Background and objectives: Conventional 2D cephalometric analysis can no longer provide acceptable data in our 3D reality. Orthognathic surgery became much more about aesthetics nowadays, then it was 20 years ago. That is why we should use all the available precise techniques to predict the most aesthetical and stable outcome.

Methods: From year of 2009–2011 a total number of 23 patients with the II class of malocclusion were observed and treated. All of them were Caucasian, 9 males and 15 females, age ranged from 17 to 44 years. SurgiCase 5.0 software from Materialise was used. The pre and post surgical 3D heads models were superimposed using anterior cranial base as a most stable structure. All the cephalometric measurements and planning of the osteotomies were performed on 3D virtual models. The marking points for cephalometry were: Gl, Na, Na’, Se, Se’, En’, Ex’, Mf’, Or, Or’, Os, Os’, Zy, Zy’, Prn’, Sn’, Al’, Ac’, Nt’, Nb’, Ss’, Ls’, Cph’, Sto’, Ch’, Li’, Go’, Sl’, Pg’, Gn’. The evaluation of soft tissue post- surgical surfaces displacement was performed using color histogram.

Conclusion: We were able to achieve accurate color histogram divergence map. The method of 3D measurements and planning of surgical outcome have shown its reliability. There is a need for long-term, prospective clinical trials to collect data for achieving better predictability of the soft tissue changes.

Conflict of interest: None declared.