Background/Objectives: Isolated cleft lips and/or palates often require orthognathic treatment. Traditional planning based on 2D images and plaster models limits precision; therefore, virtual surgical planning (VSP) and Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) technologies are increasingly being used. The aim of this scoping review was to analyze the techniques, outcomes, and gaps in research on VSP in orthognathics for patients with isolated (non-syndromic) clefts. Methods: Searches were conducted in July 2025 in seven databases (including PubMed, Scopus, and Cochrane) without language restrictions, in accordance with the PRISMA guidelines for scoping reviews. Of the 2836 records, 36 publications were eligible after deduplication and full-text screening, and their Level of Evidence (LoE) was assessed using the Oxford CEBM scale. A risk of bias assessment was also conducted according to JBI tools. Results: The identified studies primarily comprised LoE III and IV; there were no systematic reviews or randomized controlled trials (LoE I). Descriptions of bimaxillary procedures and LeFort I osteotomies dominated. The most commonly used software was ProPlan CMF, Dolphin 3D, and Rhinoceros, although other tools have emerged in recent years. The available studies suggest that VSP increases translational and rotational accuracy and facilitates individualized treatment, and bimaxillary procedures bring better functional and aesthetic outcomes in patients with severe maxillary hypoplasia. Conclusions: Despite the growing interest in VSP in orthognathics, the scientific evidence is limited and mostly of lower quality. Well-designed prospective studies are needed to assess the long-term stability, quality of life, and cost-effectiveness of modern technologies.

Background/Objectives: The deep circumflex iliac artery (DCIA) free flap with internal abdominal oblique muscle (IAOM) is a well-known method of reconstruction used in cases of oral cavity neoplasms. Because the IAOM can be insufficient for extensive defects after removal of advanced carcinomas of the tongue, floor of the mouth, or gingiva, the additional preparation of a perforator-supported external abdominal oblique (EAOM) muscle flap can be useful. The aim of this study was to introduce the use of a DCIA flap with an IAOM and EAOM island in the reconstruction of oral cavity compound defects. Methods: A retrospective analysis was performed involving eight patients who underwent reconstruction using a DCIA free flap with IAOM and perforator-supported EAOM island. Patients underwent the operation between June 2021 and February 2025 in the Department of Maxillofacial Surgery of the Rydygier Hospital in Kraków, Poland. Results: A group of eight patients underwent an operation due to squamous cell carcinoma of the oral cavity. The most common primary subsite of disease was the floor of the mouth (n = 4, 50%), followed by the lower gingiva (n = 2, 25%) and retromolar area (n = 2, 25%). All patients required resection involving part of the mandible, the floor of the mouth, and part of the tongue simultaneously with reconstruction using a DCIA free flap with IAOM and perforator-supported EAOM island. Osteotomies were performed in two flaps (one single osteotomy, one double osteotomy). Reconstruction was successfully performed in seven out of eight patients (overall success rate 88%). Conclusions: The DCIA free flap with IAOM and perforator-supported EAOM flap is a reliable method for compound soft tissue and bone defects in maxillofacial reconstruction. The use of IAOM and EAOM can be helpful in cases of three-dimensional soft tissue defects of the lower gingiva, the floor of the mouth, and the tongue. The lower gingiva and floor of the mouth can be reconstructed with IAOM, while the more mobile part of the tongue can be reconstructed with a perforator-supported EAOM island.

Background/Objectives: Deep circumflex iliac artery (DCIA) free flap with internal abdominal oblique muscle (IAOM) is a well-known method of reconstruction used in cases of oral cavity neoplasms. Because the IAOM can be insufficient for extensive defects after removal of advanced carcinomas of the tongue, floor of the mouth, or gingiva – the additional preparation of a perforator-supported external abdominal oblique (EAOM) muscle flap can be useful. The aim of this study was to introduce the use of a DCIA flap with IAOM and EAOM island in the reconstruction of oral cavity compound defects. Methods: A retrospective analysis was performed involving 8 patients who underwent reconstruction using a DCIA free flap with IAOM and perforator-supported EAOM island. Patients underwent operation between June 2021 and February 2025 in the Department of Maxillofacial Surgery of the Rydygier Hospital in Kraków, Poland. Results: A group of 8 patients underwent operation due to squamous cell carcinoma of the oral cavity. The most common primary subsite of disease was the floor of the mouth (n=4, 50%), followed by the lower gingiva (n=2, 25%), and retromolar area (n=2, 25%). All patients required resection involving part of the mandible, floor of the mouth, and part of the tongue simultaneously with reconstruction using a DCIA free flap with IAOM and perforator-supported EAOM island. Osteotomies were performed in 2 flaps (1 single osteotomy, 1 double osteotomy). Reconstruction was successfully performed in 7 out of 8 patients (overall success rate 88%). Conclusions: The DCIA free flap with IAOM and perforator-supported EAOM flap is a reliable method for compound soft tissue and bone defects in maxillofacial reconstruction. The use of IAOM and EAOM can be helpful in cases of three-dimensional soft tissue defects of the lower gingiva, floor of the mouth and the tongue. The lower gingiva and floor of the mouth can be reconstructed with IAOM, while the more mobile part of the tongue can be reconstructed with a perforator-supported EAOM island.