Correlation between esthetic expectations for orthognathic treatment and psychological characteristics among Chinese adult patients
Abstract
Introduction This study aimed to evaluate the association of esthetic expectations with self-reported personal characteristics, anxiety, depression, self-esteem, oral health-related quality of life, and the Orthognathic Quality of Life Questionnaire (OQLQ) in Chinese adult patients before orthognathic treatment.Methods This study involved 213 patients with clinically significant skeletal deformity requiring orthognathic surgery for comprehensive treatment. Each patient completed a series of Chinese version scales, including the self-rating anxiety scale, self-rating depression scale, self-esteem scale, the Oral Health Impact Profile-14 questionnaire, and the OQLQ. The patients' self-reported personal characteristics were also recorded, including facial appearance ratings before and after orthognathic treatment, highest education level, mean monthly income, and enthusiasm toward orthodontic or orthognathic treatment. The Least Absolute Shrinkage and Selection Operator multivariate linear regression model was conducted for the selection of the above factors. The final multivariate linear regression model was built with variables identified under the optimal tuning parameter.Results A total of 213 patients (87 men and 126 women) were included in this study. The patients' esthetic expectation scores were significantly associated with their total scores, which encompassed the education level, mean monthly income, enthusiasm toward orthodontic or orthognathic treatment, self-esteem scale, the Chinese version of the 14-item Oral Health Impact Profile questionnaire, OQLQ, etc. In the multivariate linear regression model, the OQLQ, enthusiasm toward orthognathic treatment, depression, and expected facial appearance score after the treatment were the most important factors to predict esthetic expectation.Conclusions High esthetic expectations for orthognathic treatment were mostly associated with higher expected facial appearance scores after the treatment, greater enthusiasm toward orthognathic treatment, worse depression (confusion), and 2 domains (social aspects of deformity and oral function) of OQLQ. Therefore, OQLQ, enthusiasm toward orthognathic treatment, and expected facial appearance score after treatment may be used to predict patients' esthetic expectations before commencing orthognathic treatment in daily clinical practice.
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The relationship between body image and orthodontic treatment is bidirectional.
“Furthermore, the relationship between body image and orthodontic treatment is bidirectional: while treatment can improve body image by enhancing the appearance of the teeth and face, a patient’s initial body image perception can also affect their attitudes and expectations towards treatment.”
From Correlation between latent categories of body image and sleep quality in adolescent orthodontic patients. (2025) · cites this paper as [10]
Cites
A self-rating depression scale
ZUNG, W. W. K. (1965) · Archives of General Psychiatry · doi:10.1001/archpsyc.1965.01720310065008 · Cited by 9,813 · see citing works
A Rating Instrument For Anxiety Disorders
Zung, W. W. K. (1971) · Psychosomatics · doi:10.1016/s0033-3182(71)71479-0 · Cited by 4,578 · see citing works
Measures of Personality and Social Psychological Attitudes
(1991) · Elsevier eBooks · doi:10.1016/c2013-0-07551-2 · Cited by 3,237 · see citing works
Cunningham, S. J., Garratt, A., & Hunt, N. P. (2000) · Community Dentistry And Oral Epidemiology · doi:10.1034/j.1600-0528.2000.280305.x · Cited by 312 · see citing works
Cunningham, S. J., Garratt, A., & Hunt, N. P. (2002) · Community Dentistry And Oral Epidemiology · doi:10.1034/j.1600-0528.2002.300201.x · Cited by 233 · see citing works
Ravindran, A. V., Matheson, K., Griffiths, J., Merali, Z., & Anisman, H. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(01)00389-5 · Cited by 154 · see citing works
Perceptions of outcome following orthognathic surgery
Cunningham, S. J., Hunt, N. P., & Feinmann, C. (1996) · British Journal of Oral and Maxillofacial Surgery · doi:10.1016/s0266-4356(96)90271-5 · Cited by 136 · see citing works
Alanko, O., Svedström‐Oristo, A., & Tuomisto, M. T. (2010) · Acta Odontologica Scandinavica · doi:10.3109/00016357.2010.494618 · Cited by 124 · see citing works
Factors influencing postoperative satisfaction of orthognathic surgery patients.
Chen, B., Zhang, Z., & Wang, X. (2002) · PubMed · Cited by 70 · see citing works
Desire for orthodontic treatment and associated factors among adolescents in southern Brazil
Feldens, C. A., Nakamura, E. K., Tessarollo, F. R., & Closs, L. Q. (2014) · The Angle Orthodontist · doi:10.2319/021014-105.1 · Cited by 66 · see citing works
Patients' expectations as predictors of orthognathic surgery outcomes.
Kiyak, H. A., VITALIANO, P. P., & Crinean, J. (1988) · Health Psychology · doi:10.1037//0278-6133.7.3.251 · Cited by 64 · see citing works
[Validation of a Chinese version of the oral health impact profile-14].
Xin, W.-N., & Ling, J. (2006) · PubMed · Cited by 62 · see citing works
Patients' expectations as predictors of orthognathic surgery outcomes.
Kiyak, H. A., VITALIANO, P. P., & Crinean, J. (1988) · Health Psychology · doi:10.1037/0278-6133.7.3.251 · Cited by 60 · see citing works
Kovalenko, A., Slabkovskaya, A. B., Drobysheva, N. S., Persin, L. S., Drobyshev, A. Y., & Maddalone, M. (2011) · The Angle Orthodontist · doi:10.2319/060211-363.1 · Cited by 54 · see citing works
Measures of Patients’ Expectations About Recovery: A Systematic Review
Ebrahim, S., Malachowski, C., el Din, M. K., Mulla, S. M., Montoya, L., Bance, S., & Busse, J. W. (2014) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-014-9535-4 · Cited by 48 · see citing works
Health-related quality of life and depression in patients with dentofacial deformity
de Ávila, É. D., de Molon, R. S., Loffredo, L. C. M., Massucato, E. M. S., & Hochuli‐Vieira, E. (2012) · Oral and Maxillofacial Surgery · doi:10.1007/s10006-012-0338-5 · Cited by 46 · see citing works
What Are Orthognathic Patients' Expectations of Treatment Outcome—A Qualitative Study
Ryan, F. S., Barnard, M., & Cunningham, S. J. (2012) · Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.joms.2012.01.002 · Cited by 45 · see citing works
Patient satisfaction following orthognathic surgical correction of skeletal Class III malocclusion.
Zhou, Y., Hägg, U., & Rabie, A. (2001) · PubMed · Cited by 40 · see citing works
Meade, E. A., & Inglehart, M. R. (2009) · American Journal of Orthodontics and Dentofacial Orthopedics · doi:10.1016/j.ajodo.2008.03.022 · Cited by 36 · see citing works
Presurgical Motivations, Self-Esteem, and Oral Health of Orthognathic Surgery Patients
Yu, D., Wang, F., Wang, X., Fang, B., & Shen, S. G. (2013) · Journal of Craniofacial Surgery · doi:10.1097/scs.0b013e318285d5a4 · Cited by 35 · see citing works
Self-citationRispoli, A., Acocella, A., Pavone, I., Tedesco, A., Giacomelli, E., Ortiz, L., & Scott, A. A. (2004) · PubMed · Cited by 32 · see citing works
Patcas, R., Cunningham, S. J., Shute, J., Lloyd, T., Obwegeser, J. A., Arjomand, L., & Sharma, S. (2017) · Journal of Cranio-Maxillofacial Surgery · doi:10.1016/j.jcms.2017.03.012 · Cited by 25 · see citing works
Psychological aspects of orthognathic treatment.
Palumbo, B., Cassese, R., Fusetti, S., & Gp, T. (2006) · PubMed · Cited by 11 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Orthognathic surgery improves quality of life: a survey clinical study
Şen, E., Duran, H., Sarı, M., Akbulut, N., & Demir, O. (2024) · BMC Oral Health · doi:10.1186/s12903-024-04638-3 · Cited by 19 · see citing works
BAYAZIT, Ş., Eğe, B., & Koparal, M. (2022) · Journal of Stomatology Oral and Maxillofacial Surgery · doi:10.1016/j.jormas.2022.09.001 · Cited by 11 · see citing works
Is YouTube a reliable source of information for temporomandibular joint ankylosis?
Chaudhary, G. R., Amipara, H., & Singh, P. (2024) · Oral and Maxillofacial Surgery · doi:10.1007/s10006-024-01270-x · Cited by 7 · see citing works
Patients’ perceptions matter: Risk communication and psychosocial factors in orthodontics
Zhao, Y., Shi, X., Liu, J., Huo, R., Xia, K., Wang, Y., Zhu, G., Lu, W., Zhang, L., Meng, Y., et al. (2024) · American Journal of Orthodontics and Dentofacial Orthopedics · doi:10.1016/j.ajodo.2024.06.011 · Cited by 6 · see citing works
Xu, C., Zhang, Y., Xiong, B., Wang, H., & Liang, M. (2025) · BMC Oral Health · doi:10.1186/s12903-025-06571-5 · Cited by 3 · see citing works
“Adolescents with negative body image may have heightened expectations for treatment, which, if unmet, can increase psychological stress and dissatisfaction [10, 11].”
Wang, J., Tang, Y., Ren, M., Zhao, W., & Bai, Y. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1505961 · Cited by 1 · see citing works
Pergel, T., Akkoyun, E. F., Topak, H., Kaşarcioğlu, G., & Dolanmaz, D. (2026) · Selcuk Dental Journal · doi:10.15311/selcukdentj.1745202
- Authors
- Nie, P., Teng, F., Wang, F., Shen, G., Zhu, M., & Yu, D.
- Affiliations
- Shanghai Jiao Tong University (CN)
- Zhejiang University Medical College Affiliated Stomatological Hospital (CN)
- Corresponding author
- Zhu, Min
- Yu, Dedong
- Venue
- American Journal of Orthodontics and Dentofacial Orthopedics
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 160
- Issue
- 1
- Pages
- 94-100
- ISSN
- 0889-5406 (ISSN-L)
- OpenAlex
- W3159869736
- Cited by
- 7
- References
- 22
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2022: 1
- FWCI
- 1.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Orthodontics and Dentofacial Orthopedics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (51605289)
- Shanghai Jiao Tong University (YG2017QN11, YG2017QN12)
- Topics
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Keywords
- orthognathic surgery, facial appearance, Orthognathic Quality of Life Questionnaire, depression, anxiety, self-esteem, oral health-related quality of life, skeletal deformities, Chinese patients
- MeSH terms
- Adult, China, Esthetics, Dental, Female, Humans, Male, Motivation, Quality of Life, Surveys and Questionnaires, Orthognathic Surgical Procedures
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