İSKELETSEL SINIF III MALOKLÜZYONA SAHİP ORTOGNATİK CERRAHİ HASTALARININ BENLİK SAYGISI, ELEŞTİRİYE DUYARLILIK VE SOSYAL GÖRÜNÜŞ KAYGISI DÜZEYLERİNİN UZUN DÖNEM TAKİBİ
Amaç: Bu araştırmanın amacı ortodontik tedavileri yapılan iskeletsel sınıf III maloklüzyona sahip hastaların ortognatik cerrahi öncesinde ve cerrahiden en az 6 ay sonrasındaki benlik saygısı, eleştiriye duyarlılık ve sosyal görünüş kaygısının değerlendirilmesi ve cinsiyetin bu psikolojik durumlar üzerine etkisinin incelenmesidir.Gereç ve Yöntemler: Çalışmaya iskeletsel sınıf III maloklüzyona sahip, ortognatik tedavi ihtiyacı olan ve herhangi bir sendromu bulunmayan 45 hasta (18 erkek; 27 kız) dahil edilmiştir. Hastaların ortalama yaşı 21.4±2.02 yıldır. Hastaların tümüne Le Fort 1 osteotomi ve bilateral sagittal split ramus osteotomisi ile çift çene ortognatik cerrahi uygulanmıştır. Hastalara ortognatik cerrahi olmadan önce ve cerrahiden en az 6 ay sonra Rosenberg Benlik Saygısı Ölçeği ve Sosyal Görünüş Kaygısı Ölçeği uygulanmıştır. Çalışmadan elde edilen verilerin istatistiksel analizinde bağımlı ve bağımsız örneklem t testi kullanılmıştır ve p<0.05 değeri anlamlı kabul edilmiştir.Bulgular: Ortognatik cerrahi sonrasında hastaların benlik saygısı cerrahi öncesine göre anlamlı şekilde artarken, eleştiriye duyarlılık ve sosyal görünüş kaygısı anlamlı şekilde azalmıştır (p<0.05). Cerrahi öncesinde ve cerrahi sonrasındaki benlik saygısı, eleştiriye duyarlılık ve sosyal görünüş kaygısı düzeylerinde cinsiyetler arasında anlamlı farklılık gözlenmemiştir.Sonuçlar: Ortognatik cerrahi sonrasında, hastaların benlik saygısı, eleştiriye duyarlılık ve sosyal görünüş kaygısı gibi psikolojik durumları olumlu yönde etkilenmiş ve hastalar cerrahi sonrasında psikososyal anlamda fayda görmüşlerdir.Anahtar Kelimeler: Benlik saygısı, kaygı, ortognatik cerrahi
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- 1. Jensen S. The psychosocial dimensions of oral and maxillofacial surgery: A critical review of the literature. J Oral Surg 1978;36:447-53.
2. Berger JL, Pangrazio-Kulbersh V, Bacchus SN, Kaczynski R. Stability of bilateral sagittal split ramus osteotomy: rigid fixation versus transosseous wiring. Am J Orthod Dentofacial Orthop 2000;118:397-403.
3. Kiyak HA, McNeill RW, West RA, Hohl T, Bucher F, Sherrick P. Predicting psychologic responses to orthognathic surgery. J Oral Maxillofac Surg 1982;40:150-5.
4. Hutton CE. Patients' evaluation of surgical correction of prognathism: survey of 32 patients. J Oral Surg 1967;25:225.
5. Motegi E, Hatch JP, Rugh JD, Yamaguchi H. Health-related quality of life and psychosocial function 5 years after orthognathic surgery. Am J Orthod Dentofacial Orthop 2003;124:138-43.
6. Peppard PE, Austin D, Brown RL. Association of alcohol consumption and sleep disordered breathing in men and women. J Clin Sleep Med 2007;3:265.
7. Bennett M, Phillips CL. Assessment of health-related quality of life for patients with severe skeletal disharmony: a review of the issues. Int J Adult Orthodon Orthognath Surg 1998;14:65-75.
8. Phillips C, Bennett ME, Broder HL. Dentofacial disharmony: psychological status of patients seeking treatment consultation. Angle Orthod 1998;68:547-56.
9. Frost V, Peterson G. Psychological aspects of orthognathic surgery: how people respond to facial change. Oral Surg Oral Med Oral Pathol 1991;71:538-42.
10. Laufer D, Glick D, Gutman D, Sharon A. Patient motivation and response to surgical correction of prognathism. Oral Surg Oral Med Oral Pathol 1976;41:309-13.
11. Nurminen L, Pietilä T, Vinkka-Puhakka H. Motivation for and satisfaction with orthodontic-surgical treatment: a retrospective study of 28 patients. Eur J Orthod 1999;21:79-87.
12. Hoppenreijs T, Hakman E, Van't Hof M, Stoelinga P, Tuinzing D, Freihofer H. Psychologic implications of surgical-orthodontic treatment in patients with anterior open bite. Int J Adult Orthodon Orthognath Surg 1998;14:101-12.
13. Rittersma J, Casparie AF, Reerink E. Patient information and patient preparation in orthognathic surgery: a medical audit study. J Maxillofac Surg 1980;8:206-9.
14. Hillerström K, Sörensen S, Wictorin L. Biological and Psycho-Social Factors in Patients with Malformation of the Jaws: II. Twelve Months after Maxillo-Facial Surgery. Scand J Plast Reconstr Surg 1971;5:34-40.
15. Crowell N, Sazima H, Elder S. Survey of patients' attitudes after surgical correction of prognathism: study of 33 patients. J Oral Surg 1970;28:818.
16. Heldt L, Haffke EA, Davis LF. The psychological and social aspects of orthognathic treatment. Am J Orthod 1982;82:318-28.
17. Ouellette P. Psychological ramifications of facial change in relation to orthodontic treatment and orthognathic surgery. J Oral Surg 1978;36:787.
18. Hunt OT, Johnston CD, Hepper PG, Burden DJ. The psychosocial impact of orthognathic surgery: a systematic review. Am J Orthod Dentofacial Orthop 2001;120:490-6.
19. Nicodemo D, Pereira MD, Ferreira LM. Self-esteem and depression in patients presenting angle class III malocclusion submitted for orthognathic surgery. Med Oral Patol Oral Cir Bucal 2008;13:48.
20. Williams D, Bentley R, Cobourne M, et al. Psychological characteristics of women who require orthognathic surgery: comparison with untreated controls. Br J Oral Maxillofac Surg 2009;47:191-5.
21. Dion K, Berscheid E, Walster E. What is beautiful is good. J Pers Soc Psychol 1972;24:285.
22. Varela M, García-Camba J. Impact of orthodontics on the psychologic profile of adult patients: a prospective study. Am J Orthod Dentofacial Orthop 1995;108:142-8.
23. Kiyak HA, West RA, Hohl T, McNeill RW. The psychological impact of orthognathic surgery: a 9-month follow-up. Am J Orthod 1982;81:404-12.
24. Stirling J, Latchford G, Morris D, Kindelan J, Spencer R, Bekker H. Elective orthognathic treatment decision making: a survey of patient reasons and experiences. J Orthod 2007;34:113-27.
25. Robinson JP, Shaver PR, Wrightsman LS. Measures of Personality and Social Psychological Attitudes: Measures of Social Psychological Attitudes: Academic Press; 2013.
26. Kiyak HA, Hohl T, West RA, McNeill RW. Psychologic changes in orthognathic surgery patients: a 24-month follow up. J Oral Maxillofac Surg 1984;42:506-12.
27. Garvill J, Garvill H, Kahnberg K-E, Lundgren S. Psychological factors in orthognathic surgery. J Craniomaxillofac Surg 1992;20:28-33.
28. Cunningham S, Hunt N, Feinmann C. Perceptions of outcome following orthognathic surgery. Br J Oral Maxillofac Surg 1996;34:210-3.
29. Flanary CM, Barnwell GM, VanSickels JE, Littlefield JH, Rugh AL. Impact of orthognathic surgery on normal and abnormal personality dimensions: a 2-year follow-up study of 61 patients. Am J Orthod Dentofacial Orthop 1990;98:313-22.
30. Olson R, Laskin D. Expectations of patients from orthognathic surgery. J Oral Surg 1980;38:283-5.
31. Finlay PM, Moos SF, Atkinson JM. Orthognathic surgery: patient expectations; psychological profile and satisfaction with outcome. Br J Oral Maxillofac Surg 1995;33:9-14.
32. Forssell H, Finne K, Forssell K, Panula K, Blinnikka L. Expectations and perceptions regarding treatment: a prospective study of patients undergoing orthognathic surgery. Int J Adult Orthodon Orthognath Surg 1997;13:107-13.
33. Bertolini F, Russo V, Sansebastiano G. Pre-and postsurgical psycho-emotional aspects of the orthognathic surgery patient. Int J Adult Orthodon Orthognath Surg 1999;15:16-23.
34. Patzer Gl. Improving Self‐Esteem By Improving Physical Attractiveness. J Esthet Restor Dent 1997;9:44-6.
35. Fitts WH. Manual for the Tennessee self concept scale. Nashville, TN: Counselor Recordings and Tests 1965.
36. Reichmuth M, Greene KA, Orsini MG, Cisneros GJ, King GJ, Kiyak HA. Occlusal perceptions of children seeking orthodontic treatment: impact of ethnicity and socioeconomic status. Am J Orthod Dentofacial Orthop 2005;128:575-82.
37. Williams DM, Bentley R, Cobourne MT, et al. The impact of idealised facial images on satisfaction with facial appearance: Comparing ‘ideal’and ‘average’faces. J Dent 2008;36:711-7.
38. Kovalenko A, Slabkovskaya A, Drobysheva N, Persin L, Drobyshev A, Maddalone M. The association between the psychological status and the severity of facial deformity in orthognathic patients. Angle Orthod 2011;82:396-402.