3-H in 3-D: Envisaging Beyond the Current Hype, the Hope and Hurdles of Three-Dimensional "Virtual Planning" in Orthognathic Surgery/3-H en 3-D: Contemplando mas alla del Entusiasmo actual, la Esperanza y los Obstaculos de la "Planificacion Virtual" Tridimensional en Cirugia Ortognatica

Recent technical and technological advancements in orthognathic surgery concepts, intricate in the diagnosis and treatment planning for corrections of dento-facial deformities, have achieved stable oro-dental functional occlusion and facial esthetic harmony. Undeniably, this can be attributed to the integration of modern, innovative and advanced facial analysis and computer-aided imaging exams into well-orchestrated and executed orthodontic and surgical methods. Three-Dimensional (3-D) virtual planning is a fine example. Today, the acquisition of 3-D images of a patient's craniofacial complex via cone-beam computed tomography (CBCT), supported by software tools allowing the construction of 3-D dynamic and interactive visual models, eliminates the uncertainty experienced with two-dimensional images. Thereby allowing for a more accurate or predictable treatment plan and efficient surgery, especially for patients with complex dento-facial deformities. This review article aims to describe the current benefits as well as shortcomings of 3-D virtual planning via discussing examples and illustrations from orthognathic procedures, attained from the reported English and Spanish literature during the last 10 years. It is designed to deliver updated and practical guidelines for dental practitioners and specialists (particularly, oral and maxillofacial), as well as researchers involved in 3-D virtual approaches as an alternative to conventional/traditional surgical planning; thereby validating its superiority or benefits in terms of outcome prediction for soft and hard tissues, operational time- and cost-effectiveness; for its integration in day-to-day practise. KEY WORDS: Cone-beam computed tomography; Cephalometry; Orthognathic surgery; Three-dimensional imaging; Planning. Los recientes avances tecnicos y tecnologicos en los conceptos de la cirugia ortognatica, involucrados en la planificacion del diagnostico y tratamiento para la correccion de deformidades dento-faciales han sido notablemente considerables en lograr una oclusion oro-dental funcional y una estetica facial armonica. Innegablemente, esto se puede atribuir a la integracion de analisis faciales avanzados, modernos e innovadores y examenes de imagenes asistidos por computadora a metodos ortodonticos y quirurgicos bien orquestados y ejecutados. La planificacion virtual tri-dimensional (3-D) es un buen ejemplo. Hoy, la adquisicion de imagenes 3-D del complejo cranio-facial de pacientes via tomografia compu