Research progress in the clinical application of minimally invasive orthognathic surgery

doi:10.3969/j.issn.1674-8115.2025.01.012

Abstract

Abstract:

Orthognathic surgery is a procedure that involves cutting the deformed segments of the upper and lower jawbones and moving the dentoalveolar complex to a predetermined corrective position, aiming to establish a harmonious dental arch and occlusal relationship and improve facial appearance. With the rapid advancement of medical technology and the accumulation of clinical experience, minimally invasive orthognathic surgery, which uses endoscopy, piezoelectric bone scalpels, lasers, navigation systems, and robotic-assisted surgical devices, is gaining increasing attention due to its advantages of minimal trauma and high precision. However, the clinical application of minimally invasive orthognathic surgery has not yet been systematically explored. Given its significant role in advancing the field of orthognathic surgery, this paper aims to provide a comprehensive review of the latest progress in the clinical application of minimally invasive orthognathic surgery and offer an outlook on future directions, with the goal of providing valuable insights for future research and clinical practice.

Key words: orthognathic surgery, minimally invasive, accelerated rehabilitation

CLC Number:

R782

WANG Ruiyang, LIU Kai, WANG Xudong. Research progress in the clinical application of minimally invasive orthognathic surgery[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(1): 101-106.

TrendMD

References 33

1	WEISS R O 2nd, ONG A A, REDDY L V, et al. Orthognathic surgery-LeFort I osteotomy[J]. Facial Plast Surg, 2021, 37(6): 703-708.
2	BAHMANYAR S, NAMIN A W, WEISS R O 2nd, et al. Orthognathic surgery of the mandible[J]. Facial Plast Surg, 2021, 37(6): 716-721.
3	杨鑫, 王晓霞, 李自力, 等. 正颌手术前后患者心理韧性与生活质量相关性研究 [J]. 口腔医学研究, 2021, 37: 750-754.
	YANG X, WANG X X, LI Z L, et al. Study on the correlation between mental toughness and quality of life of patients before and after orthognathic surgery [J]. Journal of Stomatology, 2021, 37: 750-754.
4	KIM D H, KIM S W, KIM G J, et al. Efficacy and safety of minimally invasive thyroid surgery: a network meta-analysis[J]. Laryngoscope, 2023, 133(10): 2470-2479.
5	GHOLIZADEH M, BAKHSHALI M A, MAZLOOMAN S R, et al. Minimally invasive and invasive liver surgery based on augmented reality training: a review of the literature[J]. J Robot Surg, 2023, 17(3): 753-763.
6	BRUNNER S E, DURMAZ L O, MEINZER A, et al. Minimally invasive bimanual fetal surgery-a review[J]. Children, 2022, 9(9): 1377.
7	COSTA D L, DE AZEVEDO E T, PRZYSIEZNY P E, et al. Use of lasers and piezoelectric in intraoral surgery[J]. Oral Maxillofac Surg Clin North Am, 2021, 33(2): 275-285.
8	MACEDO D V, MONNAZZI M S, DE ALMEIDA M S, et al. A novel guide for minimally invasive genioplasty[J]. Oral Maxillofac Surg, 2023, 27(4): 707-710.
9	RODRIGUEZ J H, PONSKY J L. Operating with the endoscope[J]. Surg Clin North Am, 2020, 100(6): xvii-xviii.
10	POUTOGLIDIS A, FYRMPAS G, VLACHTSIS K, et al. Role of the endoscope in cochlear implantation: a systematic review[J]. Clin Otolaryngol, 2022, 47(6): 708-716.
11	ROACH J, LIVERMORE L, PLAHA P. Endoscope-assisted resection for cystic cerebellar hemangioblastomas[J]. World Neurosurg, 2022, 167: e217-e221.
12	OSORIO J, MARTINEZ D, LÓPEZ J P, et al. Endoscopically assisted LeFort I osteotomy for minimally invasive orthognathic surgery: a technical note[J]. J Craniofac Surg, 2023, 34(6): 1862-1863.
13	IWAI T, SUGIYAMA S, HONDA K, et al. Endoscopically-assisted intraoral vertical ramus osteotomy to prevent injury of the maxillary artery and mandibular neurovascular bundle[J]. J Dent Sci, 2024, 19(1): 671-672.
14	ALASSERI N, ALASRAJ A, AL-MORAISSI E. Minimally invasive genioplasty: an observational study[J]. Oral Maxillofac Surg, 2023, 27(4): 639-645.
15	ALTWAIJRI A. Minimally invasive approaches in orthognathic surgery: a narrative review of contemporary techniques and their clinical outcomes[J]. J Pharm Bioallied Sci, 2024, 16(Suppl 2): S1652-S1656.
16	ALREFAI M, DABOUL A, FLEISCHHACKER B, et al. Piezoelectric versus conventional techniques for orthognathic surgery: systematic review and meta-analysis[J]. J Stomatol Oral Maxillofac Surg, 2022, 123(5): e273-e278.
17	BERTOSSI D, ALBANESE M, NOCINI R, et al. Osteotomy in genioplasty by piezosurgery[J]. J Craniofac Surg, 2021, 32(3): e317-e321.
18	ANTÚNEZ-CONDE HIDALGO R, SILVA CANAL J L, NAVARRO CUÉLLAR C, et al. Guided genioplasty: comparison between conventional technique and customized guided surgery[J]. J Pers Med, 2023, 13(12): 1702.
19	黄锦华, 卞洁, 孟志兵, 等. 超声骨刀联合截骨裂钻在面部轮廓截骨整形术中的应用[J]. 中国美容医学, 2021, 30(2): 77-79.
	HUANG J H, BIAN J, MENG Z B, et al. Application of ultrasonic bone knife combined with osteotomy drill in facial contour osteotomy [J]. Chinese Journal of Aesthetic Medicine, 2021, 30(2): 77-79.
20	SAHIN T, GARREAU E, KOMAKLI Y, et al. Mandibular anterior segmental subapical osteotomy for incisor axis correction[J]. J Stomatol Oral Maxillofac Surg, 2017, 118(5): 271-278.
21	DEAN A, HEREDERO-JUNG S, SOLIVERA J, et al. Computer-assisted and navigated piezoelectric surgery: a new technology to improve precision and surgical safety in craniomaxillofacial surgery[J]. Laryngoscope Investig Otolaryngol, 2022, 7(3): 684-691.
22	VITALE S G, MIKUŠ M, DE ANGELIS M C, et al. Diode laser use in hysteroscopic surgery: current status and future perspectives[J]. Minim Invasive Ther Allied Technol, 2023, 32(6): 275-284.
23	THEODORO L H, MARCANTONIO R A C, WAINWRIGHT M, et al. LASER in periodontal treatment: is it an effective treatment or science fiction?[J]. Braz Oral Res, 2021, 35(Supp 2): e099.
24	HONIGMANN P, HOFER M, HIRSCH S, et al. Cold ablation robot-guided laser osteotomy in hand, wrist and forearm surgery-a feasibility study[J]. Int J Med Robot, 2022, 18(5): e2438.
25	ALKHAYATT N M, ALZAHRANI H H, AHMED S, et al. Computer-assisted navigation in oral and maxillofacial surgery: a systematic review[J]. Saudi Dent J, 2024, 36(3): 387-394.
26	ZAWAR A, CHHABRA H S, MUNDRA A, et al. Robotics and navigation in spine surgery: a narrative review[J]. J Orthop, 2023, 44: 36-46.
27	LEE K S, JUNG S H, KIM D H, et al. Artificial intelligence- and computer-assisted navigation for shoulder surgery[J]. J Orthop Surg, 2024, 32(1): 10225536241243166.
28	EBELING M, SCHEURER M, SAKKAS A, et al. First-hand experience and result with new robot-assisted laser LeFort-I osteotomy in orthognathic surgery: a case report[J]. J Pers Med, 2023, 13(2): 287.
29	KOYACHI M, SUGAHARA K, ODAKA K, et al. Accuracy of Le Fort I osteotomy with combined computer-aided design/computer-aided manufacturing technology and mixed reality[J]. Int J Oral Maxillofac Surg, 2021, 50(6): 782-790.
30	YE G, XU X, XUE Z, et al. Reducing the risk of tooth injury in anterior maxillary interdental osteotomy for cleft lip and palate patients using a surgical navigation technique[J]. Int J Oral Maxillofac Surg, 2024, 53(5): 368-375.
31	NAUJOKAT H, ROHNEN M, LICHTENSTEIN J, et al. Computer-assisted orthognathic surgery: evaluation of mandible registration accuracy and report of the first clinical cases of navigated sagittal split ramus osteotomy[J]. Int J Oral Maxillofac Surg, 2017, 46(10): 1291-1297.
32	WU J Y, HUI W Y, NIU J D, et al. Collaborative control method and experimental research on robot-assisted craniomaxillofacial osteotomy based on the force feedback and optical navigation[J]. J Craniofac Surg, 2022, 33(7): 2011-2018.
33	孙铁成. 面部轮廓整形超声手术机器人的研发与精准性研究[D]. 北京:北京协和医学院, 2022.
	SUN T C. Research on development and accuracy of ultrasonic surgical robot for facial contouring [D]. Beijing: Peking Union Medical College, 2022.

[1]	XU Yu-ting, YINGWANG Jun-zi, WANG Shu-ze, LI Biao, WANG Xu-dong. Three-dimensional measurement and analysis of nasolabial soft tissue changes following maxillary anterior movement by Le Fort Ⅰ osteotomy [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2020, 40(6): 835-840.
[2]	XU Hong, ZHU Peng-xiong, ZHOU Yan-zai, QIU Jia-pei, LIU Jun#, ZHAO Qiang#. Long-term results of minimally invasive direct coronary artery bypass [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2020, 40(5): 656-661.
[3]	QIU Wei-liu. Some considerations about the development of modern orthognathic surgery [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2020, 40(10): 1315-1317.
[4]	CAI Xiao-yang, Lü Hai-sheng, XIE You-zhuan . Effect of early neurodynamic mobilization on the recurrence of sciatica after the minimally invasive surgery-transforaminal lumbar interbody fusion [J]. , 2017, 37(4): 510-.
[5]	DAI Jie-wen, WANG Bi-xia, WEI Hong-pu， LI Biao， SHEN Shun-yao， FANG Bin， SHEN Guo-fang, WANG Xu-dong. Retrospective analysis of the procedure of digital orthognathic surgery and its clinical effects [J]. , 2016, 36(9): 1333-.
[6]	WU Shu-bin, DING Fang-bao, TANG Min, et al. Application of trans-esophageal echocardiography in trans-thoracic minimal invasive occlusion surgery of infantile multiple atrial septal defect [J]. , 2014, 34(6): 877-.
[7]	JIANG Zhao-lei, MEI Ju, WU Shu-bin, et al. The role of intraoperative transesophageal echocardiography in minimally invasive reoperative tricuspidal surgery by applying intraluminal occlusion for both caval veins [J]. , 2014, 34(2): 161-.
[8]	LU Zhao-feng, QIU Yong-ming, CHENG Xiao-bing, et al. Minimally-invasive surgical treatment of 58 patients with epidural hematoma straddling transverse sinus [J]. , 2012, 32(8): 1075-.
[9]	XIAO Hai-bo, MEI Ju, ZHANG Fu-xian, et al. Outcomes of modified Nuss procedure in treatment of recurrent pectus excavatum [J]. , 2012, 32(7): 922-.
[10]	CAI Wen-quan, ZHENG Zhi, LI Tao, et al. Outcome analysis of 23-G vitrectomy versus 20-G vitrectomy for treatment of retinal detachment [J]. , 2012, 32(2): 151-.
[11]	LI Feng, LI Wei, KANG Ning, et al. Occlusion of atrial septal defect utilizing occluder devise via minimally invasive right chest \|approach [J]. , 2011, 31(3): 343-.
[12]	LIU Jian-xing, YIN Xiao-fan, XU Jun. Minimally invasive fixation of complex proximal tibial fractures by uniaxial and polyaxial locking plates [J]. , 2010, 30(1): 84-.