The changes of self-esteem, sensitivity to criticism, and social appearance anxiety in orthognathic surgery patients: A controlled study

Objectives: To evaluate the changes of psychologic parameters, such as self-esteem, sensitivity to criticism, and social appearance anxiety, in skeletal Class III patients undergoing orthognathic surgery and to compare the psychologic status of skeletal Class III patients with control subjects. Methods: The first group consisted of 60 patients with a mean age of 22.07 +/- 1.30 years who did not need orthognathic surgery. The second group comprised 45 patients with skeletal Class III malocclusion (mean age 21.40 +/- 2.02 years) who were evaluated in terms of psychologic changes from before to after surgery. A third group consisted of 50 Class III patients (mean age 20.09 +/- 2.59 years) who were evaluated before surgery and a different 50 Class III patients (mean age 22.15 +/- 2.03 years) who were investigated after surgery. The Rosenberg Self-Esteem Scale and the Social Appearance Anxiety Scale were used to evaluate psychologic parameters both before and after surgery. Analysis was carried out with the use of independent- and dependent-sample t tests, 1-way analysis of variance, and post hoc Tukey test. Results: Self-esteem of the patients with skeletal Class III malocclusion increased, and sensitivity to criticism and social appearance anxiety decreased significantly after the surgery (P < 0.001). In the patients with Class III malocclusion, self-esteem was significantly lower and social appearance anxiety significantly higher before orthognathic surgery than in the control group, and at the postoperative evaluation Class III patients had significantly higher self-esteem than the control group (P < 0.001). Conclusions: Through the improvement in facial appearance after surgery, patients' self-esteem increases and their sensitivity to criticism and social appearance anxiety decrease.