Depression and anxiety changes in patients after orthognathic surgery: a systematic review and meta-analysis

This study was designed to evaluate the impact of orthognathic surgery on depression and anxiety in patients with dentofacial deformities. PubMed, Embase, Cochrane Library, Web of Science, CNKI and WANFANG databases were searched from 2000 to 2025. This systematic review included studies that evaluated the impact of orthognathic surgery on depression and anxiety as measured by the Symptom Checklist-90 (SCL-90), Minnesota Multiphasic Personality Inventory (MMPI), State-Trait Anxiety Inventory (STAI) and Social Appearance Anxiety Scale (SAAS). The review included 12 articles with 613 participants, of which 10 were included in the meta-analyses. It revealed that orthognathic surgery was associated with postoperative improvement in psychological status. Regarding depression, scores at more than 6 months postoperatively were significantly lower than preoperative levels for both SCL-90 (MD 0.20, 95% CI [0.07 to 0.32]) and MMPI (MD 1.77, 95% CI [-0.50 to 4.04]). However, a more pronounced reduction in depression was observed at 3 months postoperatively (MD 0.33, 95% CI [-0.15 to 0.80]) compared to 6 months, suggesting a potential partial relapse during this interim period. For anxiety, significant improvement was noted at more than 6 months using the SAAS (MD 9.41, 95% CI [2.21 to 16.61]), while just a positive trend was observed with the SCL-90 (MD 0.10, 95% CI [-0.07 to 0.27]). Similarly, a more pronounced reduction in anxiety was observed at 3 months postoperatively (MD 0.33, 95% CI [-0.14 to 0.80]). Orthognathic surgery improves psychological status including anxiety and depression in patients with dentofacial deformities, with peak effects observed at 3 months that may relapse by 6 months.