# Current Trends in Orthognathic Surgery in Poland--A Retrospective Analysis of 124 Cases
## 4 Discussion  
Aesthetics and harmony of the human face is a very broad and complex issue. Attention to external appearance is an integral part of everyone's life. The psychological aspects of the society's positive reception of a person with a pretty face and good figure--and therefore self-confidence and success in interpersonal relationships--are important. Epidemiologically, dentofacial deformities (DFD) affect about 20% of the population--according to various sources [19,20]. In the classic breakdown of malocclusion, Class I accounts for the highest percentage of 50-55%, Class II accounts for 15-20% and Class III accounts for roughly 1%, which constitutes a small percentage of malocclusion [20,21]. However, we observe significant racial differences in the incidence of specific types of skeletal malocclusion. Class III deformities are more widespread in South-East Asian populations, affecting 15-23% of the people. It mainly results from the genetic determinants of the condition. It is estimated that in Caucasian populations, skeletal Class III is significantly less frequent and accounts for 1-5% of the total population [22,23]. In the study group, skeletal Class III accounted for the largest percentage (64.0%), followed by skeletal Class II (32.3%). Skeletal open bite (2.4%) held the third place, and the last one was skeletal Class I (0.8%). Many authors report the incidence of skeletal Class III as the largest group undergoing surgery due to skeletal malocclusion, which corresponds with our results [14,22,24,25]. It may result from the most noticeable deformities in the profile and aesthetics of the face in those patients, which is the main determinant of entering orthognathic treatment [22,26]. The argument for such a large number of patients with skeletal Class III treated surgically is the fact that a Class II deformity is mainly treated orthodontically. Studies of the Asian population show that the convex facial profile disfigures someone's appearance less than the concave profile does [24]. Figure 9: The duration of treatment in the groups of patients differing in the type of treatment and the results of the analysis of variance (ANOVA) and post-hoc Tukey tests. In the present study, females constituted a larger group of patients (59.7%, n = 74). The results correspond with the data that may be found in the literature where the number of females is slightly bigger. [PERSON] et al. report that females accounted for 60.93% of the patients treated surgically for a skeletal deformity [14]. In a study by [PERSON] et al., the group of females accounts for 59.0%, which closely corresponds with our analysis. The authors report that the primary motivation for surgical treatment is improvement of the appearance of the face in both females (83.87%) and males (83.33%). Increased self-confidence (43.55%) comes second. The third is the patients' improvement of occlusion (41.94%) as a determinant of surgical treatment of a skeletal deformity [26]. A study by [PERSON] et al.--in which psychological aspects after orthognathic surgery were assessed--reveals a much larger group of females (68.0%) undergoing surgical treatment [27]. Improvement of facial aesthetics--and not a functional disorder associated with a skeletal deformation--is the main factor in undergoing treatment in the study group. No statistically significant relationship between sex and the skeletal class was found in our study group--\(p>0.05\). A slight dominance of females may result from greater determination to improve their facial features and aesthetics [20; 24; 26; 27]. The mean age of surgically treated patients in our study was 28 (ranging from 17 to 48, SD = 7) and did not differ statistically significantly for skeletal Classes II and III. The results correspond with the studies by [PERSON] et al. in which the mean age of orthognathic patients was 29 years and 4 months (SD = 9), but the age amplitude was much greater (14-63) [14]. [PERSON] et al.