# Effects of individuals’ esthetic expectations and the classifications of dentofacial deformities on patients’ depression: a cross-sectional study

## TL;DR

This study finds that patients with certain types of dentofacial deformities and higher esthetic expectations are more likely to experience depression.

## Contribution

The study identifies specific DFD classifications and education levels linked to increased depression risk in patients.

## Key findings

- High school-educated DFD patients are more prone to depression than those with a master’s degree or higher.
- Class III DFD patients have a higher depression risk compared to Class II patients.
- Patients with extremely high esthetic expectations are more likely to experience depression.

## Abstract

Dentofacial deformity (DFD) is a disease in which the maxillary complex markedly diverges from normal proportions. The incidence of DFD is approximately 20% worldwide, and patients with DFDs are at increased risk for depression. Attention should be given to depression in patients with DFDs. However, factors affecting depression in patients with DFDs remain unclear. Previous studies have suggested that the type of DFD and esthetic expectations may influence patient depression, but few studies have clarified the effects of the type of DFD and esthetic expectations on patient depression.

A total of 471 patients with DFDs were enrolled. The diagnosis of DFD was made by two maxillofacial surgeons according to the Angle’s classification. The visual analog assessment scale of esthetic expectations was used to assess patients’ esthetic expectations. The 9-item Patient Health Questionnaire depression module was utilized to explore patient depression. SPSS 26.0 was used to analyze the data in this study.

Compared with DFD patients who had a master’s degree or above, those who had a high school education were more prone to depression (OR=3.848, 95% CI: 1.546-9.574). Compared with Class II DFDs, Class III DFDs were associated with a greater risk of depression (OR=1.458, 95% CI: 1.007–2.078). Compared with those who had extremely low esthetic expectations, those who had extremely high esthetic expectations (OR: 2.25, 95% CI: 1.053–4.086) were more prone to depression.

Patients who had a high school education, were diagnosed with Class III DFDs, and had higher esthetic expectations had a greater risk of depression. The above populations may need more psychological support.