Orthognathic surgery is a well-established surgical approach for correcting skeletal and dentoalveolar discrepancies in the maxillofacial region, with the dual goals of improving function and aesthetics (Friedrich et al., 2024; Ngan and Moon, 2015). It plays a vital role in addressing jaw discrepancies, facial asymmetry, and malocclusions that cannot be managed by orthodontic treatment alone (Lin et al., 2025; Ngan and Moon, 2015; Vilanova et al., 2023). Surgical correction has been shown to improve mastication, speech, and appearance, contributing significantly to patients’ overall quality of life (Lin et al., 2025; Vilanova et al., 2023; Zamboni et al., 2019). Among the common orthognathic techniques, Le Fort I osteotomy and bilateral sagittal split ramus osteotomy (BSSRO) are frequently employed to reposition the maxilla and mandible, respectively (Rios et al., 2022; Zawiślak et al., 2021). Bimaxillary procedures are often preferred in complex Class III skeletal patterns to achieve optimal three-dimensional harmony (Xianwen et al., 2017; Zawiślak et al., 2021).

During these interventions, the mental foramen and its neurovascular contents—including the mental nerve and vessels—may be exposed to mechanical stress or surgical trauma (Rahpeyma and Khajehahmadi, 2018; Yoshimoto et al., 2022). Such manipulations can lead to postoperative neurosensory disturbances and altered perfusion in the mental foramen region (Chhikara et al., 2023; Peleg et al., 2021; Rahpeyma and Khajehahmadi, 2018; Verweij et al., 2015; Yoshimoto et al., 2022). Accurate identification of the foramen and assessment of regional blood flow are essential to prevent or manage such complications (Çağlayan et al., 2019; Krishnan et al., 2024; Kumar et al., 2021). While modalities like CBCT or panoramic radiography are widely used for anatomical visualization, they lack the ability to dynamically assess vascular status and involve ionizing radiation (Krishnan et al., 2024; Kumar et al., 2021; Pelé et al., 2021).

In recent years, ultrasonography (USG) has emerged as a non-invasive, radiation-free alternative for evaluating the mental foramen region (Artas and Yalcin, 2023). High-resolution linear probes allow for anatomical localization, while color Doppler USG enables real-time assessment of regional hemodynamics (Artas and Yalcin, 2023). However, studies examining vascular changes in the mental foramen post-orthognathic surgery remain limited, and most rely on subjective sensory testing without concurrent evaluation of perfusion (Baydan and Soylu, 2024, Kim et al.). To date, no comprehensive study in the literature has examined Doppler USG flow at the level of the mental foramen in relation to orthognathic surgery. Therefore, evaluating postoperative vascular changes alongside clinical sensory testing would address a significant gap in the current body of knowledge.

The aim of this study was to investigate dynamic changes in blood flow at the level of the mental foramen following orthognathic surgery using Doppler USG. Furthermore, we aimed to assess the diagnostic value of USG by correlating vascular measurements with neurosensory test outcomes.