Quantitative Evaluation of Skeletal, Dental, and Soft Tissue Changes After Orthognathic Surgery: A Cephalometric and Statistical Analysis

<b>Background/Objectives:</b> Combining orthognathic surgery with orthodontic therapy is a crucial approach for correcting severe dentofacial deformities that orthodontics alone cannot address. This study aimed to quantify skeletal, dental, and soft tissue alterations following orthognathic surgery and to assess correlations among cephalometric parameters to improve understanding of treatment outcomes. <b>Methods:</b> A prospective observational study was conducted on 25 Romanian patients (44% female and 56% male; median age, 28 years) who underwent orthognathic surgery. Standardized pre- and postoperative lateral cephalometric radiographs were analyzed using WebCeph 2.0.0 software. The evaluated parameters included the SNA angle (sella-nasion-point A, indicating maxillary position), SNB angle (sella-nasion-point B, indicating mandibular position), ANB angle (maxillo-mandibular relationship), Pog-N-Perp (distance from pogonion to the nasion-perpendicular line), U1-NA° (inclination of the upper incisor relative to the maxillary base), L1-NB° (inclination of the lower incisor relative to the mandibular base), nasolabial angle, and facial convexity. Statistical analyses included paired <i>t</i>-tests and correlation analysis. <b>Results:</b> Significant anterior repositioning of the maxilla was observed, with SNA increasing from 83.6° to 86.3° (<i>p</i> = 0.019). The SNB angle remained stable, while ANB increased toward normalized sagittal relationships (0.9° to 3.0°, <i>p</i> = 0.060). Soft tissue analysis revealed a slight increase in the nasolabial angle (102° to 105°) and improved facial convexity. Strong correlations were found between skeletal parameters (SNB and ANB, r = -0.852, <i>p</i> < 0.001) and between skeletal and dental variables (ANB and L1-NB°, r = 0.652, <i>p</i> < 0.001), confirming coordinated skeletal-soft tissue adaptation. <b>Conclusions:</b> Orthognathic surgery significantly enhances skeletal balance and facial harmony, particularly through maxillary advancement. The integration of virtual surgical planning and interdisciplinary collaboration improves accuracy, predictability, and patient-centered outcomes in surgical orthodontics.