Orthognathic surgery corrects jaw deformities to improve aesthetics and functions. Due to the complexity of the craniomaxillofacial (CMF) anatomy, orthognathic surgery requires precise surgical planning, which involves predicting postoperative changes in facial appearance. To this end, most conventional methods involve simulation with biomechanical modeling methods, which are labor intensive and computationally expensive. Here we introduce a learning-based framework to speed up the simulation of postoperative facial appearances. Specifically, we introduce a facial shape change prediction network (FSC-Net) to learn the nonlinear mapping from bony shape changes to facial shape changes. FSC-Net is a point transform network weakly-supervised by paired preoperative and postoperative data without point-wise correspondence. In FSC-Net, a distance-guided shape loss places more emphasis on the jaw region. A local point constraint loss restricts point displacements to preserve the topology and smoothness of the surface mesh after point transformation. Evaluation results indicate that FSC-Net achieves 15× speedup with accuracy comparable to a state-of-the-art (SOTA) finite-element modeling (FEM) method.

Orthognathic surgical outcomes rely heavily on the quality of surgical planning. Automatic estimation of a reference facial bone shape significantly reduces experience-dependent variability and improves planning accuracy and efficiency. We propose an end-to-end deep learning framework to estimate patient-specific reference bony shape models for patients with orthognathic deformities. Specifically, we apply a point-cloud network to learn a vertex-wise deformation field from a patient's deformed bony shape, represented as a point cloud. The estimated deformation field is then used to correct the deformed bony shape to output a patient-specific reference bony surface model. To train our network effectively, we introduce a simulation strategy to synthesize deformed bones from any given normal bone, producing a relatively large and diverse dataset of shapes for training. Our method was evaluated using both synthetic and real patient data. Experimental results show that our framework estimates realistic reference bony shape models for patients with varying deformities. The performance of our method is consistently better than an existing method and several deep point-cloud networks. Our end-to-end estimation framework based on geometric deep learning shows great potential for improving clinical workflows.