AI-Assisted Virtual Surgical Planning and 3D-Printed Splint Transfer in Bimaxillary Orthognathic Surgery

Background Artificial intelligence (AI), virtual surgical planning, and additive manufacturing increasingly influence modern oral and maxillofacial surgery. Previous studies demonstrated the clinical feasibility, diagnostic reliability, and translational integration of AI-guided workflows in maxillofacial trauma surgery [1–11]. However, prospective investigations evaluating AI-assisted workflows in bimaxillary orthognathic surgery remain limited. Objective The aim of this study was to evaluate the feasibility, accuracy, workflow integration, and early clinical outcomes of AI-assisted virtual surgical planning combined with 3D-printed splint transfer in bimaxillary orthognathic surgery. Methods A prospective comparative feasibility study was conducted between January 2020 and December 2025 at Seeklinik Zurich, Switzerland. Consecutive patients undergoing bimaxillary orthognathic surgery using AI-assisted virtual planning and patient-specific 3D-printed splints were prospectively evaluated and compared with conventionally planned procedures. AI-assisted segmentation, cephalometric analysis, virtual planning, symmetry analysis, and additive manufacturing workflows were integrated into the surgical planning process. Clinical, radiographic, and digital outcome parameters were assessed postoperatively and during longitudinal follow-up. Results A total of 118 patients were included in the final analysis, including 62 patients treated using AI-assisted planning workflows and 56 patients undergoing conventional planning. AI-assisted workflows demonstrated significantly improved planned-versus-achieved skeletal movement accuracy and reduced postoperative deviation values. Operative time and intraoperative splint adjustment requirements were reduced in the AI-assisted group. Postoperative occlusal stability and facial symmetry remained stable throughout follow-up. Surgeon acceptance and workflow integration improved progressively during the implementation phase. Conclusion AI-assisted virtual surgical planning combined with 3D-printed splint transfer is clinically feasible and demonstrates high accuracy and stable integration into routine bimaxillary orthognathic surgery. These findings support the translational expansion of AI-guided personalized surgical workflows into orthognathic surgery.