# The role of age and gender in the relationship between personality traits, quality of life, and decision-making about orthognathic surgery—A cross-sectional study

## TL;DR

This study shows that age has a bigger impact than gender on how personality traits and quality of life influence decisions to have orthognathic surgery.

## Contribution

The study reveals that age, rather than gender, is the key factor shaping the influence of personality and quality of life on surgery decisions.

## Key findings

- Adults were significantly more likely to accept surgery than adolescents.
- In adults, lower self-esteem and higher perfectionism were linked to surgery acceptance.
- Oral function and facial esthetics concerns influenced surgery acceptance in both age groups.

## Abstract

To explore how age and gender shape the relationship between personality traits, quality of life (QoL), and a patient’s decision to undergo surgery for correction of dentofacial deformity.

In a cross-sectional study, 108 individuals aged 14–53 years (median age 18 years; interquartile range 17–26) with a moderate to very great need for surgery according to the Index of Orthognathic Functional Treatment Need were assessed. There were 43% adolescents (≤17 years) and 68% females. Participants completed validated questionnaires measuring personality characteristics (Big Five Inventory, Multidimensional Perfectionism Scale, and Self-Esteem Scale), along with the Orthognathic Quality of Life Questionnaire. The decision to accept or refuse surgery was recorded.

Overall, 51% of patients accepted surgery (48% of females and 57% of males). Adults were more likely to accept surgery than adolescents (61% vs. 37%; p = 0.019, V = 0.241; odds ratio 2.7; 95% confidence interval 1.2–5.9). In adults, lower self-esteem (SE) (p = 0.034, r = 0.270) and higher perfectionism (p = 0.012; r = 0.320), particularly concern over mistakes (CM) (p < 0.001; r = 0.469) and personal standards (p = 0.004; r = 0.370), were associated with acceptance. Among adolescents, personality traits showed no significant effect. However, in both age groups, impaired oral function (OF) (p = 0.013; r = 0.368 for adolescents and p = 0.006; r = 0.348 for adults) and greater facial esthetics concern (FE) (p = 0.018; r = 0.350 and p = 0.015; r = 0.310) influenced surgery acceptance. Males who accepted surgery had higher awareness of deformity than those who refused (p = 0.006; r = 0.463), while females who accepted surgery had lower SE (p = 0.044; r = 0.235). In both males and females FE was higher in those who accepted surgery (p = 0.009; r = 0.439 for males and p = 0.006; r = 0.320 for females), OF (p < 0.001; r = 0.597 and p = 0.003; r = 0.342), and CM (p = 0.030; r = 0.367 and p = 0.006; r = 0.325).

The relationship between personality traits, QoL, and the decision to undergo orthognathic surgery was more strongly influenced by age than by gender. OF and FE influenced acceptance across all age and gender groups, while personality-related factors were particularly relevant among adults.