{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:52:58Z","timestamp":1777578778468,"version":"3.51.4"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023652","name":"Sveu\u010dili\u0161te u Rijeci","doi-asserted-by":"publisher","award":["uniri-biomed-18-22"],"award-info":[{"award-number":["uniri-biomed-18-22"]}],"id":[{"id":"10.13039\/501100023652","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore how age and gender shape the relationship between personality traits, quality of life (QoL), and a patient\u2019s decision to undergo surgery for correction of dentofacial deformity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a cross-sectional study, 108 individuals aged 14\u201353 years (median age 18 years; interquartile range 17\u201326) with a moderate to very great need for surgery according to the Index of Orthognathic Functional Treatment Need were assessed. There were 43% adolescents (\u226417 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2009=\u20090.019, V\u2009=\u20090.241; odds ratio 2.7; 95% confidence interval 1.2\u20135.9). In adults, lower self-esteem (SE) (p\u2009=\u20090.034, r\u2009=\u20090.270) and higher perfectionism (p\u2009=\u20090.012; r\u2009=\u20090.320), particularly concern over mistakes (CM) (p\u2009&lt;\u20090.001; r\u2009=\u20090.469) and personal standards (p\u2009=\u20090.004; r\u2009=\u20090.370), were associated with acceptance. Among adolescents, personality traits showed no significant effect. However, in both age groups, impaired oral function (OF) (p\u2009=\u20090.013; r\u2009=\u20090.368 for adolescents and p\u2009=\u20090.006; r\u2009=\u20090.348 for adults) and greater facial esthetics concern (FE) (p\u2009=\u20090.018; r\u2009=\u20090.350 and p\u2009=\u20090.015; r\u2009=\u20090.310) influenced surgery acceptance. Males who accepted surgery had higher awareness of deformity than those who refused (p\u2009=\u20090.006; r\u2009=\u20090.463), while females who accepted surgery had lower SE (p\u2009=\u20090.044; r\u2009=\u20090.235). In both males and females FE was higher in those who accepted surgery (p\u2009=\u20090.009; r\u2009=\u20090.439 for males and p\u2009=\u20090.006; r\u2009=\u20090.320 for females), OF (p\u2009&lt;\u20090.001; r\u2009=\u20090.597 and p\u2009=\u20090.003; r\u2009=\u20090.342), and CM (p\u2009=\u20090.030; r\u2009=\u20090.367 and p\u2009=\u20090.006; r\u2009=\u20090.325).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0340828","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T18:37:25Z","timestamp":1768588645000},"page":"e0340828","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["The role of age and gender in the relationship between personality traits, quality of life, and decision-making about orthognathic surgery\u2014A cross-sectional study"],"prefix":"10.1371","volume":"21","author":[{"given":"Renata","family":"Vidakovic","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Zigante","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7622-5324","authenticated-orcid":true,"given":"Jeta","family":"Kelmendi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4836-3903","authenticated-orcid":true,"given":"Stjepan","family":"Spalj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"pone.0340828.ref001","doi-asserted-by":"crossref","first-page":"29","DOI":"10.21037\/fomm-21-61","article-title":"Surgery first: current state of the art orthognathic surgery and its potential as a primary treatment modality in obstructive sleep apnea with concurrent dentofacial deformities","volume":"4","author":"C Pearl","year":"2022","journal-title":"Front Oral Maxillofac Med"},{"key":"pone.0340828.ref002","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/978-981-13-6958-2_1","article-title":"Introduction: an overview of the concept of quality of life","volume-title":"Multidimensional approach to quality of life issues","author":"BRK Sinha","year":"2019"},{"issue":"1","key":"pone.0340828.ref003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/2231-0762.115700","article-title":"Oral health related quality of life","volume":"3","author":"D Bennadi","year":"2013","journal-title":"J Int Soc Prev Community Dent"},{"issue":"2","key":"pone.0340828.ref004","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1034\/j.1600-0528.2002.300201.x","article-title":"Development of a condition-specific quality of life measure for patients with dentofacial deformity: II. 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A cross-sectional study","volume":"9","author":"R Almedlej","year":"2020","journal-title":"J Family Med Prim Care"},{"issue":"1","key":"pone.0340828.ref010","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s40359-020-00423-3","article-title":"The big five personality traits, perfectionism and their association with mental health among UK students on professional degree programmes","volume":"8","author":"EG Lewis","year":"2020","journal-title":"BMC Psychol"},{"issue":"1","key":"pone.0340828.ref011","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/SCS.0000000000006927","article-title":"Orthognathic quality of life: what are we measuring? 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A scoping review","volume":"51","author":"R Grillo","year":"2023","journal-title":"J Craniomaxillofac Surg"},{"issue":"14","key":"pone.0340828.ref032","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.3390\/healthcare12141396","article-title":"Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors","volume":"12","author":"M Merino","year":"2024","journal-title":"Healthcare (Basel)"},{"issue":"2","key":"pone.0340828.ref033","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1177\/14614448211065425","article-title":"The associations of active and passive social media use with well-being: A critical scoping review","volume":"24","author":"PM Valkenburg","year":"2021","journal-title":"New Media & Society"},{"issue":"3","key":"pone.0340828.ref034","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/0146167202250193","article-title":"Sex differences in judgments of physical attractiveness: a social relations analysis","volume":"29","author":"DK Marcus","year":"2003","journal-title":"Pers Soc Psychol Bull"},{"issue":"6","key":"pone.0340828.ref035","first-page":"547","article-title":"Dentofacial disharmony: psychological status of patients seeking treatment consultation","volume":"68","author":"C Phillips","year":"1998","journal-title":"Angle Orthod"},{"issue":"2","key":"pone.0340828.ref036","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":"J Stirling","year":"2007","journal-title":"J Orthod"},{"issue":"3","key":"pone.0340828.ref037","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.bjoms.2020.01.005","article-title":"Impact of orthognathic surgery on quality of life: a comparison between orthodontics-first and surgery-first approaches","volume":"58","author":"H Saghafi","year":"2020","journal-title":"Br J Oral Maxillofac Surg"},{"issue":"3","key":"pone.0340828.ref038","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1093\/ejo\/cjz093","article-title":"Impact of orthodontic-surgical treatment on quality of life: a meta-analysis","volume":"42","author":"CM de Araujo","year":"2020","journal-title":"Eur J Orthod"},{"issue":"4","key":"pone.0340828.ref039","doi-asserted-by":"crossref","first-page":"521","DOI":"10.2319\/100121-735.1","article-title":"Influence of personality traits on a patient\u2019s decision to accept orthognathic surgery for correction of dentofacial deformity","volume":"92","author":"R Vidakovic","year":"2022","journal-title":"Angle Orthod"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0340828","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T18:37:31Z","timestamp":1768588651000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0340828"}},"subtitle":[],"editor":[{"given":"Andrej M","family":"Kielbassa","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0340828","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]}}}