ArticleBMC oral health2026
Analysis of predictive factors for post-orthodontic stability: a retrospective cohort study.
Article in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
background Orthodontic relapse remains a challenge in clinical practice. This study aimed to comprehensively evaluate the independent contributions and time-dependent patterns of multidimensional factors influencing the relapse risk, to provide insights for formulating personalized stability strategies.
methods This multi-center retrospective cohort study included 474 participants with a median follow-up of 6 years. Variables included baseline, anatomical, treatment, and retention factors. Relapse was assessed by comparing intraoral photographs at post-treatment and follow-up (≥ 3 years post-debonding). Multivariate logistic and Cox regression analyses were performed to identify relapse predictors, with stratified analyses by molar relationship.
results Relapse rate was 21.3%. Protective factors included female sex (odds ratio [OR] = 0.475, p = 0.013) and tooth extraction treatment (OR = 0.437, p = 0.006). Convex facial profile (OR = 2.057, p = 0.031), high-angle vertical pattern (OR = 2.086, p = 0.043) and longer follow-up duration (OR = 1.152, p = 0.010) were risk factors. Retainer adherence was strongly protective: full-time wear (OR = 0.070, p < 0.001) and nighttime wear (OR = 0.316, p = 0.004) during the first year, as well as longer total wear duration (1–2 years: OR = 0.408, p = 0.028; >2 years: OR = 0.352, p = 0.006) significantly reduced relapse risk. Cox regression confirmed that full-time wear (hazard ratio [HR] = 0.231, p < 0.001) and wear duration > 2 years (HR = 0.366, p < 0.001) significantly reduced the instantaneous hazard of relapse. Stratified analysis revealed convex profile (OR = 5.706, p = 0.006) and high-angle pattern (OR = 4.234, p = 0.015) specifically increased relapse risk in Class II patients, whereas female sex (OR = 0.101, p = 0.003) was most protective in Class III patients.
conclusions Convex facial profile and high-angle pattern indicated increased relapse risk, particularly in Class II patients. Female sex (especially in Class III patients) and extraction treatment showed protective effects. High retainer adherence (full-time wear and prolonged use) was the most critical stability factor. Clinical practice calls for personalized retention strategies based on individual risk profiles.
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