Association of OQLQ Scores with Treatment Acceptance in Orthognathic Surgery: A Cross-Sectional Study

Background/Objectives: This study aimed to evaluate whether patients’ decisions to undergo orthodontic–surgical treatment for dentofacial deformity are associated with Orthognathic Quality of Life Questionnaire (OQLQ) scores, and to identify which domains show the strongest relationship with treatment acceptance. Methods: Adult patients (≥18 years) who were offered orthognathic surgery by the same orthodontic specialist team completed the Hungarian version of the OQLQ. The primary outcome was whether the patient proceeded with surgery following consultation (yes/no). The questionnaire comprises 22 items across four domains, from which domain-specific and total scores (range: 0–88) were calculated. Given the non-normal distribution and group imbalance, comparisons between groups were performed using nonparametric tests, and associations were further evaluated using Firth penalized logistic regression adjusted for age and sex. Results: A total of 133 patients were included, of whom 107 proceeded with surgery and 26 did not proceed. Median total OQLQ scores were higher in the surgery group than in the decline group (40.0 IQR: 27.0–52.0 vs. 31.5 16.0–52.5), although this difference was not statistically significant. In adjusted analyses, the total OQLQ score was not independently associated with treatment acceptance. Among the domains, only facial aesthetics showed a modest association that reached statistical significance (OR per 1-point increase: 1.10; 95% CI: 1.002–1.22). Conclusions: In this single-center cross-sectional study, OQLQ scores showed only a limited association with treatment acceptance. The observed effect was modest, and only the facial aesthetics domain demonstrated a statistically significant relationship, with a confidence interval close to unity, indicating a borderline and potentially unstable association. These findings suggest that patient-reported quality of life alone is insufficient to explain treatment decisions. The OQLQ may be useful as a supportive tool in clinical consultation, particularly for identifying concerns related to facial appearance, but should not be used as a standalone predictor of whether patients proceed with surgery.