Self-esteem in university students according to orthodontic treatment need (index of complexity, outcome, and need) and angle classification: A cross-sectional study
Rahme Özfevzi, Refia Lale TanerObjectives:
Orthodontic malocclusion may affect both functional and psychosocial aspects of health; however, its relationship with global self-esteem in young adults remains unclear. This study aimed to compare self-esteem levels according to orthodontic treatment need assessed by the index of complexity, outcome, and need (ICON) and by Angle classification among university students.
Material and Methods:
A cross-sectional study was conducted between April and December 2024 among 290 university students. Self-esteem was assessed using the validated Turkish version of the Rosenberg self-esteem scale (RSES; 10 items, 4-point Likert scale). Orthodontic status was evaluated by a calibrated orthodontist using the ICON (treatment-need cutoff ≥43) and Angle classification (Class I, II/1, II/2, III). Intra-examiner reliability was high for both ICON and Angle assessments (κ = 0.91 and 0.89, respectively). Data were anonymized and analyzed using non-parametric statistical tests (Mann–Whitney U and Kruskal–Wallis H tests).
Results:
Of the 269 valid responses, the mean ± standard deviation RSES score was 32.04 ± 5.13. No significant difference in self-esteem was observed between ICON-defined treatment-need groups (U = 7168.00, r = 0.048, p = 0.446). In contrast, a small but statistically significant difference was found among Angle classifications (H = 13.10, η 2 = 0.038, p = 0.004). The RSES demonstrated high internal consistency (Cronbach’s α = 0.869).
Conclusion:
Self-esteem did not differ according to orthodontic treatment need as defined by ICON but showed slight variation across Angle classifications. These findings suggest that psychosocial factors may subtly influence perceptions of dental esthetics. Incorporating such dimensions into orthodontic assessment may contribute to more patient-centered treatment planning.