Orthognatic Quality of Life: What Are We Measuring?

Objective: To assess properties of Orthognathic Quality of Life Questionnaire in Croatian cultural context by analyzing: how dentofacial deformity influences quality of life (QoL), what aspects of QoL are patients' primary motives to undergo orthognathic surgery, what changes after surgery and how personality traits influence QoL. Materials and Methods: A total of 472 subjects (65% females) aged 12 to 45 years (median 20) were included. Orthognathic Quality of Life Questionnaire, Oral Health Impact Profile, Psychosocial Impact of Dental Aesthetics Questionnaire, Orofacial Aesthetics Scale, Self-Esteem Scale, Multidimensional Perfectionism Scale, and Big Five Inventory were used. The subjects' dentofacial deformity and malocclusion severity was assessed by Index of Complexity, Outcome and Need, and Index of Orthodontic Treatment Need. Results: Social aspect is mostly influenced by dentofacial deformity (P<0.05). Impaired oral function was the primary motive to undergo orthognathic surgery (P<0.001). Social aspect and aesthetic concern mostly decreased after the surgery (P<0.001). Self-esteem was the strongest predictor of the orthognathic QoL, the increase of self-esteem decreases the QoL impairment. Neuroticism and extraversion were in the background of problems in social interactions and facial aesthetic concerns, while perfectionism affected social contacts (r = 0.284-0.410; P<0.001). Only awareness of deformity did not correlate to any of the other instruments. Conclusion: Impaired oral function seems to be the most powerful motive for orthognathic surgery, but social aspects and facial aesthetic concern are more accurate indicators of conditions and changes. Self-esteem is the strongest personality trait influencing orthognathic QoL.