ORIGINAL ARTICLE Young patients’ treatment motivation and satisfaction with orthognathic surgery outcomes: The role of ‘‘possible selves’’ Elizabeth A. Meade a and Marita Rohr Inglehart b Rochester, Minn, and Ann Arbor, Mich Introduction: We investigated how young patients’ motivation for orthognathic surgery affected their satisfac- tion with treatment outcomes. The objective was to explore whether patients’ ‘‘possible selves’’ (ie, their ideas of what they might become in the future) and their parents’ proxy assessments of the patients’ possible selves were significantly correlated with the patients’ treatment satisfaction. Methods: Questionnaire data were col- lected from 115 former patients (ages, 13-21 at time of surgery) and 117 parents (response rates, 41% and 42%, respectively), with responses from 95 patient-parent pairs. The patients’ motivations before surgery were assessed by determining how energized they were by thoughts about themselves after the surgery, and how much they had focused on the outcomes. The parents completed a parallel measure of their chil- dren’s motivation. Patient satisfaction was determined with the postsurgical patient satisfaction question- naire. Results: The more emotionally energized the patients had been before the surgery, the more satisfied they were with the outcomes (Spearman rho 5 .54, P \0.001). Similarly, the more these patients had focused on esthetic changes and improved functioning, the more satisfied they were with the outcomes (Spearman rho 5 .46, P \0.001; rho 5 .41, P \0.001, respectively). Parents’ recalls of their children’s moti- vation before the surgery were consistent with the children’s self-reports (all P \0.001) and correlated with the children’s satisfaction (P \0.001 in the energized domain; P \0.01 for the esthetic changes domain). Conclusions: Young patients’ recalls of their possible self-based motivation for orthognathic surgery were highly correlated with their treatment satisfaction. Oral surgeons and orthodontists should discuss with young patients and their parents the patient’s motivation during the consultation phase before treatment to assess how energized and focused they are on future treatment outcomes. (Am J Orthod Dentofacial Orthop 2010;137:26-34) B ased on the most recent data on occlusal charac- teristics and assuming that the most severe mal- occlusions are associated with an underlying skeletal discrepancy, Bailey et al 1 estimated that 1.8 million people in the United States need surgery to cor- rect a severe malocclusion. Advances in orthognathic surgery over the past 25 years—eg, computer imaging, 2 rigid internal fixation, 2 and shorter hospital stays 3 — made surgery a viable option for many patients. In addi- tion, the social acceptance of orthognathic surgery has increased over the years. 4 Many patients become aware of their dentofacial deformity in early adolescence, 5 and it is not surprising that the demographic profile of or- thognathic patients is becoming increasingly younger. 6 Because of these changes in the patient population, it seems important to understand how satisfied they are with the outcomes of their orthognathic surgeries and which factors can predict their level of treatment satisfaction. Patients generally reported high satisfaction with the outcome of orthognathic surgery. 7-13 For example, between 71% and 86.3% of patients reported that they would reelect surgical correction, 7-13 87% to 89% would recommend surgery to others, 14-16 and between 80% and 100% of patients reported satisfaction with the surgery. 8,9,11,13.15-17 Considering the increase in younger orthognathic surgery patients, it is interesting to explore whether satisfaction with surgery outcomes differs depending on the patients’ age. Although some authors found no differences in satisfaction levels be- tween age groups, 8,11,13,18 2 studies showed clear evi- dence that the youngest patients were the least a Private practice, Rochester, Minn. b Associate professor, Department of Periodontics and Oral Medicine, School of Dentistry; adjunct associate professor, Department of Psychology, College of Literature, Science and Arts, University of Michigan, Ann Arbor. The authors report no commerical, proprietary, or financial interest in the products or companies described in this article. Supported by a grant from the Delta Dental Fund to the first author. Reprint requests to: Marita Rohr Inglehart, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109- 1078; e-mail, mri@umich.edu. Submitted, October 2007; revised and accepted, March 2008. 0889-5406/$36.00 Copyright Ó 2010 by the American Association of Orthodontists. doi:10.1016/j.ajodo.2008.03.022 26