{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:03:50Z","timestamp":1782515030835,"version":"3.54.5"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,6,20]],"date-time":"2020-06-20T00:00:00Z","timestamp":1592611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,3]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and objectives<\/jats:title>\n                  <jats:p>High-angle Class II malocclusion is considered challenging to treat to a stable result and, although studies report treatment outcome in terms of morphology, patient satisfaction has not been addressed. The objectives of the present study were to examine patients\u2019 motives for treatment and satisfaction with the results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Material and methods<\/jats:title>\n                  <jats:p>A structured questionnaire was distributed 3 years post-operatively to 93 consecutively treated patients with an initial diagnosis of mandibular-plane angle (ML\/NSL) \u226534.0 degrees and ANB angle \u22654.0 degrees. Three surgical subsamples were defined: one-piece Le Fort I, bilateral sagittal split osteotomy, or a combination of the two (Bimax). Lateral cephalometric radiographs were used to assess morphological characteristics and post-treatment changes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Questionnaire participation was 69.8 per cent. The most frequently reported motives for seeking treatment were to improve oral function (85.0 per cent) and dental appearance (71.7 per cent). Thirty per cent were very satisfied, 53.3 per cent were satisfied, and 16.7 per cent were dissatisfied with the overall treatment result. Dissatisfaction was associated with a persisting post-treatment anterior open bite (AOB), horizontal relapse at B point, and with sensory impairment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions and implications<\/jats:title>\n                  <jats:p>A higher rate of dissatisfaction was found than what has usually been reported for othognathic surgical patients, and this was associated with a persisting AOB. In addition, mandibular relapse and impaired sensory function were related to dissatisfaction and are associated with mandibular surgery. Prospective high-angle Class II patients should be comprehensively informed about the unpredictability of treatment outcomes in terms of occlusion and facial appearance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejo\/cjaa038","type":"journal-article","created":{"date-parts":[[2020,5,31]],"date-time":"2020-05-31T19:06:30Z","timestamp":1590951990000},"page":"215-221","source":"Crossref","is-referenced-by-count":13,"title":["Patient satisfaction after orthognathic surgery: a 3 year follow-up of 60 high-angle Class II individuals"],"prefix":"10.1093","volume":"43","author":[{"given":"Nina","family":"Torgersbr\u00e5ten","sequence":"first","affiliation":[{"name":"Department of Orthodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arild","family":"Stenvik","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisen","family":"Espeland","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,6,20]]},"reference":[{"key":"2021040615261787100_CIT0001","first-page":"191","article-title":"Orthognathic surgery: a hierarchy of stability","volume":"11","author":"Proffit","year":"1996","journal-title":"The International Journal of Adult Orthodontics and Orthognathic Surgery,"},{"key":"2021040615261787100_CIT0002","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1746-160X-3-21","article-title":"The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension","volume":"3","author":"Proffit","year":"2007","journal-title":"Head and Face Medicine,"},{"key":"2021040615261787100_CIT0003","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1067\/mod.2001.110983","article-title":"Mandibular advancement surgery in high-angle and low-angle class II patients: different long-term skeletal responses","volume":"119","author":"Mobarak","year":"2001","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021040615261787100_CIT0004","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.ijom.2004.01.015","article-title":"Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part II. Radiographic parameters","volume":"33","author":"Borstlap","year":"2004","journal-title":"International Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0005","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/S0889-5406(05)81521-5","article-title":"A comparative study of stability after mandibular advancement surgery","volume":"100","author":"Douma","year":"1991","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021040615261787100_CIT0006","first-page":"107","article-title":"Expectations and perceptions regarding treatment: a prospective study of patients undergoing orthognathic surgery","volume":"13","author":"Forssell","year":"1998","journal-title":"The International Journal of Adult Orthodontics and Orthognathic surgery,"},{"key":"2021040615261787100_CIT0007","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/S0889-5406(03)00391-3","article-title":"Health-related quality of life and psychosocial function 5 years after orthognathic surgery","volume":"124","author":"Motegi","year":"2003","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021040615261787100_CIT0008","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.ijom.2004.02.003","article-title":"Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part I. Clinical parameters","volume":"33","author":"Borstlap","year":"2004","journal-title":"International Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0009","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.ajodo.2011.06.039","article-title":"Patients\u2019 perceptions of improvements after bilateral sagittal split osteotomy advancement surgery: 10 to 14 years of follow-up","volume":"141","author":"Trovik","year":"2012","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021040615261787100_CIT0010","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1093\/ejo\/cjm081","article-title":"A 3-year patient-centred follow-up of 516 consecutively treated orthognathic surgery patients","volume":"30","author":"Espeland","year":"2008","journal-title":"European Journal of Orthodontics,"},{"key":"2021040615261787100_CIT0011","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1179\/146531207225022023","article-title":"Elective orthognathic treatment decision making: a survey of patient reasons and experiences","volume":"34","author":"Stirling","year":"2007","journal-title":"Journal of Orthodontics,"},{"key":"2021040615261787100_CIT0012","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1016\/j.joms.2009.12.007","article-title":"Motivating factors for patients undergoing orthognathic surgery evaluation","volume":"68","author":"Proothi","year":"2010","journal-title":"Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0013","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.ajodo.2011.12.026","article-title":"Impact of dentofacial deformity and motivation for treatment: a qualitative study","volume":"141","author":"Ryan","year":"2012","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021040615261787100_CIT0014","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1097\/SCS.0000000000002384","article-title":"Orthognathic Surgery: outcome in a Facebook group","volume":"27","author":"Larsen","year":"2016","journal-title":"The Journal of Craniofacial Surgery,"},{"key":"2021040615261787100_CIT0015","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1016\/j.ijom.2018.01.007","article-title":"Patient satisfaction and oral health-related quality of life 10\u201315 years after orthodontic-surgical treatment of mandibular prognathism","volume":"47","author":"Schilbred Eriksen","year":"2018","journal-title":"International Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0016","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/0266-4356(95)90078-0","article-title":"Orthognathic surgery: patient expectations; psychological profile and satisfaction with outcome","volume":"33","author":"Finlay","year":"1995","journal-title":"The British Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0017","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1179\/146531205225021096","article-title":"Patients\u2019 motivations for treatment and their experiences of orthodontic preparation for orthognathic surgery","volume":"32","author":"Williams","year":"2005","journal-title":"Journal of Orthodontics,"},{"key":"2021040615261787100_CIT0018","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1097\/SCS.0000000000003922","article-title":"Evaluation of the post orthognathic surgery satisfaction: a comparative cross-sectional study of patients Class II and III","volume":"28","author":"Pereira","year":"2017","journal-title":"The Journal of Craniofacial Surgery,"},{"key":"2021040615261787100_CIT0019","doi-asserted-by":"crossref","first-page":"495","DOI":"10.2319\/040615-227.1","article-title":"Patient satisfaction after orthodontic treatment combined with orthognathic surgery: a systematic review","volume":"86","author":"Pach\u00eaco-Pereira","year":"2016","journal-title":"The Angle Orthodontist,"},{"key":"2021040615261787100_CIT0020","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/j.bjoms.2009.12.004","article-title":"A systematic review of patient self-completed questionnaires suitable for oral and maxillofacial surgery","volume":"48","author":"Kanatas","year":"2010","journal-title":"The British Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0021","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/j.ijom.2007.01.011","article-title":"Quality of life in patients with dentofacial deformity: a comparison of measurement approaches","volume":"36","author":"Lee","year":"2007","journal-title":"International Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0022","volume-title":"Variability of the Cranial and Dental Phenotype in Williams Syndrome","author":"Axelsson","year":"2005"},{"key":"2021040615261787100_CIT0023","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1016\/j.ajodo.2012.07.012","article-title":"Long-term stability of anterior open-bite closure with bilateral sagittal split osteotomy","volume":"142","author":"Fontes","year":"2012","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021040615261787100_CIT0024","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.bjoms.2018.04.003","article-title":"Numbness of the lower lip does not adversely affect quality of life or patients\u2019 satisfaction after mandibular orthognathic surgery","volume":"56","author":"Ahmad","year":"2018","journal-title":"The British Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0025","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.ajodo.2005.09.033","article-title":"Surgical-orthodontic treatment and patients\u2019 functional and psychosocial well-being","volume":"132","author":"Pahkala","year":"2007","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021040615261787100_CIT0026","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/0002-9416(85)90238-6","article-title":"Patient perceptions of orthognathic surgery","volume":"88","author":"Flanary","year":"1985","journal-title":"American Journal of Orthodontics,"},{"key":"2021040615261787100_CIT0027","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.bjoms.2005.07.016","article-title":"Patients\u2019 perception of improvement after orthognathic surgery: pilot study","volume":"44","author":"Modig","year":"2006","journal-title":"The British Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0028","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1097\/SCS.0b013e318285d5a4","article-title":"Presurgical motivations, self-esteem, and oral health of orthognathic surgery patients","volume":"24","author":"Yu","year":"2013","journal-title":"The Journal of Craniofacial Surgery,"},{"key":"2021040615261787100_CIT0029","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s10006-010-0212-2","article-title":"Perception of improvement after orthognathic surgery: the important variables affecting patient satisfaction","volume":"14","author":"Rustemeyer","year":"2010","journal-title":"Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0030","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/S0266-4356(96)90271-5","article-title":"Perceptions of outcome following orthognathic surgery","volume":"34","author":"Cunningham","year":"1996","journal-title":"The British Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0031","first-page":"16","article-title":"Pre- and postsurgical psycho-emotional aspects of the orthognathic surgery patient","volume":"15","author":"Bertolini","year":"2000","journal-title":"The International Journal of Adult Orthodontics and Orthognathic Surgery,"},{"key":"2021040615261787100_CIT0032","first-page":"159","article-title":"Long-term stability of surgical class III treatment: a study of 5-year postsurgical results","volume":"17","author":"Busby","year":"2002","journal-title":"The International Journal of Adult Orthodontics and Orthognathic Surgery,"},{"key":"2021040615261787100_CIT0033","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1016\/j.ijom.2017.12.010","article-title":"Survey of patient experiences of orthognathic surgery: health-related quality of life and satisfaction","volume":"47","author":"Al-Asfour","year":"2018","journal-title":"International Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0034","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1093\/ejo\/21.1.79","article-title":"Motivation for and satisfaction with orthodontic-surgical treatment: a retrospective study of 28 patients","volume":"21","author":"Nurminen","year":"1999","journal-title":"European Journal of Orthodontics,"},{"key":"2021040615261787100_CIT0035","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.joms.2010.06.203","article-title":"Motives for surgical-orthodontic treatment and effect of treatment on psychosocial well-being and satisfaction: a prospective study of 118 patients","volume":"69","author":"Oland","year":"2011","journal-title":"Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0036","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1597\/14-021","article-title":"Psychosocial outcomes in orthognathic surgery: a review of the literature","volume":"52","author":"Liddle","year":"2015","journal-title":"The Cleft Palate-Craniofacial Journal,"},{"key":"2021040615261787100_CIT0037","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.ijom.2015.10.019","article-title":"Assessment of the changes in quality of life of patients with class II and III deformities during and after orthodontic-surgical treatment","volume":"45","author":"Baherimoghaddam","year":"2016","journal-title":"International Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0038","first-page":"217","article-title":"Factors influencing postoperative satisfaction of orthognathic surgery patients","volume":"17","author":"Chen","year":"2002","journal-title":"The International Journal of Adult Orthodontics and Orthognathic Surgery,"},{"key":"2021040615261787100_CIT0039","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/0278-2391(84)90009-0","article-title":"Psychologic changes in orthognathic surgery patients: a 24-month follow up","volume":"42","author":"Kiyak","year":"1984","journal-title":"Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0040","first-page":"247","article-title":"Treatment expectations versus outcomes among orthognathic surgery patients","volume":"6","author":"Ostler","year":"1991","journal-title":"The International Journal of Adult Orthodontics and Orthognathic Surgery,"},{"key":"2021040615261787100_CIT0041","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1067\/mod.2003.43","article-title":"Long-term follow-up of Class II adults treated with orthodontic camouflage: a comparison with orthognathic surgery outcomes","volume":"123","author":"Mihalik","year":"2003","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021040615261787100_CIT0042","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1016\/j.joms.2008.01.014","article-title":"Complex orthognathic surgery: assessment of patient satisfaction","volume":"66","author":"Posnick","year":"2008","journal-title":"Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0043","doi-asserted-by":"crossref","first-page":"2217","DOI":"10.1016\/j.joms.2009.04.101","article-title":"Clinical review of factors leading to perioperative dissatisfaction related to orthognathic surgery","volume":"67","author":"Kim","year":"2009","journal-title":"Journal of Oral and Maxillofacial Surgery,"},{"key":"2021040615261787100_CIT0044","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1093\/ejo\/cjy071","article-title":"Perceptions of outcomes of orthodontic treatment in adolescent patients: a qualitative study","volume":"41","author":"AlQuraini","year":"2019","journal-title":"European Journal of Orthodontics,"},{"key":"2021040615261787100_CIT0045","first-page":"280","article-title":"Who seeks surgical-orthodontic treatment: a current review","volume":"16","author":"Bailey","year":"2001","journal-title":"The International Journal of Adult Orthodontics and Orthognathic Surgery,"}],"container-title":["European Journal of Orthodontics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ejo\/article-pdf\/43\/2\/215\/36873329\/cjaa038.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ejo\/article-pdf\/43\/2\/215\/36873329\/cjaa038.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T16:15:31Z","timestamp":1617725731000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejo\/article\/43\/2\/215\/5860255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,20]]},"references-count":45,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,6,20]]},"published-print":{"date-parts":[[2021,4,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ejo\/cjaa038","relation":{},"ISSN":["0141-5387","1460-2210"],"issn-type":[{"value":"0141-5387","type":"print"},{"value":"1460-2210","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,4,1]]},"published":{"date-parts":[[2020,6,20]]}}}