Patients' perceptions of orthognathic treatment, well-being, and psychological or psychiatric status: a systematic review.
OBJECTIVE
To conduct a systematic review of studies concerning the psychosocial well-being of surgical-orthodontic patients.


METHODS
Articles published between 2001 and 2009 were searched using PubMed, Web of Science, and PsycInfo. Only articles written in English were included. Articles on methodological issues or on patients with clefts or syndromes or studies in which treatment had included surgically assisted maxillary expansion or intermaxillary fixation were excluded. The exclusion of articles was carried out in collaboration with two reviewers. To find new relevant articles, references from all the obtained review articles were hand-searched. Thirty-five articles fulfilled the selection criteria and were included in this review.


RESULTS
The main motives for seeking treatment were improvements in self-confidence, appearance, and oral function. Patients were not found to suffer from psychiatric problems. Treatment resulted in self-reported improvements in well-being, even though these improvements were not found with current assessment methods. Changes in well-being were most often registered using measures designed for evaluation of the impact of oral health on quality of life (e.g. the Orthognathic Quality of Life Questionnaire and the Oral Health Impact Profile).


CONCLUSIONS
Surgical-orthodontic patients do not experience psychiatric problems related to their dentofacial disharmony in general. However, subgroups of patients may still experience problems, such as anxiety or depression, as many studies only report patients' mean problem scores and compare them to controls' scores or population norms. New assessment methods focusing on day-to-day changes in mood and well-being, as well as prospective studies with controls, are needed.
Department of Oral Development and Orthodontics, Institute of Dentistry, University of Turku, Finland.
Outi M E
OM
Alanko
Anna-Liisa
AL
Svedström-Oristo
Martti T
MT
Tuomisto
D001294:Attitude to Health; D004955:Esthetics, Dental; D006801:Humans; D008310:Malocclusion / Q000523:psychology; D009042:Motivation; D009971:Orthodontics, Corrective / Q000523:psychology*; D056948:Orthognathic Surgical Procedures / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011788:Quality of Life; D012649:Self Concept