Patients’ own reasons and patient-perceived recommendations for orthognathic surgery

• Published in: American journal of orthodontics and dentofacial orthopedics Vol. 118; no. 2; pp. 134 - 140
• Main Authors: Rivera, Semilla M., Hatch, John P., Dolce, Calogero, Bays, Robert A., Van Sickels, Joseph E., Rugh, John D.
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.08.2000
• Subjects: Adolescent; Adult; Age Factors; Communication; Decision Making; Dentist-Patient Relations; Dentistry; Esthetics, Dental; European Continental Ancestry Group; Facial Pain - psychology; Female; Humans; Internal-External Control; Male; Malocclusion - psychology; Mexican Americans; Middle Aged; Observer Variation; Oral Surgical Procedures - psychology; Patient Participation - psychology; Patient Participation - statistics & numerical data; Self Concept; Sex Factors; Surveys and Questionnaires; Tooth Loss - psychology; United States; United States
• ISSN: 0889-5406; 1097-6752
• DOI: 10.1067/mod.2000.107010

In an attempt to learn more about patients’ decision-making processes, an analysis was performed to examine patients’ reasons for undergoing orthognathic surgery and their understanding of the reasons surgery was recommended. Before surgery, 105 females and 38 males completed an open-ended questionnaire in which they listed their reasons for choosing orthognathic surgery and their perceptions of their orthodontists’ recommendations. Three raters classified the responses into 7 categories: esthetics, psychosocial, functional, TMJ/pain, authority, prevention, and other. Rater agreement ranged from a κ of.55 to 1.00. Patients reported undergoing orthognathic surgery primarily for esthetic, functional, and TMJ improvements, 71%, 47%, and 28%, respectively. Females reported more TMJ-related reasons than males (P <.05). Patients reporting function (P <. 05), TMJ (P <.05), and prevention of future problems (P <.05) were older than patients not reporting these reasons. Mexican American patients indicated more psychosocial reasons (P <.05) than European Americans. Patients understood that orthognathic surgery was recommended primarily for esthetic, functional, and TMJ improvements, 52%, 44%, and 18%, respectively. Males reported receiving more preventative recommendations (23%) than females (10%). Mexican American patients reported receiving more psychosocial recommendations (P <.05) than European Americans. Agreement between each paired patient/patient-perceived reason was highest for TMJ problems (κ = 0.588). In conclusion, patients underwent orthognathic surgery to improve esthetic, functional and TMJ problems and interpreted orthodontists’ recommendations for similar reasons. On a case-to-case basis, agreement between patient and orthodontist-represented reasons was modest, suggesting differences between patients’ own reasons and their perceptions of orthodontists’ recommendations. (Am J Orthod Dentofacial Orthop 2000;118:134-40)