Abstract
BACKGROUND/PURPOSE: Prior research highlights the psychological burden of facial deformities, yet there remains a lack of evidence regarding which postoperative variables most strongly influence mental well-being. This study explored the relationship between psychological status, physical function, and quality of life in patients with craniofacial malocclusion undergoing orthognathic surgery, aiming to identify predictors of psychiatric referral and patient satisfaction. MATERIALS AND METHODS: A retrospective, single-center study was conducted at Chung Shan Medical University Hospital, reviewing 60 de-identified medical records of patients who received orthognathic surgery between 2019 and 2024. Variables assessed included pain, oral function, anxiety, depression, body image, facial satisfaction, and quality of life, using validated scales. Spearman correlation analyses were used, followed by binary logistic regression with psychiatric referral as the outcome variable. RESULTS: Significant correlations were found between oral function and depression (negative), and between oral function and mood disturbance (positive). Quality of life was significantly associated with emotional stability, while facial satisfaction was positively correlated with self-image. Logistic regression analysis identified facial satisfaction as a significant negative predictor of psychiatric referral (OR = 0.64, 95 % CI: 0.45-0.92, P = 0.021). Other predictors, including eating difficulty and psychological distress scores, did not reach statistical significance. CONCLUSION: Orthognathic surgery exerts a multifaceted impact on patients' emotional well-being, self-perception, and life quality. Postoperative functional and aesthetic improvements are associated with improved psychological outcomes, especially self-image and emotional stability. Among various predictors, patient satisfaction with facial appearance and function was the strongest factor in reducing psychiatric referral needs.