PAS-O, PAS-M), AHI, RDI, LSAT, BMI, tooth-to-lip measurements | Virtual Surgical Planning (VSP) | Pre-surgical plan vs. Post-surgical results | Significant improvement in airway space, reduction in AHI and RDI, preservation of tooth-to-lip measurements, and maintenance of facial aesthetics | Follow up of 1 year |
| Qu X et al., 2017 [33] | 52 patients undergoing mandibular reconstruction with osteocutaneous free flaps | Observational study | 41.4 years (range 19–68) | Surgical accuracy (coincidence rate of fibular segments), implant placement accuracy, aesthetic outcomes | Virtual Surgical Planning (VSP) and double-barreled fibular reconstruction | Preoperative VSP vs. Postoperative outcomes | High coincidence rate for upper and lower barrels (93.43% and 89.72% respectively), significant improvement in ramus reconstruction, and generally positive aesthetic outcomes with a few issues | July 2010 – September 2016 |
| Mendez BM et al., 2015 [34] | 2 patients with complex craniofacial defects | Observational study | 10 years (case 1), 34 years (case 2) | Cost and production time of 3D models, operative time, blood loss, hospital stay | In-office 3D printing technology for surgical models | None | Average cost of $25 and assembly time of 14 hours; successful surgeries with no perioperative complications | October 2014 – February 2015 |
| Antonini F et al., 2020 [35] | 100 adult patients who underwent two-jaw orthognathic surgery | Retrospective case–control study | 22.1 years (range 14–46 years) | Accuracy of maxillary repositioning (x, y, z axes), overall accuracy, discrepancies between planned and postoperative results | Virtual Surgical Planning (VSP) | Different years of VSP execution (2013–2017) | Improved accuracy over years, with an increase in measurements within 1 mm discrepancy; decreasing discrepancies over time | March 2013 – September 2017 |
| De Riu G et al., 2018 [36] | 49 patients (19 males, 30 females) | Retrospective, Observational | 26.4 years | 15 angular and linear measures of jaw movements | 3D planning with Maxilim® software, intermediate splints, bimaxillary orthognathic surgery | Maxilla-first vs. Mandibula-first, Genioplasty vs. No Genioplasty | Mean linear differences between planned and actual movements; significant differences in SNA, SNB, and anterior facial height | June 2011 to January 2016 |
| Haq J et al., 2014 [37] | 5 patients (3 females, 2 males) | Case series | 44.6 years (range 29–58) | Maximum incisal opening; pain levels; heterotopic bone formation | Custom-made Biomet implants, virtual surgical planning, resection of ankylosis | Preoperative vs. Postoperative conditions | Improvement in mouth opening; recurrence of heterotopic bone in some cases | 2010 to 2012 |
| Li Y et al., 2015 [38] | 12 patients (ages 18–35) from West China Hospital of Stomatology | Clinical study | Not explicitly stated | Linear differences, angular differences, precision of virtual planning | Computer-aided orthognathic surgery, virtual planning, guiding templates | Simulated vs. actual postoperative outcomes | Mean linear differences < 1.8 mm; Mean angular differences < 2.5 degrees; Accurate transfer of virtual plans to surgery | January 1 to August 31, 2014 |
| Ying X et al., 2021 [39] | 20 patients (16 women, 4 men) | Retrospective | 25.00 ± 3.96 years | Landmark coordinates (x, y, z), RMSD, deviation analysis | Segmental LeFort I osteotomy, BSSRO, mandibular anterior subapical osteotomy, genioplasty | VSP vs. postoperative results | Acceptable accuracy of VSP, RMSD within clinical relevance | 2018 to 2020 |