3dMD-Assisted Facial Simulation for Preoperative Expectation Management and Psychological Support in Orthognathic Surgery: A Retrospective Propensity Score- Matched Study
This retrospective propensity score-matched study demonstrates that 3dMD-assisted individualized 3D facial simulation effectively improves preoperative expectation management, reduces perioperative anxiety and depression, and accelerates functional recovery in orthognathic surgery patients without compromising surgical safety or objective outcomes compared to traditional 2D education.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
The Blueprint for a New Face
Imagine you are about to get a very special, custom-made suit. But instead of fabric, the tailor is working on your face, and the changes are permanent. This is the reality for people undergoing orthognathic surgery. It's a fancy medical term for operations that move the jawbones to fix how teeth bite together and how the face looks. Think of it as a major construction project inside your head: the surgeon has to cut and shift the hard bones of your jaw to make everything fit better. While this fixes big problems with chewing and breathing, it also changes your appearance, which can be a huge emotional rollercoaster.
Before the surgery even starts, patients often feel a mix of excitement and terror. They have to imagine what their new face will look like, but trying to picture a 3D change using only 2D pictures (like a flat photo) or a doctor's drawing is like trying to guess what a house looks like from a single sketch on a napkin. It's hard to know if you'll like the result. This is where expectation management comes in. It's the art of helping patients have a realistic idea of the outcome so they don't feel shocked or disappointed later. Doctors have always tried to explain things with words and flat images, but a new tool called 3dMD (a high-tech camera system that takes instant, 360-degree 3D photos) promises to show patients a "digital twin" of their future face. The big question researchers wanted to answer was: Does seeing a realistic, moving 3D model of your future face actually help you feel less scared and happier with the result, compared to just looking at old-fashioned flat pictures?
The Study: A Digital Crystal Ball vs. A Sketchbook
A team of researchers from the Affiliated Hospital of Qingdao University decided to find out. They looked back at the records of 178 patients who had already undergone jaw surgery between January 2023 and February 2025. To make a fair comparison, they used a statistical trick called Propensity Score Matching (PSM). You can think of this like a matchmaking service for science: they paired up patients who were almost identical in age, weight, and how worried they were before surgery, but who had received different types of pre-op education.
In the end, they compared two groups of 50 patients each:
- The "2D Group": These patients got the standard treatment. They talked to their surgeon for 40 minutes, looked at flat photos of their face, saw hand-drawn diagrams of where the bones would be cut, and looked at photos of other people who had similar surgeries.
- The "3D Group": These patients got everything the 2D group got, plus a special treat. They used the 3dMD system to get a 3D scan of their face. Then, the doctors showed them a computer simulation where they could rotate a 3D model of their face, see the bones underneath the skin, and watch a "virtual surgery" that predicted exactly what their face would look like after the operation.
The Results: Less Scared, Faster Healing
The researchers checked how the patients felt at three different times: right before surgery (T1), one week after surgery (T2), and six months after surgery (T3). They used three main tools to measure feelings: a test for anxiety (SAS), a test for depression (SDS), and a questionnaire about how happy they were with their face and social life (OQLQ).
The "One Week Later" Surprise
One week after the surgery (T2), the difference between the two groups was striking. The patients who saw the 3D simulation felt significantly less anxious and less depressed than those who only saw the 2D pictures.
- Anxiety Scores: The 3D group averaged 46.86, while the 2D group averaged 48.58.
- Depression Scores: The 3D group averaged 45.56, while the 2D group averaged 46.76.
- Quality of Life: The 3D group also scored much better on how they felt about their social life, facial beauty, and how they perceived their own looks.
The researchers suggest that seeing the 3D model acted like a "rehearsal" for the brain. Because the patients had already "seen" their new face in a realistic way before the surgery, the actual change didn't feel as shocking or scary one week later. They knew what to expect.
The "Six Months Later" Reality Check
By six months post-surgery (T3), the gap had mostly closed. Both groups had improved significantly, and their anxiety and depression scores were almost the same. The only thing that stayed different was how the 3D group felt about their aesthetic perception (how they judged their own beauty); they still felt slightly better about it than the 2D group. This suggests that while the initial shock of surgery fades for everyone, the 3D simulation might leave a lasting positive mark on how patients view their new look.
Faster Recovery?
Here is a fun twist: The 3D group didn't just feel better; they physically recovered faster in some ways.
- Hospital Stay: The 3D group stayed in the hospital for 6.46 days, while the 2D group stayed 7.02 days.
- Pain Duration: The 3D group felt pain for 4.32 days, compared to 4.92 days for the 2D group.
- Mouth Opening: The 3D group could open their mouths fully again in 11.42 days, while the 2D group took 12.18 days.
The researchers note that the actual surgery time and how long the face stayed swollen were the same for both groups. This means the 3D simulation didn't make the surgery itself easier or faster. Instead, it seems that because the 3D group was less stressed and more prepared, they followed the recovery rules (like eating soft foods and doing mouth exercises) better, which helped them bounce back quicker.
Did the Surgery Work?
Crucially, the study found that the 3D simulation didn't change the actual medical outcome. Both groups had their jaws moved to the exact same correct positions. The 3D group didn't get "better" bones; they just got a better understanding of what was happening.
The Bottom Line
This study suggests that giving patients a 3D, interactive preview of their future face is a powerful tool. It doesn't change the surgery itself, but it acts like a psychological safety net. By replacing the scary "what if?" with a clear "this is what will happen," it helps patients feel less anxious right after the operation and might even help them heal a bit faster. While the study was done on a specific group of patients and needs more research to be sure it works for everyone, it paints a hopeful picture: sometimes, the best medicine isn't just a scalpel, but a clear, realistic picture of the future.
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