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March 28, 2026European Oral Research0 citationsOpen Access

Evaluation of orthognathic surgery planning with artificial intelligence: a prospective, comparative study

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ETEnes TemizkanBYB. Zeynep YörükBKBanu Kılıç

Key Points

  • Assess the accuracy of AI-based cephalometric analyses against 3D CT gold standard measurements in orthognathic surgery candidates.
  • Candidates underwent pretreatment 3D CT scans.
  • 3D cephalometric software established gold standard landmark positions.
  • Two-dimensional cephalometric images were derived from 3D scans.
  • AI programs identified landmarks on 2D images for comparison with the 3D gold standard.
  • ANB angle showed no significant differences (p=0.061).
  • Other measurements (SNA, SNB, Wits appraisal, Y Axis Angle, facial height ratios) exhibited significant discrepancies (p<0.05).
  • Notable errors in AI-based analyses compared to 3D CT standard were observed.

Abstract

PurposeThis study aimed to evaluate the accuracy of cephalometric analyses performed by deep learning-based AI programs (NemoCeph 2D, OrthoDx, AudaxCeph, and WebCeph) by comparing their results with the gold standard measurements obtained from 3D CT scans in orthognathic surgery patients. Materials and methodsOrthognathic surgery candidates underwent pretreatment 3D CT scans. These scans were manually analyzed using 3D cephalometric software to establish goldstandard landmark positions. Two-dimensional cephalometric images were then derived from the 3D scans, and deep learning–based AI programs automatically identified the landmarks on these images. The AI-generated measurements were compared with the 3D gold standard, and the differences were analyzed statistically.ResultsWhile the ANB angle showed no significant differences between the methods (p=0.061), other measurements—including SNA, SNB, Wits appraisal, Y Axis Angle, and various facial height ratios—showed significant discrepancies (p<0.05).ConclusionAI-based cephalometric analyses showed notable errors compared with the 3D CT gold standard. These findings suggest that deep learning algorithms require further refinement before they can be reliably used for orthognathic surgery planning.

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Cite This Study

Temizkan et al. (2026) studied this question.

synapsesocial.com/papers/69c771988bbfbc51511e19dbhttps://doi.org/10.26650/eor.20261702936
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