title: Perceived changes by peer group of social impact associated with combined orthodontic-surgical correction of class III malocclusion.
abstract: OBJECTIVE
  Whereas the psychosocial benefits of orthognathic treatment for the individual patient are established, there is little data relating to social perceptions in relation to changes in facial appearance as a result of combined orthodontic and orthognathic treatment. This study aimed to investigate the social impact of combined orthodontic-orthognathic surgical correction for class III malocclusion in Caucasian subjects.
  
  
  METHODS
  This cross-sectional study compared perceptions of facial appearance prior to and after orthognathic correction of class III malocclusion. Eighty undergraduate students were shown photographs of four Caucasian subjects (2 male and 2 female) pre- and post-orthognathic class III correction. Observers were asked to rate these subjects in relation to four different outcomes: (i) social competence (SC); (ii) intellectual ability (IA); (iii) psychological adjustment (PA); (iv) attractiveness. A mixed-model analysis of variance (ANOVA) was calculated to determine the effect of each variable.
  
  
  RESULTS
  Statistically significant differences were found in ratings of the same face before and after treatment. After treatment, faces were rated as more psychologically adjusted, more sociable, more likely to be successful and more attractive; with the mean psychological adjustment rating being associated with the most change (before treatment=8.06 [SD 2.30]; after treatment=6.64 [SD 2.03], t=2.04, p<0.001).
  
  
  CONCLUSIONS
  After combined orthodontic-orthognathic correction of class III malocclusion in Caucasians, individuals are rated by young adults as being better adjusted both psychologically and socially, more likely to be successful and more attractive.
authors.affiliation: Department of Orthodontics, King's College London Dental Institute, London, UK; Department of Orthodontics, East Kent Hospitals University NHS Foundation Trust, London, UK.
authors.forename: Aliza
authors.initials: A
authors.lastname: Jesani
authors.affiliation: Department of Orthodontics, East Kent Hospitals University NHS Foundation Trust, London, UK.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: DiBiase
authors.affiliation: Department of Orthodontics, King's College London Dental Institute, London, UK. Electronic address: martyn.cobourne@kcl.ac.uk.
authors.forename: Martyn T
authors.initials: MT
authors.lastname: Cobourne
authors.affiliation: Department of Social & Behavioral Sciences, King's College London Dental Institute, London, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Newton
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001504:Beauty; D003430:Cross-Sectional Studies; D005145:Face / Q000033:anatomy & histology; D005260:Female; D006801:Humans; D007360:Intelligence; D008297:Male; D008313:Malocclusion, Angle Class III / Q000523:psychology* / Q000601:surgery / Q000628:therapy; D009971:Orthodontics, Corrective / Q000379:methods; D056948:Orthognathic Surgical Procedures / Q000379:methods; D010379:Peer Group; D012917:Social Adjustment; D012938:Social Perception; D066107:Social Skills; D055815:Young Adult
keywords: Caucasians; Orthodontics; Orthognathic surgery; Social impact