Ryan, FS; (2013) Psychological aspects of dentofacial discrepancy and orthognathic treatment. Doctoral thesis (PhD), UCL (University College London).

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Abstract

This mixed methods study, conducted in four sections, examined a number of key areas in relation to dentofacial discrepancy and orthognathic treatment: Chapter 1: Pre-treatment psychological characteristics of orthognathic patients This was a cross-sectional study using validated questionnaires to assess the pre-treatment psychological profile, personality, quality of life, and perceptions of appearance of 68 orthognathic patients. These factors were compared with normative values and significant differences were found between the patients and normative population for several psychological traits. Chapter 2: Impact, motivations, and expectations in relation to orthognathic treatment: A qualitative study This was a qualitative study exploring the impact of dentofacial deformity, orthognathic patients’ motivations for, and expectations of, treatment. Data were collected from 18 pre-treatment patients using in-depth interviews and these were analysed using the Critical Qualitative Theory method. The full range of impacts, motivations, and expectations was analysed and reported, together with a clinically useful typology of patients based on expectations. Chapter 3: Social anxiety in orthognathic patients This study involved assessing social anxiety in orthognathic patients. The Brief Fear of Negative Evaluation Scale was used. As no UK normative data existed, initially a national survey was conducted of a random sample of 1196 individuals from the general UK population to establish norms for social anxiety with which to compare the cohort of 61 pre-treatment orthognathic patients. The results revealed that orthognathic patients had significantly higher levels of social anxiety than the general population. Chapter 4: Shared decision-making in orthognathic treatment There is increasing evidence that the extent to which patients are involved in their treatment decisions may affect outcomes. In this study, the extent to which clinicians involved 61 orthognathic patients in treatment decision-making was assessed using the OPTION scale. The results revealed overall low levels of shared decision-making and reasons for this are discussed.

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