Revisão integrativa da literatura: cirurgia ortognática e novas técnicas
DOI:
https://doi.org/10.34119/bjhrv8n6-402Keywords:
orthognathic surgery, computer-aided surgery, 3D printing, virtual surgical planningAbstract
Background: Orthognathic surgery has undergone a significant technological evolution. Digital tools such as virtual surgical planning (VSP), three-dimensional (3D) printing, and computer-aided design/computer-aided manufacturing (CAD/CAM) have become central to the specialty, promising greater precision and predictability. Objective: To synthesize the scientific evidence on new techniques in orthognathic surgery, evaluating their methodologies, clinical outcomes, accuracy, and limitations. Methods: An integrative literature review was conducted in the PubMed/MEDLINE, ScienceDirect, and PMC databases. The search included articles published in the last 20 years using descriptors such as "orthognathic surgery," "virtual surgical planning," "3D printing," "computer-aided surgery," and "surgery-first approach." A total of 22 articles, including reviews, prospective studies, and systematic reviews, were selected. The analysis focused on the description of new techniques, clinical outcomes, and methodological quality, with a qualitative assessment of the level of evidence. Results: The main innovations identified were VSP, 3D-printed surgical guides and custom plates, the surgery-first approach, piezosurgery, and intraoperative navigation. The evidence indicates that these technologies increase surgical accuracy, reduce operative time, and allow for predictable results. VSP shows mean linear deviations of approximately 1.0-1.5 mm. The surgery-first approach reduces total treatment time. However, limitations such as the learning curve, high cost, and challenges in soft tissue prediction persist. Conclusion: New techniques in orthognathic surgery, especially those based on digital workflows, represent a significant advance over conventional methods, offering greater accuracy and efficiency. Despite the promising results, there is a need for more randomized clinical trials to establish a higher level of evidence and standardize protocols.
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