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Factors associated with orthodontist’s decision to indicated orthodontic camouflage or orthognathic surgery in skeletal class III malocclusions without growth

Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: The therapeutic decision depends on a complex set of factors related to both the patient and the professional. Aim: To determine the factors associated with the orthodontist's decision to prescribe orthodontic camouflage or orthognathic surgery in skeletal Class III malocclusions without growth. Materials and Methods: An online survey was conducted with 271 orthodontists. The validity and reliability of a 16-question questionnaire were determined, and submission links were generated using SurveyMonkey software. The instrument was distributed via social media and email, achieving an 80% response rate. Pearson's chi-squared test and binomial logistic regression was used. Results: All factors evaluated were considered important in the treatment decision (p<0.001). The gonial angle was a significant risk factor (OR:5.36; 95%CI:1.53-18.72; p=0.009), as was anterior crossbite (OR:49.14; 95%CI:2.61-92.59; p=0.009). Occlusal stability (OR:0.01; 95%CI:0.00-0.29; p=0.009), third molar position and space (OR:0.14; 95%CI: 0.07-0.30; p<0.001) were protective factors. The orthodontist's experience of up to 10 years (OR:0.12; 95%CI:0.04-0.36; p<0.001), up to 40 years (OR:0.22; 95%CI:0.08-0.60; p=0.003), along with training through courses or internships (OR:0.08; 95%CI:0.04-0.18; p<0.001) or a second specialty (OR:0.37; 95%CI:0.15-0.93; p=0.035), also acted as protective factors. The proposed model has a moderately good fit (p=0.400). Conclusions: Orthodontic camouflage is the most common treatment option for Class III malocclusion. The gonial angle and anterior crossbite predispose to orthognathic surgery; while occlusal stability, the presence and spacing of the lower third molar, along with greater professional experience and surgical training, are associated with a lower likelihood of indicating surgery.
DOI: 10.4317/jced.64160
Language: English
Subfield: Orthodontics
Field: Dentistry
Open Access status: diamond
OpenAlex ID: W7211977631
FWCI:
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