Surgical planning for orthognathic procedures demands swift and accurate biomechanical modeling of facial soft tissues. Efficient simulations are vital in the clinical pipeline, as surgeons may iterate through multiple plans. Biomechanical simulations typically use the finite element method (FEM). Prior works divide FEM simulations into increments to enhance convergence and accuracy. However, this practice elongates simulation time, thereby impeding clinical integration. To accelerate simulations, deep learning (DL) models have been explored. Yet, previous efforts either perform simulations in a single step or neglect the temporal aspects in incrementalsimulations. This study investigates the use of spatiotemporal incremental modeling for biomechanics simulations of facial soft tissue. We implement the method using a graph neural network. Our method synergizes spatial features with temporal aggregation using DL networks trained on incremental FEM simulations from 17 subjects that underwent orthognathicsurgery. Our proposed spatiotemporal incremental method achieved a mean accuracy of 0.37 mm with a mean computation time of 1.52 s. In comparison, a spatial-only incremental method yielded a mean accuracy of 0.44 mm and a mean computation time of 1.60 s, while a spatial-only single-step method yielded a mean accuracy of 0.41 mm and a mean computation time of 0.05 s. Statistical analysis demonstrated that the spatiotemporal incremental method reduced mean errors compared to the spatial-only incremental method, emphasizing the importance of incorporating temporal information in incremental simulations. Overall, we successfully implemented spatiotemporal incremental learning tailored to simulate soft tissue deformation while substantially reducing simulation time compared toFEM.
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