Kiyak H A, McNeill R W, West R A, Hohl T, Heaton P J
Am J Orthod. 1986 May;89(5):383-92. doi: 10.1016/0002-9416(86)90069-2.
The aims of this study were to determine the effects of surgical and conventional orthodontics on patients' body image and self-esteem and the association between personality characteristics and postoperative reports of pain, paresthesia, swelling, and satisfaction among 90 patients who underwent surgical orthodontics. Patients who underwent surgery completed questionnaires before their operations and up to 6 months after surgery. Self-esteem and body image were compared longitudinally between these patients and 33 persons who were undergoing orthodontic treatment only and 33 persons who had decided against treatment. Results suggest that patients' self-esteem, body image, and degree of extroversion are unrelated to postsurgical satisfaction and discomfort. Neuroticism was correlated with satisfaction, so that patients who scored in the higher range on a scale of neuroticism were less satisfied immediately after surgery and at removal of fixation wires. Neurotic patients also were more likely to complain of pain and swelling 6 months after surgery. Surgical patients held a more negative facial image and were more introverted than those in the other two groups but were similar in other personality traits before surgery. Both surgical and orthodontic patients improved significantly in body image over time, with the greatest increase among the former. Similar shifts in self-esteem occurred for the three groups, suggesting that surgery per se may not be the major determinant of longitudinal changes in self-esteem. Notably, the positive effect of surgery and orthodontic treatment on body image is an important motive for many persons seeking treatment. Results of this study provide important insights into how to prepare and counsel patients undergoing orthodontic treatment with and without surgery.
本研究的目的是确定外科正畸和传统正畸对患者身体意象和自尊的影响，以及90例接受外科正畸治疗患者的人格特征与术后疼痛、感觉异常、肿胀及满意度报告之间的关联。接受手术的患者在手术前及术后长达6个月的时间内完成问卷。纵向比较这些患者与33例仅接受正畸治疗的患者以及33例决定不接受治疗的患者的自尊和身体意象。结果表明，患者的自尊、身体意象和外向程度与术后满意度和不适无关。神经质与满意度相关，因此在神经质量表上得分较高的患者在术后即刻及拆除固定丝时满意度较低。神经质患者在术后6个月也更有可能抱怨疼痛和肿胀。与其他两组相比，接受手术的患者面部意象更为负面，且更内向，但术前在其他人格特质方面相似。随着时间的推移，接受外科和正畸治疗的患者身体意象均有显著改善，其中前者改善幅度最大。三组患者的自尊也有类似变化，这表明手术本身可能不是自尊纵向变化的主要决定因素。值得注意的是，手术和正畸治疗对身体意象的积极影响是许多寻求治疗的人的重要动机。本研究结果为如何对接受正畸治疗（无论是否接受手术）的患者进行准备和咨询提供了重要见解。
