{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:18:39Z","timestamp":1783358319081,"version":"3.54.6"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002352","name":"Ain Shams University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002352","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the accuracy of soft tissue simulation in bimaxillary osteotomy for orthognathic surgical correction of Class III dentofacial deformities using 3D conformation meshes and facial aesthetic units.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials &amp; methods<\/jats:title>\n                    <jats:p>A retrospective analysis of CBCT scans of 13 Egyptian patients who underwent simultaneous maxillary advancement and mandibular setback surgery for correction of class III skeletal deformities. Preoperative and postoperative CBCT scans were superimposed using voxel-based registration. Dolphin software generated soft tissue predictions according to the measured surgical movements. This was compared with the actual soft tissue changes following orthognathic surgery. Prediction accuracy was assessed using dense surface correspondence analysis with region-specific segmentation into facial aesthetic units, comparing Euclidean and directional (X, Y, Z) distances between predicted and actual outcomes, and color-coded maps were used to visualize the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across all regions, the highest prediction errors was in the anteroposterior dimension, with the upper lip showing the greatest deviation (median 2.04\u00a0mm). The chin region exhibited the lowest overall prediction error of 1.82\u00a0mm. The lower lip and cheek regions showed moderate prediction errors. The prediction error was relatively low at the nose. Color maps indicated a consistent pattern of underprediction of the soft tissue changes following Le Fort I maxillary advancement and mandibular setback surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prediction errors across facial regions remained within an acceptable range of less than 2\u00a0mm. The sophisticated methodology of this study, incorporating dense correspondence analysis and facial unit segmentation, provided a more precise assessment of soft tissue prediction accuracy of bimaxillary osteotomy for correction of class III deformities. These findings support the clinical reliability of Dolphin software while highlighting the importance of advanced analytical approaches in orthognathic surgical planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>The application of the conformation meshes and the mathematical facial segmentation into aesthetic units provided an insight into the magnitude and direction of 3D prediction errors in Egyptian population, this should be considered in planning orthognathic surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-026-08833-2","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:55:59Z","timestamp":1782798959000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["State-of-the-art 3D analysis of soft tissue prediction for orthognathic correction of dentofacial deformities in the Egyptian population"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0013-977X","authenticated-orcid":false,"given":"Nehal Ibrahim","family":"Shobair","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyang","family":"Ju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0876-2910","authenticated-orcid":false,"given":"Amr Amin","family":"Ghanem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Diaa Zain","family":"El Abedeen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3163-8184","authenticated-orcid":false,"given":"Amr","family":"Ekram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Abdel Moneim","family":"Barakat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf Farouk","family":"Ayoub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"8833_CR1","doi-asserted-by":"crossref","unstructured":"Bueno S, Hammad Y, Schlieve T. Does the type of planning in orthognathic surgery influence patient satisfaction? Oral Maxillofac Surg . 2023 Dec 1;27(4):685\u201392. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/36121522\/. Cited 2025 Jan 28.","DOI":"10.1007\/s10006-022-01114-6"},{"key":"8833_CR2","doi-asserted-by":"crossref","unstructured":"Asada K, Motoyoshi M, Tamura T, Nakajima A, Mayahara K, Shimizu N. Satisfaction with orthognathic surgery of skeletal Class III patients. Am J Orthod Dentofacial Orthop . 2015 Nov 1;148(5):827\u201337. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/26522044\/. Cited 2025 Jan 28.","DOI":"10.1016\/j.ajodo.2015.05.021"},{"issue":"4","key":"8833_CR3","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/j.ijom.2018.10.008","volume":"48","author":"PGM Knoops","year":"2019","unstructured":"Knoops PGM, Borghi A, Breakey RWF, Ong J, Jeelani NUO, Bruun R, et al. Three-dimensional soft tissue prediction in orthognathic surgery: a clinical comparison of Dolphin, ProPlan CMF, and probabilistic finite element modelling. Int J Oral Maxillofac Surg. 2019;48(4):511\u20138.","journal-title":"Int J Oral Maxillofac Surg"},{"key":"8833_CR4","doi-asserted-by":"crossref","unstructured":"Shobair N, Ghanem AA, Ayoub A, Barakat A, Diaa M. The Prediction Accuracy of Dolphin 3D Software for Facial Soft Tissue Changes After Bimaxillary Orthognathic Surgery. Ain Shams Dental Journal . 2021 Sep 1;23(3):55\u201361. Available from: https:\/\/asdj.journals.ekb.eg\/article_275021.html. Cited 2025 Jan 28.","DOI":"10.21608\/asdj.2022.103220.1080"},{"key":"8833_CR5","doi-asserted-by":"crossref","unstructured":"Kim D, Kuang T, Rodrigues YL, Gateno J, Shen SGF, Wang X et al. A novel incremental simulation of facial changes following orthognathic surgery using FEM with realistic lip sliding effect. Med Image Anal . 2021 Aug 1;72. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/34090256\/. Cited 2025 Jan 28.","DOI":"10.1016\/j.media.2021.102095"},{"key":"8833_CR6","doi-asserted-by":"crossref","unstructured":"Resnick CM, Dang RR, Glick SJ, Padwa BL. Accuracy of three-dimensional soft tissue prediction for Le Fort I osteotomy using Dolphin 3D software: a pilot study. Int J Oral Maxillofac Surg . 2017 Mar 1;46(3):289\u201395. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/27856149\/. Cited 2025 Jan 28.","DOI":"10.1016\/j.ijom.2016.10.016"},{"key":"8833_CR7","doi-asserted-by":"crossref","unstructured":"Khambay B, Ullah R. Current methods of assessing the accuracy of three-dimensional soft tissue facial predictions: technical and clinical considerations. Int J Oral Maxillofac Surg . 2015 Jan 1;44(1):132\u20138. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/25305699\/. Cited 2025 Jan 28.","DOI":"10.1016\/j.ijom.2014.04.007"},{"key":"8833_CR8","doi-asserted-by":"crossref","unstructured":"Almukhtar A, Khambay B, Ayoub A, Ju X, Al-Hiyali A, Macdonald J et al. Direct DICOM Slice Landmarking A Novel Research Technique to Quantify Skeletal Changes in Orthognathic Surgery. PLoS One . 2015 Aug 7;10(8). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/26252768\/. Cited 2025 Jan 28.","DOI":"10.1371\/journal.pone.0131540"},{"issue":"4","key":"8833_CR9","doi-asserted-by":"publisher","first-page":"e0152381","DOI":"10.1371\/journal.pone.0152381","volume":"11","author":"MY Cheung","year":"2016","unstructured":"Cheung MY, Almukhtar A, Keeling A, Hsung TC, Ju X, McDonald J, Ayoub A, Khambay BS. The Accuracy of Conformation of a Generic Surface Mesh for the Analysis of Facial Soft Tissue Changes. PLoS ONE. 2016;11(4):e0152381. https:\/\/doi.org\/10.1371\/journal.pone.0152381 . PMID: 27093637; PMCID: PMC4836697.","journal-title":"PLoS ONE"},{"key":"8833_CR10","unstructured":"Ju X, Siebert JP. (2001) Conformation from generic animatable models to 3D scanned data. In: 6th Num\u00e9risation 3D\/Scanning 2001 Congress, Paris, France, 2001, pp. 239\u2013244."},{"key":"#cr-split#-8833_CR11.1","doi-asserted-by":"crossref","unstructured":"Xu W, Lu R, Hu Y, Cao L, Wang T, Tan H et al. Reliability of Cone Beam CT for Morphometry of Nasolabial Soft Tissue in Patients with Skeletal Class III Malocclusion: A Qualitative and Quantitative Analysis. 2021 Aug 11","DOI":"10.21203\/rs.3.rs-757829\/v1"},{"key":"#cr-split#-8833_CR11.2","unstructured":"Available from: https:\/\/www.researchsquare.com\/article\/rs-757829\/v1. Cited 2025 Jan 28."},{"key":"8833_CR12","doi-asserted-by":"crossref","unstructured":"Dusseldorp JK, Stamatakis HC, Ren Y. Soft tissue coverage on the segmentation accuracy of the 3D surface-rendered model from cone-beam CT. Clin Oral Investig . 2017 Apr 1;21(3):921\u201330. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/27206862\/. Cited 2025 Jan 28.","DOI":"10.1007\/s00784-016-1844-x"},{"key":"8833_CR13","doi-asserted-by":"crossref","unstructured":"Hsung TC, Yeung WK, Choi WS, Luk WK, Cheng YY, Lam YH. Recording Natural Head Position Using Cone Beam Computerized Tomography. Sensors (Basel) . 2021 Dec 1;21(24). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/34960281\/. Cited 2025 Jan 28.","DOI":"10.3390\/s21248189"},{"key":"8833_CR14","doi-asserted-by":"crossref","unstructured":"Kim H, J\u00fcrgens P, Nolte LP, Reyes M. Anatomically-driven soft-tissue simulation strategy for cranio-maxillofacial surgery using facial muscle template model. Med Image Comput Comput Assist Interv . 2010;13(Pt 1):61\u20138. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/20879215\/. Cited 2025 Jan 28.","DOI":"10.1007\/978-3-642-15705-9_8"},{"key":"8833_CR15","doi-asserted-by":"crossref","unstructured":"Lian YK, Hsieh AMC, Tsai MS, Jiang HR, Yen CY, Hsia YJ et al. Treatment efficiency and stability of skeletal Class III malocclusion with a surgery-first approach. Orthod Craniofac Res . 2018 May 1;21(2):90\u20135. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/29493904\/. Cited 2025 Jan 28.","DOI":"10.1111\/ocr.12221"},{"key":"8833_CR16","doi-asserted-by":"crossref","unstructured":"Luchi GHM, Conci RA, Tomazi FHS, Da Silva Berticelli R, Guarenti MM, Fritscher GG et al. Assessment of the Postoperative Stability of Mandibular Orthognathic Surgery for Correction of Class III Skeletal Malocclusion. J Craniofac Surg . 2017;28(1):151\u20136. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/27977486\/. Cited 2025 Jan 28.","DOI":"10.1097\/SCS.0000000000003311"},{"key":"8833_CR17","doi-asserted-by":"crossref","unstructured":"Kotaniemi KVM, Heli\u00f6vaara A, Kotaniemi M, Stoor P, Leikola J, Palotie T et al. Comparison of postoperative skeletal stability of maxillary segments after Le Fort I osteotomy, using patient-specific implant versus mini-plate fixation. J Craniomaxillofac Surg . 2019 Jul 1;47(7):1020\u201330. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/31085061\/. Cited 2025 Jan 28.","DOI":"10.1016\/j.jcms.2019.04.003"},{"key":"8833_CR18","doi-asserted-by":"crossref","unstructured":"Van Der Linden C, Van Der Linden WJ, Reyneke JP. Skeletal stability following mandibular advancement with and without advancement genioplasty. Int J Oral Maxillofac Surg . 2015;44(5):621\u20136. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/25592706\/. Cited 2025 Jan 28.","DOI":"10.1016\/j.ijom.2014.11.002"},{"key":"8833_CR19","doi-asserted-by":"crossref","unstructured":"Van Hemelen G, Van Genechten M, Renier L, Desmedt M, Verbruggen E, Nadjmi N. Three-dimensional virtual planning in orthognathic surgery enhances the accuracy of soft tissue prediction. J Craniomaxillofac Surg . 2015 Jul 1;43(6):918\u201325. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/26027866\/. Cited 2025 Jan 28.","DOI":"10.1016\/j.jcms.2015.04.006"},{"key":"8833_CR20","doi-asserted-by":"crossref","unstructured":"Jabar N, Robinson W, Goto TK, Khambay BS. The validity of using surface meshes to evaluate three-dimensional maxillary and mandibular surgical changes. Int J Oral Maxillofac Surg . 2015 Jul 1;44(7):914\u201320. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/25752242\/. Cited 2025 Jan 28.","DOI":"10.1016\/j.ijom.2015.02.005"},{"key":"8833_CR21","doi-asserted-by":"crossref","unstructured":"Shafi MI, Ayoub A, Ju X, Khambay B. The accuracy of three-dimensional prediction planning for the surgical correction of facial deformities using Maxilim. Int J Oral Maxillofac Surg . 2013 Jul;42(7):801\u20136. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/23465803\/. Cited 2025 Jan 28.","DOI":"10.1016\/j.ijom.2013.01.015"},{"key":"8833_CR22","unstructured":"Almukhtar AMY. Three-dimensional study to quantify the relationship between facial hard and soft tissue movement as a result of orthognathic surgery. 2016; Available from: https:\/\/eleanor.lib.gla.ac.uk\/record=b3153683. Cited 2025 Jan 28."},{"key":"8833_CR23","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1111\/j.1469-7580.2011.01411.x","volume":"219","author":"P Claes","year":"2011","unstructured":"Claes P, Walters M, Vandermeulen D, Clement JG. Spatially-dense 3D facial asymmetry assessment in both typical and disordered growth. J Anat. 2011;219:444\u201355. https:\/\/doi.org\/10.1111\/j.1469-7580.2011.01411.x.","journal-title":"J Anat"},{"key":"8833_CR24","doi-asserted-by":"crossref","unstructured":"Hou L, He Y, Yi B, Wang X, Liu X, Zhang Y et al. Evaluation of soft tissue prediction accuracy for orthognathic surgery with skeletal class III malocclusion using maxillofacial regional aesthetic units. Clin Oral Investig . 2023 Jan 1;27(1):173\u201382. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/36161529\/. Cited 2025 Jan 28.","DOI":"10.1007\/s00784-022-04705-5"},{"key":"8833_CR25","doi-asserted-by":"crossref","unstructured":"Ruggiero F, Borghi A, Bevini M, Badiali G, Lunari O, Dunaway D et al. Soft tissue prediction in orthognathic surgery: Improving accuracy by means of anatomical details. PLoS One . 2023 Nov 1;18(11):e0294640. Available from: https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10681161\/. Cited 2025 Jan 28.","DOI":"10.1371\/journal.pone.0294640"},{"key":"8833_CR26","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Ulloa M. Restoration of the face covering using selected skin in regional aesthetic units. Br J Plast Surg . 1956;9(3):212\u201321. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/13374260\/. Cited 2025 Feb 18.","DOI":"10.1016\/S0007-1226(56)80036-2"},{"key":"8833_CR27","doi-asserted-by":"crossref","unstructured":"Olejnik A, Verstraete L, Croonenborghs TM, Politis C, Swennen GRJ. The Accuracy of Three-Dimensional Soft Tissue Simulation in Orthognathic Surgery\u2014A Systematic Review. J Imaging . 2024 May 1;10(5):119. Available from: https:\/\/www.mdpi.com\/2313-433X\/10\/5\/119\/htm. Cited 2025 Jan 28.","DOI":"10.3390\/jimaging10050119"},{"key":"8833_CR28","doi-asserted-by":"crossref","unstructured":"Marchetti C, Bianchi A, Muyldermans L, Di Martino M, Lancellotti L, Sarti A. Validation of new soft tissue software in orthognathic surgery planning. Int J Oral Maxillofac Surg . 2011 Jan;40(1):26\u201332. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/21030211\/. Cited 2025 Jan 28.","DOI":"10.1016\/j.ijom.2010.09.004"},{"key":"8833_CR29","doi-asserted-by":"crossref","unstructured":"Schendel SA, Jacobson R, Khalessi S. 3-dimensional facial simulation in orthognathic surgery: is it accurate? J Oral Maxillofac Surg . 2013 Aug;71(8):1406\u201314. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/23642546\/. Cited 2025 Jan 28.","DOI":"10.1016\/j.joms.2013.02.010"},{"key":"8833_CR30","doi-asserted-by":"publisher","unstructured":"Knoops PGM, Borghi A, Breakey RWF, Ong J, Jeelani NUO, Bruun R et al. Three-dimensional soft tissue prediction in orthognathic surgery: a clinical comparison of Dolphin, ProPlan CMF, and probabilistic finite element modelling. Int J Oral Maxillofac Surg . 2019 Apr 1;48(4):511\u20138. Available from: https:\/\/doi.org\/10.1016\/j.ijom.2018.10.008. Cited 2020 May 27.","DOI":"10.1016\/j.ijom.2018.10.008"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-026-08833-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-08833-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-08833-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:03:33Z","timestamp":1783357413000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12903-026-08833-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8833"],"URL":"https:\/\/doi.org\/10.1186\/s12903-026-08833-2","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"assertion":[{"value":"29 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted per the principles of the Declaration of Helsinki. Ethics approval was obtained from the Ain Shams University Faculty of Dentistry Institutional Review Board, with an ethical approval number (FDASU-Rec ER032506). This retrospective study utilizes data from an existing database. No direct patient involvement was required, and all data was fully anonymized before analysis. Therefore, the Institutional Review Board waived individual informed consent, as it met the criteria for exemption under ethical guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1187"}}