{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:04:44Z","timestamp":1780067084281,"version":"3.54.0"},"reference-count":64,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the relationship between body dysmorphic disorder (BDD), orthodontic parameters, and the level of depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A total of 205 adolescents (142 females, 63 males; aged 12\u201318) completed the Body Dysmorphic Disorder Questionnaire (BDDQ) and the Beck Depression Inventory (BDI). Orthodontic parameters, including skeletal malocclusion type, maxillary and mandibular anterior crowding, and Index of Treatment Need (IOTN) scores, were recorded. Associations were analyzed using appropriate statistical methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      BDDQ positivity was observed in 69.8% (n = 143) of participants. BDDQ-positive individuals had significantly higher BDI scores compared to BDDQ-negative individuals (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). No significant group differences were found in terms of age, crowding, IOTN scores, or skeletal malocclusion type. However, correlation analysis showed a weak but statistically significant negative association between malocclusion type and BDDQ positivity (r = \u20130.146,\n                      <jats:italic>P<\/jats:italic>\n                      = .042), and a moderate positive correlation between BDDQ positivity and BDI scores (r = 0.317,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BDD was significantly associated with depression levels. Although most orthodontic variables showed no direct relationship with BDD, malocclusion type demonstrated a weak but significant correlation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/050925-367.1","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:51:50Z","timestamp":1770771110000},"page":"200-205","source":"Crossref","is-referenced-by-count":1,"title":["Relationship between body dysmorphic disorder, depression, and malocclusion severity in adolescents"],"prefix":"10.2319","volume":"96","author":[{"given":"Hasan","family":"Camc\u0131","sequence":"first","affiliation":[{"name":"Associate Professor, Afyonkarahisar Health Sciences University, Dentistry Faculty, Department of Orthodontics, Afyonkarahisar, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6mer","family":"Geni\u015f","sequence":"additional","affiliation":[{"name":"Research Assistant, Afyonkarahisar Health Sciences University, Dentistry Faculty, Department of Orthodontics, Afyonkarahisar, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"issue":"3","key":"i1945-7103-96-2-200-b01","series-title":"Prim Care","first-page":"465","article-title":"Adolescent growth and development","volume":"41","author":"Chulani","year":"2014","unstructured":"Chulani VL,\nGordon LP. Adolescent growth and development. Prim Care. 2014;41(3):465\u2013487."},{"issue":"1","key":"i1945-7103-96-2-200-b02","series-title":"Reprod Health","first-page":"1","article-title":"Awareness of pubertal body changes among primary school children aged 10\u201314 years in Eastern Uganda: challenges and opportunities","volume":"19","author":"Bunoti","year":"2022","unstructured":"Bunoti SN,\nTumwesigye NM,\nAtuyambe L. Awareness of pubertal body changes among primary school children aged 10\u201314 years in Eastern Uganda: challenges and opportunities. Reprod Health. 2022;19(1):1\u201310."},{"issue":"1","key":"i1945-7103-96-2-200-b03","series-title":"Angle Orthod","first-page":"111","article-title":"The influence of text messages on the cooperation of Class II patients regarding the use of intermaxillary elastics","volume":"89","author":"Leone","year":"2019","unstructured":"Leone SMM,\nde Souza-Constantino AM,\nFerreira-Conti ACC, et al. The influence of text messages on the cooperation of Class II patients regarding the use of intermaxillary elastics. Angle Orthod. 2019;89(1):111\u2013116."},{"issue":"3","key":"i1945-7103-96-2-200-b04","series-title":"Psychiatry Res","first-page":"305","article-title":"Clinical features of body dysmorphic disorder in adolescents and adults","volume":"141","author":"Phillips","year":"2006","unstructured":"Phillips KA,\nDidie ER,\nMenard W,\nPagano ME,\nFay C,\nWeisberg RB. Clinical features of body dysmorphic disorder in adolescents and adults. Psychiatry Res. 2006;141(3):305\u2013314."},{"issue":"940","key":"i1945-7103-96-2-200-b05","series-title":"Postgrad Med J","first-page":"67","article-title":"Body dysmorphic disorder","volume":"80","author":"Veale","year":"2004","unstructured":"Veale D. Body dysmorphic disorder. Postgrad Med J. 2004;80(940):67\u201371."},{"issue":"1","key":"i1945-7103-96-2-200-b06","series-title":"Eur Child Adolesc Psychiatry","first-page":"133","article-title":"Clinical characteristics of 172 children and adolescents with body dysmorphic disorder","volume":"31","author":"Rautio","year":"2022","unstructured":"Rautio D,\nJassi A,\nKrebs G, et al. Clinical characteristics of 172 children and adolescents with body dysmorphic disorder. Eur Child Adolesc Psychiatry. 2022;31(1):133\u2013144."},{"issue":"12","key":"i1945-7103-96-2-200-b07","series-title":"Int J Prev Med","first-page":"1626","article-title":"Correlation of body image anxiety with social phobia and their association with depression in adolescents from a rural area of India","volume":"5","author":"Waghachavare","year":"2014","unstructured":"Waghachavare VB,\nQuraishi SR,\nDhumale GB,\nGor AD. Correlation of body image anxiety with social phobia and their association with depression in adolescents from a rural area of India. Int J Prev Med. 2014;5(12):1626\u20131632."},{"issue":"5","key":"i1945-7103-96-2-200-b08","series-title":"Psychol Med","first-page":"1043","article-title":"Pubertal changes in hormone levels and depression in girls","volume":"29","author":"Angold","year":"1999","unstructured":"Angold A,\nCostello EJ,\nErkanli A,\nWorthman CM. Pubertal changes in hormone levels and depression in girls. Psychol Med. 1999;29(5):1043\u20131053."},{"issue":"3","key":"i1945-7103-96-2-200-b09","series-title":"Arch Gen Psychiatry","first-page":"225","article-title":"Mental health, educational, and social role outcomes of adolescents with depression","volume":"59","author":"Fergusson","year":"2002","unstructured":"Fergusson DM,\nWoodward LJ. Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry. 2002;59(3):225\u2013231."},{"issue":"4","key":"i1945-7103-96-2-200-b10","series-title":"Int J Cogn Ther","first-page":"311","article-title":"Cognitive mechanisms of change in CBT for adolescent depression: associations among client involvement, cognitive distortions, and treatment outcome","volume":"6","author":"Shirk","year":"2013","unstructured":"Shirk SR,\nCrisostomo PS,\nJungbluth N,\nGudmundsen GR. Cognitive mechanisms of change in CBT for adolescent depression: associations among client involvement, cognitive distortions, and treatment outcome. Int J Cogn Ther. 2013;6(4):311\u2013324."},{"issue":"1","key":"i1945-7103-96-2-200-b11","series-title":"Med Oral Patol Oral Cir Bucal","first-page":"E48","article-title":"Self-esteem and depression in patients with Class III malocclusion submitted for orthognathic surgery","volume":"13","author":"Nicodemo","year":"2008","unstructured":"Nicodemo D,\nDomingues Pereira M,\nFerreira LM. Self-esteem and depression in patients with Class III malocclusion submitted for orthognathic surgery. Med Oral Patol Oral Cir Bucal. 2008;13(1):E48\u2013E51."},{"issue":"10","key":"i1945-7103-96-2-200-b12","series-title":"Children","first-page":"1691","article-title":"Body image and psychological impact of dental appearance in adolescents with malocclusion: a preliminary exploratory study","volume":"10","author":"Sicari","year":"2023","unstructured":"Sicari F,\nMerlo EM,\nGentile G, et al. Body image and psychological impact of dental appearance in adolescents with malocclusion: a preliminary exploratory study. Children. 2023;10(10):1691."},{"issue":"6","key":"i1945-7103-96-2-200-b13","series-title":"Eur J Orthod","first-page":"593","article-title":"The psycho-social impact of malocclusions and treatment expectations of adolescent orthodontic patients","volume":"38","author":"Twigge","year":"2016","unstructured":"Twigge E,\nRoberts RM,\nJamieson L,\nDreyer CW,\nSampson WJ. The psycho-social impact of malocclusions and treatment expectations of adolescent orthodontic patients. Eur J Orthod. 2016;38(6):593\u2013601."},{"issue":"5","key":"i1945-7103-96-2-200-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"712","article-title":"Influence of social media and corrected smile photographs in patients with malocclusion","volume":"164","author":"Karkun","year":"2023","unstructured":"Karkun R,\nBatra P,\nSingh AK. Influence of social media and corrected smile photographs in patients with malocclusion. Am J Orthod Dentofacial Orthop. 2023;164(5):712\u2013727."},{"issue":"1","key":"i1945-7103-96-2-200-b15","series-title":"Prog Orthod","first-page":"14","article-title":"The relationship between different levels of facial attractiveness and malocclusion perception: an eye tracking and survey study","volume":"24","author":"Zorlu","year":"2023","unstructured":"Zorlu M,\nCamc\u0131 H. The relationship between different levels of facial attractiveness and malocclusion perception: an eye tracking and survey study. Prog Orthod. 2023;24(1):14."},{"issue":"1","key":"i1945-7103-96-2-200-b16","series-title":"Eur J Orthod","first-page":"43","article-title":"Quality of life in patients with severe malocclusion before treatment","volume":"32","author":"Rusanen","year":"2010","unstructured":"Rusanen J,\nLahti S,\nTolvanen M,\nPirttiniemi P. Quality of life in patients with severe malocclusion before treatment. Eur J Orthod. 2010;32(1):43\u201348."},{"issue":"4","key":"i1945-7103-96-2-200-b17","series-title":"J Stomatol Oral Maxillofac Surg","first-page":"e145","article-title":"Body dysmorphic disorder (BDD) in the orthodontic and orthognathic setting: a systematic review","volume":"123","author":"Dons","year":"2022","unstructured":"Dons F,\nMulier D,\nMaleux O,\nShaheen E,\nPolitis C. Body dysmorphic disorder (BDD) in the orthodontic and orthognathic setting: a systematic review. J Stomatol Oral Maxillofac Surg. 2022;123(4):e145\u2013e152."},{"issue":"1","key":"i1945-7103-96-2-200-b18","series-title":"Nurs Made Incred Easy","first-page":"32","article-title":"Body dysmorphic disorder: the drive for perfection","volume":"17","author":"Perkins","year":"2019","unstructured":"Perkins A. Body dysmorphic disorder: the drive for perfection. Nurs Made Incred Easy. 2019;17(1):32\u201338."},{"issue":"10","key":"i1945-7103-96-2-200-b19","series-title":"Br Dent J","first-page":"929","article-title":"Body dysmorphic disorder and facial aesthetic treatments in dental practice","volume":"227","author":"James","year":"2019","unstructured":"James M,\nClarke P,\nDarcey R. Body dysmorphic disorder and facial aesthetic treatments in dental practice. Br Dent J. 2019;227(10):929\u2013933."},{"issue":"3","key":"i1945-7103-96-2-200-b20","series-title":"Eur J Orthod","first-page":"309","article-title":"The development of an index of orthodontic treatment priority","volume":"11","author":"Brook","year":"1989","unstructured":"Brook PH,\nShaw WC. The development of an index of orthodontic treatment priority. Eur J Orthod. 1989;11(3):309\u2013320."},{"issue":"4","key":"i1945-7103-96-2-200-b21","series-title":"Psychosomatics","first-page":"317","article-title":"Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder","volume":"46","author":"Phillips","year":"2005","unstructured":"Phillips KA,\nMenard W,\nFay C,\nWeisberg R. Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics. 2005;46(4):317\u2013325."},{"issue":"1","key":"i1945-7103-96-2-200-b22","series-title":"Clin Dermatol","first-page":"16","article-title":"Body dysmorphic disorder: a critical appraisal of diagnostic, screening, and assessment tools","volume":"41","author":"T\u00fcrk","year":"2023","unstructured":"T\u00fcrk CB,\nMaymone MBC,\nKroumpouzos G. Body dysmorphic disorder: a critical appraisal of diagnostic, screening, and assessment tools. Clin Dermatol. 2023;41(1):16\u201327."},{"key":"i1945-7103-96-2-200-b23","series-title":"Beck Depression Inventory\u2013II","author":"Beck","year":"1996","unstructured":"Beck AT,\nSteer RA,\nBrown G. Beck Depression Inventory\u2013II. 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Soc Psychiatry Psychiatr Epidemiol. 1997;32(1):24\u201329."},{"issue":"2","key":"i1945-7103-96-2-200-b26","series-title":"Dialogues Clin Neurosci","first-page":"221","article-title":"Body dysmorphic disorder","volume":"12","author":"Bjornsson","year":"2010","unstructured":"Bjornsson AS,\nDidie ER,\nPhillips KA. Body dysmorphic disorder. Dialogues Clin Neurosci. 2010;12(2):221\u2013232."},{"issue":"3","key":"i1945-7103-96-2-200-b27","series-title":"Dermatol Rep","first-page":"8774","article-title":"The prevalence and determinants of body dysmorphic disorder among young social media users: a cross-sectional study","volume":"12","author":"Alsaidan","year":"2020","unstructured":"Alsaidan MS,\nAltayar NS,\nAlshmmari SH, et al. The prevalence and determinants of body dysmorphic disorder among young social media users: a cross-sectional study. Dermatol Rep. 2020;12(3):8774."},{"issue":"2","key":"i1945-7103-96-2-200-b28","series-title":"Compr Psychiatry","first-page":"77","article-title":"Gender similarities and differences in 200 individuals with body dysmorphic disorder","volume":"47","author":"Phillips","year":"2006","unstructured":"Phillips KA,\nMenard W,\nFay C. Gender similarities and differences in 200 individuals with body dysmorphic disorder. Compr Psychiatry. 2006;47(2):77\u201387."},{"issue":"6","key":"i1945-7103-96-2-200-b29","series-title":"Int J Environ Res Public Health","first-page":"2880","article-title":"Social media use and body image disorders: association between frequency of comparing one\u2019s own physical appearance to that of people being followed on social media and body dissatisfaction and drive for thinness","volume":"18","author":"Jiotsa","year":"2021","unstructured":"Jiotsa B,\nNaccache B,\nDuval M,\nRocher B,\nGrall-Bronnec M. 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J Taibah Univ Med Sci. 2021;16(5):689\u2013694."},{"issue":"3","key":"i1945-7103-96-2-200-b01","series-title":"Prim Care","first-page":"465","article-title":"Adolescent growth and development","volume":"41","author":"Chulani","year":"2014","unstructured":"Chulani VL,\nGordon LP. Adolescent growth and development. Prim Care. 2014;41(3):465\u2013487."},{"issue":"1","key":"i1945-7103-96-2-200-b02","series-title":"Reprod Health","first-page":"1","article-title":"Awareness of pubertal body changes among primary school children aged 10\u201314 years in Eastern Uganda: challenges and opportunities","volume":"19","author":"Bunoti","year":"2022","unstructured":"Bunoti SN,\nTumwesigye NM,\nAtuyambe L. Awareness of pubertal body changes among primary school children aged 10\u201314 years in Eastern Uganda: challenges and opportunities. Reprod Health. 2022;19(1):1\u201310."},{"issue":"1","key":"i1945-7103-96-2-200-b03","series-title":"Angle Orthod","first-page":"111","article-title":"The influence of text messages on the cooperation of Class II patients regarding the use of intermaxillary elastics","volume":"89","author":"Leone","year":"2019","unstructured":"Leone SMM,\nde Souza-Constantino AM,\nFerreira-Conti ACC, et al. The influence of text messages on the cooperation of Class II patients regarding the use of intermaxillary elastics. Angle Orthod. 2019;89(1):111\u2013116."},{"issue":"3","key":"i1945-7103-96-2-200-b04","series-title":"Psychiatry Res","first-page":"305","article-title":"Clinical features of body dysmorphic disorder in adolescents and adults","volume":"141","author":"Phillips","year":"2006","unstructured":"Phillips KA,\nDidie ER,\nMenard W,\nPagano ME,\nFay C,\nWeisberg RB. Clinical features of body dysmorphic disorder in adolescents and adults. Psychiatry Res. 2006;141(3):305\u2013314."},{"issue":"940","key":"i1945-7103-96-2-200-b05","series-title":"Postgrad Med J","first-page":"67","article-title":"Body dysmorphic disorder","volume":"80","author":"Veale","year":"2004","unstructured":"Veale D. Body dysmorphic disorder. Postgrad Med J. 2004;80(940):67\u201371."},{"issue":"1","key":"i1945-7103-96-2-200-b06","series-title":"Eur Child Adolesc Psychiatry","first-page":"133","article-title":"Clinical characteristics of 172 children and adolescents with body dysmorphic disorder","volume":"31","author":"Rautio","year":"2022","unstructured":"Rautio D,\nJassi A,\nKrebs G, et al. Clinical characteristics of 172 children and adolescents with body dysmorphic disorder. Eur Child Adolesc Psychiatry. 2022;31(1):133\u2013144."},{"issue":"12","key":"i1945-7103-96-2-200-b07","series-title":"Int J Prev Med","first-page":"1626","article-title":"Correlation of body image anxiety with social phobia and their association with depression in adolescents from a rural area of India","volume":"5","author":"Waghachavare","year":"2014","unstructured":"Waghachavare VB,\nQuraishi SR,\nDhumale GB,\nGor AD. Correlation of body image anxiety with social phobia and their association with depression in adolescents from a rural area of India. Int J Prev Med. 2014;5(12):1626\u20131632."},{"issue":"5","key":"i1945-7103-96-2-200-b08","series-title":"Psychol Med","first-page":"1043","article-title":"Pubertal changes in hormone levels and depression in girls","volume":"29","author":"Angold","year":"1999","unstructured":"Angold A,\nCostello EJ,\nErkanli A,\nWorthman CM. Pubertal changes in hormone levels and depression in girls. Psychol Med. 1999;29(5):1043\u20131053."},{"issue":"3","key":"i1945-7103-96-2-200-b09","series-title":"Arch Gen Psychiatry","first-page":"225","article-title":"Mental health, educational, and social role outcomes of adolescents with depression","volume":"59","author":"Fergusson","year":"2002","unstructured":"Fergusson DM,\nWoodward LJ. Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry. 2002;59(3):225\u2013231."},{"issue":"4","key":"i1945-7103-96-2-200-b10","series-title":"Int J Cogn Ther","first-page":"311","article-title":"Cognitive mechanisms of change in CBT for adolescent depression: associations among client involvement, cognitive distortions, and treatment outcome","volume":"6","author":"Shirk","year":"2013","unstructured":"Shirk SR,\nCrisostomo PS,\nJungbluth N,\nGudmundsen GR. Cognitive mechanisms of change in CBT for adolescent depression: associations among client involvement, cognitive distortions, and treatment outcome. Int J Cogn Ther. 2013;6(4):311\u2013324."},{"issue":"1","key":"i1945-7103-96-2-200-b11","series-title":"Med Oral Patol Oral Cir Bucal","first-page":"E48","article-title":"Self-esteem and depression in patients with Class III malocclusion submitted for orthognathic surgery","volume":"13","author":"Nicodemo","year":"2008","unstructured":"Nicodemo D,\nDomingues Pereira M,\nFerreira LM. Self-esteem and depression in patients with Class III malocclusion submitted for orthognathic surgery. Med Oral Patol Oral Cir Bucal. 2008;13(1):E48\u2013E51."},{"issue":"10","key":"i1945-7103-96-2-200-b12","series-title":"Children","first-page":"1691","article-title":"Body image and psychological impact of dental appearance in adolescents with malocclusion: a preliminary exploratory study","volume":"10","author":"Sicari","year":"2023","unstructured":"Sicari F,\nMerlo EM,\nGentile G, et al. Body image and psychological impact of dental appearance in adolescents with malocclusion: a preliminary exploratory study. Children. 2023;10(10):1691."},{"issue":"6","key":"i1945-7103-96-2-200-b13","series-title":"Eur J Orthod","first-page":"593","article-title":"The psycho-social impact of malocclusions and treatment expectations of adolescent orthodontic patients","volume":"38","author":"Twigge","year":"2016","unstructured":"Twigge E,\nRoberts RM,\nJamieson L,\nDreyer CW,\nSampson WJ. The psycho-social impact of malocclusions and treatment expectations of adolescent orthodontic patients. Eur J Orthod. 2016;38(6):593\u2013601."},{"issue":"5","key":"i1945-7103-96-2-200-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"712","article-title":"Influence of social media and corrected smile photographs in patients with malocclusion","volume":"164","author":"Karkun","year":"2023","unstructured":"Karkun R,\nBatra P,\nSingh AK. Influence of social media and corrected smile photographs in patients with malocclusion. Am J Orthod Dentofacial Orthop. 2023;164(5):712\u2013727."},{"issue":"1","key":"i1945-7103-96-2-200-b15","series-title":"Prog Orthod","first-page":"14","article-title":"The relationship between different levels of facial attractiveness and malocclusion perception: an eye tracking and survey study","volume":"24","author":"Zorlu","year":"2023","unstructured":"Zorlu M,\nCamc\u0131 H. The relationship between different levels of facial attractiveness and malocclusion perception: an eye tracking and survey study. Prog Orthod. 2023;24(1):14."},{"issue":"1","key":"i1945-7103-96-2-200-b16","series-title":"Eur J Orthod","first-page":"43","article-title":"Quality of life in patients with severe malocclusion before treatment","volume":"32","author":"Rusanen","year":"2010","unstructured":"Rusanen J,\nLahti S,\nTolvanen M,\nPirttiniemi P. Quality of life in patients with severe malocclusion before treatment. Eur J Orthod. 2010;32(1):43\u201348."},{"issue":"4","key":"i1945-7103-96-2-200-b17","series-title":"J Stomatol Oral Maxillofac Surg","first-page":"e145","article-title":"Body dysmorphic disorder (BDD) in the orthodontic and orthognathic setting: a systematic review","volume":"123","author":"Dons","year":"2022","unstructured":"Dons F,\nMulier D,\nMaleux O,\nShaheen E,\nPolitis C. Body dysmorphic disorder (BDD) in the orthodontic and orthognathic setting: a systematic review. J Stomatol Oral Maxillofac Surg. 2022;123(4):e145\u2013e152."},{"issue":"1","key":"i1945-7103-96-2-200-b18","series-title":"Nurs Made Incred Easy","first-page":"32","article-title":"Body dysmorphic disorder: the drive for perfection","volume":"17","author":"Perkins","year":"2019","unstructured":"Perkins A. Body dysmorphic disorder: the drive for perfection. Nurs Made Incred Easy. 2019;17(1):32\u201338."},{"issue":"10","key":"i1945-7103-96-2-200-b19","series-title":"Br Dent J","first-page":"929","article-title":"Body dysmorphic disorder and facial aesthetic treatments in dental practice","volume":"227","author":"James","year":"2019","unstructured":"James M,\nClarke P,\nDarcey R. Body dysmorphic disorder and facial aesthetic treatments in dental practice. 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