Clinical and perioperative outcomes of computer-guided versus conventional plan-transfer workflows in orthognathic surgery for skeletal anterior open bite: a randomized controlled trial.

INTRODUCTION: Skeletal anterior open bite (AOB) often requires orthognathic surgery. This study compared the clinical and perioperative outcomes of computer-guided and conventional plan-transfer workflows following virtual surgical planning. METHODS: Eighteen adults with skeletal AOB underwent virtual surgical planning and were subsequently randomized to computer-guided transfer of the established surgical plan using CAD/CAM guides (n = 9) or conventional model-surgery transfer using articulator-mounted casts and occlusal wafers (n = 9). Outcomes included intraoperative handling, operative time, blood loss, complications, healing, and AOB correction. RESULTS: Mean operative time was 6.0 ± 0.5 h versus 6.5 ± 0.6 h (p = 0.08), and blood loss was 450 ± 60 versus 520 ± 80 mL (p = 0.12) for the computer-guided and conventional groups, respectively. Intraoperative handling was perceived as easier with computer guidance, although this assessment was subjective. No major intraoperative complications occurred. Mean postoperative AOB was 1.33 ± 0.50 mm in both groups (p = 1.00). CONCLUSION: No statistically significant between-group differences were detected in operative time, blood loss, or postoperative AOB. Computer-guided plan transfer was perceived to facilitate intraoperative handling, although this assessment was subjective. Given the small sample size and limited statistical power, the absence of statistically significant differences should not be interpreted as evidence of equivalence between the workflows. Larger adequately powered studies are warranted.