Psychodynamic Features Associated With Orthognathic Surgery: A Comparison Between Conventional Orthognathic Treatment and “Surgery-First” Approach

Purpose: The aims of this study were to assess the personality traits of orthognathic patients and to investigate and compare the changes related to psychosocial well-being, self-esteem, anxiety, and quality of life between presurgical and postsurgical phases in patients undergoing traditional and surgery-first orthognathic treatments. Patients and Methods: This prospective study recruited patients referred for traditional 3-stage orthognathic treatment and surgery-first orthognathic treatment. Patients were administered psychological and quality-of-life tests 3 times: during the last visit before surgery, about 4 weeks after surgery, and 6 months after surgery. Results: Of the 33 patients included, 14 presented parameters that were suggestive of personality (borderline, compulsive, antisocial, passive-aggressive) disorders. The results of the 36-item Short Form Health Survey showed significant differences with better scores for the “surgery-first” group for bodily pain, vitality, social functioning, and mental health (P < .05). As for the Beck Depression Inventory second edition results, at final check, surgery-first patients reported fewer depressive symptoms too. Conclusions: A surgery-first orthognathic approach allows a precocious re-establishment of harmonic esthetics of the face, thus positively influencing the compliance and psychological status of the patients.