The butterfly effect in oral and maxillofacial surgery: Understanding and applying chaos theory and complex systems principles

Ricardo Grillo, Bruno Alvarez Quinta Reis, Bernardo Correia Lima, Leonardo Augustus Peral Ferreira Pinto, Josete Barbosa Cruz Meira, Fernando Melhem-Elias

Research output: Contribution to journalReview articlepeer-review


The present paper provides a historical context for chaos theory, originating in the 1960s with Edward Norton Lorenz's efforts to predict weather patterns. It introduces chaos theory, fractal geometry, nonlinear dynamics, and the butterfly effect, highlighting their exploration of complex systems. The authors aim to bridge the gap between chaos theory and oral and maxillofacial surgery (OMFS) through a literature review, exploring its applications and emphasizing the prevention of minor deviations in OMFS to avoid significant consequences. A comprehensive literature review was conducted on PubMed, Web of Science, and Google Scholar databases. The selection process adhered to the PRISMA-ScR guidelines and Leiden Manifesto principles. Articles focusing on chaos theory principles in health sciences, published in the last two decades, were included. The review encompassed 37 articles after screening 386 works. It revealed applications in outcome variation, surgical planning, simulations, decision-making, and emerging technologies. Potential applications include predicting infections, malignancies, dental fractures, and improving decision-making through disease prediction systems. Emerging technologies, despite criticisms, indicate advancements in AI integration, contributing to enhanced diagnostic accuracy and personalized treatment strategies. Chaos theory, a distinct scientific framework, holds potential to revolutionize OMFS. Its integration with advanced techniques promises personalized, less traumatic surgeries and improved patient care. The interdisciplinary synergy of chaos theory and emerging technologies presents a future in which OMFS practices become more efficient, less traumatic, and achieve a level of precision never seen before.

Original languageEnglish (US)
Pages (from-to)652-658
Number of pages7
JournalJournal of Cranio-Maxillofacial Surgery
Issue number5
StatePublished - May 2024


  • Digital technology
  • Nonlinear dynamics
  • Orthognathic surgery
  • Orthognathic surgical procedures
  • Planning techniques
  • Printing
  • Three-dimensional

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology


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