engleski

High orthognatic functional treatment need is less powerfull predictor of patients' decision to accept orthognatic surgery than high orthodontic treatment need

Aim: Some patients with pronounced skeletal malocclusions and altered facial aesthetics refuse orthognatic surgery suggested by orthodontists and the reasons are often not known or understood. Therefore, the aim of this study was to investigate factors influencing patients' decision to accept surgery. Subjects and methods: Sample was consisted of 95 subjects with skeletal malocclusions (65% females), aged 17-45 years (median 21, interquartile range 19-25). Suggested surgery was accepted by 58 subjects while refused by 37. Their psychosocial issues and treatment needs were evaluated by Orthognatic Quality of Life Questionnaire, Index of Orthognathic Functional Treatment Need (IOFTN) and Index of Orthodontic Treatment Need - Dental Health Component (IOTN DHC). Differences between groups of subjects accepting and refusing surgery were analysed by t-test and logistic regression. Results: The odds of accepting orthognatic surgery is 3.4x higher in people with high facial aesthetic concern compared to those with low, 3.9x higher in people with high IOFTN score and 7.7x higher in those with high IOTN DHC score (p≤0.006) in univariate analyses. However, when controlling for age, sex, oral function impairment, awareness of facial deformity and inhibitions in social contacts only IOTN DHC and facial aesthetics concern were significant predictors of orthognatic surgery acceptance increasing the odds for acceptance 5.8x (95% CI: 1.6-21.3 ; p=0.009) and 3.7x (95% CI: 1.1-12.4 ; p=0.032). High IOFTN is not significant predictor of a decision to accept surgery. Conclusion: Facial aesthetic concern is very important factor in decision making process of accepting orthognatic treatment for skeletal malocclusion. Functional orthognatic treatment need is less important predictor than orthodontic treatment need.

orthognathic surgery ; treatment need ; aesthetic concern ; oral function

Financijska postpora Sveucilista u Rijeci za projekt uniri-biomed-18-22