{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:08:59Z","timestamp":1792451339030,"version":"4.5.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Understanding age-related differences in the psychological aspects of orthodontic treatment is crucial for patient-centered care. This study compared treatment motivation, psychosocial impact, and perfectionism between child and adult patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, 306 orthodontic patients (223 children, 83 adults) completed validated questionnaires assessing motivation, psychosocial impact (PIDAQ), and perfectionism (FMPS). Patient-perceived aesthetic need (IOTN-AC) and orthodontist-evaluated clinical need (IOTN-DHC) were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Adults reported significantly higher total treatment motivation (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.021) and a markedly greater psychosocial impact of malocclusion (PIDAQ: 58 vs. 35,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) than children, with higher scores in social, psychological, and aesthetic concern domains. Adults also showed stronger functional motivation (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.004), greater concern over mistakes (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.018), and lower parental expectations (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.029). A significant discrepancy existed between patient self-perceived need (IOTN-AC) and orthodontist assessment (IOTN-DHC) in both groups (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Regression analysis showed that higher psychosocial impact (PIDAQ) was associated with female gender, older age, higher perfectionism, and greater self-perceived aesthetic need, but not with clinical need (IOTN-DHC). The total PIDAQ score was the only significant independent predictor of higher treatment motivation (\u03b2 = 0.10,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adult orthodontic patients experience a greater psychosocial burden and distinct motivational drivers compared to children. Treatment motivation is primarily driven by psychosocial distress, not clinical severity, highlighting the need for clinicians to prioritize patient-reported outcomes and address perception gaps to deliver effective, patient-centered care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1714237","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T05:35:34Z","timestamp":1768973734000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Age matters in orthodontics: divergent motivations, perfectionism, and patient-clinician discord in treatment need assessment"],"prefix":"10.3389","volume":"12","author":[{"given":"Guo","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Stomatology, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengjie","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Stomatology, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"44","DOI":"10.3390\/clinpract15030044","article-title":"Mental health and malocclusion: a comprehensive review.","volume":"15","author":"Alsulaiman","year":"2025","journal-title":"Clin Pract."},{"key":"B2","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1093\/ejo\/cjac063","article-title":"Minimally important differences in oral health-related quality of life after fixed orthodontic treatment: a prospective cohort study.","volume":"45","author":"Lau","year":"2023","journal-title":"Eur J 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