PINNOCHIO: Physics-Informed Neural Network for Coupled Hyperelastic Interface-Volume Simulation in Orthognathic Surgery

Predicting patient-specific facial soft-tissue deformation is critical for iterative orthognathic surgery planning. However, current computational methods face a strict accuracy-efficiency trade-off: high-fidelity Finite Element Methods (FEM) are computationally prohibitive, whereas pure deep learning models often produce biomechanically inconsistent results. While Physics-Informed Neural Networks (PINNs) offer a promising avenue, learning the complex heterogeneous mechanics of bone--soft-tissue interactions with only partial clinical supervision (i.e., outer facial surfaces) remains highly unstable. To overcome these challenges, we present PINNOCHIO, a novel physics-informed framework for facial soft-tissue simulation. PINNOCHIO introduces a hybrid sequential decomposition that explicitly decouples discontinuous bone--soft-tissue interface movements from continuous volumetric hyperelastic deformation. This structural separation enables stable training and facilitates a physics-enabled sim-to-real adaptation strategy, ensuring internal biomechanical consistency without requiring volumetric ground truth. Evaluated on a 40-patient clinical cohort, PINNOCHIO outperforms existing baselines in both surface accuracy and physical validity. Furthermore, it achieves a substantial speedup over FEM, successfully resolving the accuracy-efficiency trade-off to provide a highly reliable and practical tool for interactive surgical planning.