To investigate the correlation between state-trait anxiety levels and quality of life before and after orthognathic surgery in patients with dentofacial deformities, and explore the feasibility of using the state-trait anxiety inventory(STAI) to screen postoperative patients with low quality of life.

Patients with dentofacial deformities who underwent orthognathic surgery in Peking University Stomatological Hospital from September 2019 to March 2021 were selected as the research objects. STAI [including state anxiety inventory(SAI) and trait anxiety inventory(TAI)] and orthognathic quality of life questionnaire(OQLQ) were used to investigate patients before surgery, 2 weeks after surgery, 3 months after surgery and 6 months after surgery. The total scores of SAI and TAI ranged from 20 to 80 points, with higher scores implying a higher level of state-trait anxiety. The OQLQ includes four dimensions: social function, facial aesthetics, oral function and aesthetic perception, with total scores ranging from 22 to 88, higher scores representing a lower life quality level. SPSS 26.0 software used for statistical analysis, the measurement data was expressed as Mean±SD. Repeated measures ANOVA and the Bonferroni method were used to compare the SAI, TAI and OQLQ scores in different periods. Pearson correlation analysis was used to explore the correlation between patients’ demographic characteristics (gender, age, diagnostic classification, education, number of social contacts) and state-trait anxiety level, and life quality level at different periods, as well as the correlation between the state-trait anxiety level and the life quality level over time. Receiver operator characteristic(ROC) curve analysis was used to explore the feasibility of using the preoperative STAI scale to screen postoperative patients with low quality of life.

A total of 96 patients were included in this study, including 26 males and 70 females, aged (26.0±5.8) years. The SAI, TAI, and OQLQ total scores decreased during three postoperative periods compared to preoperative period (P<0.01), indicating that the patients’ postoperative state-trait anxiety level decreased and their life quality level improved after surgery. Pearson correlation analysis showed a negative correlation between the patient’s social contact number and their SAI and TAI scores at postoperative 2 weeks (SAI: r=-0.30, P=0.003; TAI: r=-0.35, P<0.001). SAI and TAI scores were positively correlated in different periods (r=0.48-0.84, P<0.01). Preoperative SAI scores and TAI scores were correlated with preoperative social function, aesthetic perception, facial aesthetic scores and total OQLQ scores (SAI: r=0.39-0.52, P<0.01; TAI: r=0.32-0.51, P<0.01). Preoperative SAI scores were positively correlated with social function and aesthetic perception scores and total OQLQ scores at 2 weeks postoperatively and with aesthetic perception, social function at 6 months postoperatively (r=0.20-0.52, P<0.05 or <0.01). Postoperative SAI scores were positively correlated with OQLQ scores in all dimensions and total scores except for oral function scores at 3 months postoperatively, which were not correlated with the same period (r= 0.24-0.55, P<0.05 or <0.01). Preoperative TAI scores were positively correlated with social function scores at 2 weeks(r=0.36, P<0.001) and 3 months(r=0.21, P=0.041) postoperatively. Postoperative TAI scores were positively correlated with OQLQ scores in all dimensions and total scores except for oral function scores at 2 weeks postoperatively, which were not correlated with oral function scores at the same period (r=0.21-0.58, P<0.05 or <0.01). ROC curve analysis showed that preoperative SAI scores >34.5 and >33.5 screened people with low life quality level at postoperative 3 months and 6 months, with an area under the curve (AUC) of 0.75 (95%CI: 0.62-0.87, P=0.001) and 0.71 (95%CI: 0.59-0.84, P=0.003), respectively. Preoperative TAI scores >43.5, >42.5 and >33.5 can screen patients with low quality of life at 2 weeks, 3 months and 6 months after surgery, with AUC of 0.64(95%CI: 0.52-0.75, P=0.046), 0.73(95%CI: 0.60-0.85, P=0.001)and 0.67(95%CI: 0.55-0.80, P=0.016)respectively.

The preoperative and postoperative state-trait anxiety level of patients with dentofacial deformity is correlated with the overall level of quality of life, social function, aesthetic perception and facial aesthetics. The preoperative application of STAI scale can screen patients with low quality of life after orthognathic surgery.

Orthognathic surgery; State anxiety; Trait anxiety; Dentofacial deformities; Quality of life