## 1 Introduction  
Facial appearance and attractiveness can influence how an individual's esthetic appearance is evaluated and perceived. The social well-being of an individual is negatively affected by the presence of facial deformities and dentofacial irregularities, which can result in the devaluation of the individual's own facial esthetics. Hence, orofacial appearance is considered a critical dimension, contributing to the individuals' oral health related quality of life [1]. Facial symmetry and facial profile, among a variety of other factors, have been found to impact the facial appearance of an individual [2, 3]. It can present as a reflection of underlying skeletal deformities that may require correction to attain an ideal dental occlusion and ultimately enhance the esthetic appearance. This often cannot be achieved solely through orthodontic treatment and may require orthognathic surgery (OGS) [4]. OGS is mainly performed to rectify the underlying deformities related to the jaws, with an ultimate therapeutic goal to improve functions and enhance facial esthetics. It is a complex irreversible procedure that has a permanent effect on the patient. Therefore, making the correct decisions related to case diagnosis, surgical indications, the need for pre-operative extractions, and accurately predicting the potential facial morphology, symmetry, and attractiveness is crucial. Traditionally, planning for OGS has been primarily dependent on the clinical expertise and experience of the orthodontist and oral and maxillofacial surgeon involved. In that approach, clinical decision making is achieved through clinical assessment, and the utilization of several diagnostic aids such as cephalometric analysis and study models, which sometimes may not suffice [5]. The direction and method of OGS is also determined through identification of a surgical treatment objective and visual treatment objective. For a successful OGS, a precise preoperative planning is of utmost importance. The conventional two-dimensional (2D) surgical planning of OGS comprises of radiographs and manual model surgery, which has certain limitations when it comes to cases with severe facial asymmetry. When these 2D plans are executed, there are chances of bony collision in the ramus area, discrepancy in the pitch roll and yaw rotation and difference in the midline [6; 7]. Advancements in the three-dimensional (3D) imaging has led to the development of computer aided surgical simulation using Cone Beam Computed Tomography (CBCT) images. Computer-aided surgical simulation has been adopted for planning OGS, and is used to facilitate cephalometric analysis, splint fabrication and surgery simulation. 3D imaging has significantly enhanced the visualization of the skeletal complexities of dentofacial deformities in terms of yaw rotations, occlusal plane canting and differential length of the body/ramus of the mandible [6; 8]. Furthermore, 3D printing is another technical advancement which is clinically applied for creating 3D models from digital images for planning OGS. This includes occlusal splints, osteotomy guides, repositioning guides, spacers, models, and fixing plates [9]. Virtual surgical planning for OGS provides the surgeon with a clear 3D visualization of the anatomical structures for developing the surgical plan and has resulted in significant improvements in treatment outcomes [9; 10]. The technological advancements in the field of medical science have led to an escalation in the development of artificial intelligence (AI) applications, which are being extensively used in health sciences. The development of AI applications intended to assist health professionals in providing quality health care and achieving higher accuracy in clinical decision making [11; 12; 13; 14]. AI-based applications used in medical sciences are designed using algorithms that can learn from the data during the process of training, and later make predictions from unseen data in the process of testing [15; 16].