OBJECTIVETo study the relationship between severity of skeletal Class III malocclusion and the patient's emotional status, as well as motivation for seeking surgical correction and satisfaction with the outcome of the surgery.

METHODSOne hundred and forty consecutive Chinese patients with skeletal Class III malocclusion who had been treated with a combined orthodontic and surgical approach were studied. Sixty-seven percent (40 males and 54 females) responded to a questionnaire. Fifty-four percent had two jaw deformities, 32% mandibular hyperplasia and 14% maxillary hypoplasia. Surgical procedures: 77% received two jaw surgeries, 15% maxillary advancement and 8% mandibular setback. This was a retrospective study based on questionnaires with numerical scale ranked answers (0: not at all; 1: a little; 2: moderately; 3: quite a bit; and 4: extremely).

RESULTSANB angle was significantly negatively correlated with feelings about the nickname related to their facial problems (embarrassment: gamma =-0.30, P < 0.01; worn out gamma =-0.32, P < 0.01; angry gamma =-0.24, P < 0.05). ANB angle also had a significant negative correlation with the reasons for having the surgery (pressure from their friends: gamma =-0.21, P < 0.05, and referred by physician: gamma =-0.24, P < 0.05). Changes in life style as a result of surgery were significantly negatively correlated with the ANB angle before treatment, positive influence on relationships with the opposite sex (gamma =-0.25, P < 0.05), positive influence in social activities (gamma =-0.22, P < 0.05).

CONCLUSIONThe psychological status before surgery and the outcome following orthognathic surgery in patients with skeletal Class III malocclusion were closely related to severity of the malocclusion.