Self-image of people with mandibular prognathism before and after orthognathic surgery

Justyna Szpyt, Kacper Pajor, Robert Kowalczyk, Iwona Radlińska, Marta Kożybska


Introduction: Mandibular prognathism, also called progenia, is a type of anterior malocclusion that has negative effects on physical and mental health.
The aim of the study was to determine differences in the selfimage of people with mandibular prognathism before and after orthognathic surgery.
Materials and methods: The study included 155 people – 79 of whom had a mandibular prognathism (group A) and 76 of whom had a previous mandibular prognathism that had already been corrected by surgery (group B). The research method used was a diagnostic survey that included original questions about wellbeing, self-esteem, and self-confidence.
Results: Group A statistically significantly more often experienced feelings of frustration, lower self-confidence, embarrassment, concern about appearance, especially when meeting new people, and lack of comfort due to their appearance being the center of attention than group B. People in group A were statistically significantly more likely to avoid smiling or laughing in company, to hide a smile in pictures, to avoid looking at themselves in the mirror, to compare their appearance to others, and to avoid meetings due to dissatisfaction with their appearance than were people in group B. People in group A were statistically significantly less likely to preferably rate the general appearance of the face, the profile of the face, the appearance of the face from the front, and the appearance of the teeth than were people in group B. People in group A were statistically significantly less likely to preferably rate the general appearance of the face, the profile of the face, the appearance of the face from the front, and the appearance of the teeth than were people in group B.
Conclusions: Orthognathic surgery is a very important factor affecting the psyche of people with prognathism. People with mandibular prognathism before orthognathic surgery experience more negative feelings about their appearance, more often engage in behaviors aimed at concealing a malocclusion, and rate their appearance worse than people who have undergone orthognathic surgery. In view of this, comprehensive medical care, including psychological care, should be provided before, during, and after surgery.


prognathism; malocclusion; craniofacial abnormalities; Angle class III; orthognathic surgery

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Downarowicz P, Mikulewicz M, Strazałkowska A, Pawlak W. BSSO and Le Fort I Osteotomy as surgical methods of treatment in skeletal class III malocclusion – Review of the literature and the case report. Dent Med Probl 2009;46(3):346-53.

Karłowska I. Diagnostyka wad zgryzu. In: Karłowska I, editors. Zarys współczesnej ortodoncji. Warszawa: PZWL; 2016. p. 163-81.

Pawlak W, Warych B, Kaczkowski H. Combined Orthodontic − Surgical Treatment of a Severe Class III Dentofacial Deformity – Case Report. Dent Med Probl 2007;44(1):81-6.

Zere E, Chaudhari PK, Sharan J, Dhingra K, Tiwari N. Developing Class III malocclusions: challenges and solutions. Clin Cosmet Investig Dent 2018;10:99-116. doi: 10.2147/CCIDE.S134303.

Alhammadi MS, Almashraqi AA, Khadhi AH, Arishi KA, Alamir AA, Beleges EM, et al. Orthodontic camouflage versus orthodontic-orthognathic surgical treatment in borderline class III malocclusion: a systematic review. Clin Oral Investig 2022;26(11):6443-55. doi: 10.1007/s00784-022-04685-6.

Araujo MT, Squeff LR. Orthodontic camouflage as a treatment alternative for skeletal Class III. Dental Press J Orthod 2021;26(4):e21bbo4. doi: 10.1590/2177-6709.26.4.e21bbo4.

Jankowska-Wika A. Ortodontyczne potrzeby lecznicze studentów stomatologii na podstawie badań o metodologii obiektywnej i subiektywnej [dissertation]. Poznań: Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu; 2014.

Szyndel J. Ocena satysfakcji pacjentów po zabiegach ortognatycznych, operowanych w Klinice Chirurgii Szczękowo-Twarzowej SPSK1 w Szczecinie [dissertation]. Szczecin: Pomorski Uniwersytet Medycznym w Szczecinie; 2021.

Proffit W, Turvey T, Phillips C. Orthognathic surgery: a hierarchy of stability. Int J Adult Orthodon Orthognath Surg 1996;11(3):191-204.

Baran M, Kurzepa J, Tomaszewski T, Sołoduszkiewic A, Wojciechowicz J, Stodółkiewicz A. Psychosocial effects of mandibular prognathism treatment with the use of bilateral sagittal split osteotomy. Curr Probl Psychiatry 2013;14(4):246-51.

Kościński K. Atrakcyjność twarzy: biologiczne podłoże, społeczne konsekwencje. Acad Aesthetic Anti-Aging Med 2007;2:36-40.

Kościński K. Reprodukcyjne i nie-reprodukcyjne aspekty postrzegania atrakcyjności twarzy. Antropolog Rev Suppl 2007;5:74.

Dahong X, Xiangrond C, Ying L, Yousong L, Ying G, Yan S. Effect of incisor position on the self-perceived psychosocial impacts of malocclusion among Chinese young adults. Angle Orthod 2013;83(4):617-22. doi: 10.2319/062012-508.1.

Ekuni D, Furuta M, Irie K, Azuma T, Tomofuji T, Murakami T, et al. Relationship between impacts attributed to malocclusion and psychological stress in young Japanese adults. Eur J Orthodont 2011;33(5):558-63. doi: 10.1093/ejo/cjq121.

Javed O, Bernabé E. Oral impacts on quality of life in adult patients with Class I, II and III malocclusion. Oral Health Prev Dent 2016;14(1):27-32. doi: 10.3290/j.ohpd.a34377.

Kim YK. Complications associated with orthognathic surgery. J Korean Assoc Oral Maxillofac Surg 2017;43(1):3-15. doi: 10.5125/jkaoms.2017.43.1.3.

Jędrzejewski M, Smektała T, Sporniak-Tutak K, Olszewski R. Preoperative, intraoperative, and postoperative complications in orthognathic surgery: a systematic review. Clin Oral Investig 2015;19(5):969-77. doi: 10.1007/s00784-015-1452-1.

Lee EG, Ryan FS, Shute J, Cunningham SJ. The impact of altered sensation affecting the lower lip after orthognathic treatment. J Oral Maxillofac Surg 2011;69(11):e431-45. doi: 10.1016/j.joms.2011.07.013.

Baik HS, Kim SY. Facial soft-tissue changes in skeletal Class III orthognathic surgery patients analyzed with 3-dimensional laser scanning. Am J Orthod Dentofacial Orthop 2010;138(2):167-78. doi: 10.1016/j.ajodo.2010.02.022.

Hong JS, Park YH, Kim YJ, Hong SM, Oh KM. Three-dimensional changes in pharyngeal airway in skeletal Class III patients undergoing orthognathic surgery. J Oral Maxillofac Surg 2011;69(11):e401-8. doi: 10.1016/j.joms.2011.02.011.

Nicodemo D, Pereira MD, Ferreira L. Effect of orthognathic surgery for class III correction on quality of life as measured by SF–36. Int J Oral Maxillofac Surg 2008;37(2):131-4. doi: 10.1016/j.ijom.2007.07.024.

Proffit W, Fields H, Sarver D, editors. Ortodoncja współczesna. Tom 2. Wrocław: Elsevier Urban & Partner; 2010. P. 364.

Szpyt J, Gębska M. Therapeutic management of patients with class III skeletal malocclusion. Mandibular prognathism, maxillary retrognathism – a case report. J Educ Health Sport 2019;9(5):20-31. doi: 10.5281/zenodo.2656446.

Zhou YH, Hägg U, Rabie AB. Concerns and motivations of skeletal Class III patients receiving orthodontic-surgical correction. Int J Adult Orthodon Orthognath Surg 2001;16(1):7-17.

Szpyt JO, Gębska M. Assessment of the quality of life of orthodontic and surgical patients. Analysis of the factors that motivate the initiation of treatment within the masticatory system. J Educ Health Sport 2021;11(6):120-36. doi: 10.12775/JEHS.2021.11.06.013.

Finlay PM, Atkinson JM, Moos KF. Orthognathic surgery: patient expectations; psychological profile and satisfaction with outcome. Br J Oral Maxillofac Surg 1995;33(1):9-14. doi: 10.1016/0266-4356(95)90078-0.

Nicodemo D, Pereira MD, Ferreira LM. Self-esteem and depression in patients presenting angle Class III malocclusion submitted for orthognathic surgery. Med Oral Patol Oral Cir Bucal 2008;13(1):E48-51.

Schilbred Eriksen E, Moen K, Wisth PJ, Løes S, Klock KS. Patient satisfaction and oral health-related quality of life 10–15 years after orthodontic-surgical treatment of mandibular prognathism. Int J Oral Maxillofac Surg 2018;47(8):1015-21. doi: 10.1016/j.ijom.2018.01.007.


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