Objective: Our aim is to determine if virtual surgery performed on 3-D cone beam CT models correctly simulated the actual surgical outcome of Class III orthognathic surgical patients. Methods: All data was acquired from the UNC orthognathic surgery stability studies. We created segmentations of the maxillofacial hard tissues of twenty class III patients. We performed virtual surgeries on cone beam CT images using the CranioMaxilloFacial Application software. Results: The virtual surgical models were superimposed on the models of the actual surgical outcomes. The virtual surgery accurately recreated all surgical movements. Surgery residents showed greater variability in lateral ramus positioning than attending faculty. Conclusions: Our methodology demonstrated valid recreation of the subjects' craniofacial skeleton. It allows the surgeon to better predict surgical outcomes. Future validation of occlusal and soft tissue components would be valuable. Virtual surgical training for surgical residents could be beneficial. Supported by NIDCR DE 005215 and the SA
