Mixed-methods assessment of perceptions of mandibular anterior malalignment and need for orthodontic retreatment.

INTRODUCTION: Postorthodontic occlusal changes may stem from true relapse or may be a consequence of characteristic temporal changes. The aims of this research were to identify occlusal discrepancies related to the mandibular labial segment prompting a decision to undergo orthodontic retreatment.

METHODS: A mixed-methods assessment was undertaken comprising a qualitative analysis involving focus groups exploring the relative importance of a range of occlusal features in the decision to undergo retreatment and investigating the motives for seeking retreatment. Quantitative assessment of these occlusal discrepancies was undertaken by 50 lay and 50 professional raters.

RESULTS: Several themes were identified in the qualitative analysis, with dental esthetics a major motive in seeking retreatment; variations in both the perception of relapse and retainer wear were identified. Horizontal irregularities of the mandibular anterior teeth were consistently perceived as the most severe. The professionals had slightly higher odds for suggesting the need for retreatment than did the laypeople, although this did not have statistical significance (odds ratio, 1.23; 95% confidence interval, 0.52-2.19; P = 0.65).

CONCLUSIONS: The perception of mandibular labial segment irregularity and its influence on the need for orthodontic retreatment are complex and multifaceted. Nevertheless, horizontal discrepancies of the mandibular incisors were regarded as the most significant by both lay and professional raters.