Analysis Of Factors Caused Malocclusions And Orthodontic Perceptions Associated With Patients Seeking Orthodontic Re-treatment

Objective The strategy was proposed to improve the clinical treatment based on theanalysis of patients seeking orthodontic re-treatment.Methods The present study had two parts. The first was total144patients, wereinvolved in this study, including47males(32.6%) and97females(67.4%), with thedistribution of age19.0±7.4years old, collected from Orthodontic Department, School ofStomatology, The Fourth Military Medical University during2004-2011. They were splitinto teenaged group(≤18years old)and adults(≥18years old) group. Two orthodonticspecialists were invited to analyze the reasons caused malocclusions of patients seekingorthodontic re-treatment according to the treatment records, plaster models, photographs,panoramic radiographs and lateral cephalograms. The intra-examiner agreement of2specialists was assessed by Kappa statistic. The reasons of malocclusions were analyzedby descriptive statistics; Chi-square test was used to study on difference of teenaged andadult groups. And the second, the questionnaire based dealing with patients’ experiences and subjective perception involved people’s decision, expectation, dental estheticself-perception and malocclusion perception for re-treatment was assessed. Patients’experiences were analyzed by descriptive statistics. Chi-square test was used to study ondifference of patient’s decisions between first and second orthodontic treatment andpatient’s expectation for re-treatment based on their responses. Subject’s differences indental esthetic self-perception and malocclusion perception were assessed by multivariateanalysis of variance.Results Firstly,2specialists’ intra-examiner agreement was good (Kappa=0.895).The difference between two groups was significant in statistics (χ2=15.016, P=0.010).The factors of orthodontic re-treatment mainly consisted in poor techniques of treatment(24.3%), relapse (21.5%), undesirable growing development (16.6%), improper diagnosisand treatment planings with poor techniques of treatment (8.3%), improper diagnosis andtreatment planings (7.6%). Secondly, there were significant statistic differences insubject’s decisions between first and second treatment. Also, statistic differences werefound in patient’s expectation for re-treatment. Subject’s differences in dental estheticself-perception and malocclusion perception were found by multivariate analysis ofvariance.Conclusions The improper diagnosis and treatment planings, poor techniques oftreatment, relapse, undesirable growing development or inheritance, are the primaryproblems in patients for re-treatment. In addition, the malocclusions in patients forre-treatment show different between the teenaged and adult groups. The followingproblems including techniques of treatment, diagnosis and planning of the therapy, theprevention of undesirable growing development and relapse must be carefully consideredwhen starting orthodontic treatment.Patients seeking re-treatment had a increasingly orthodontic perceptions. They weremostly satisfied with own’s dental appearance，but still have desire of orthodontictreatment. They all considerate malocclusions were influential in facial appearance, healthand social relationship.