Developing and validating a questionnaire on maxillary molar distalization: a survey of Iraqi orthodontists

Molar distalizers are widely used orthodontic appliances for correction of malocclusions especially for patients having crowding or Class II malocclusions. Constructing and validating a reliable online questionnaire about perceptions and experiences of orthodontists related to maxillary molar distalization and implementation of that questionnaire among Iraqi orthodontists. This cross-sectional study was conducted in accordance with STROBE guidelines (Strengthening the Reporting of Observational studies in Epidemiology). At the first step, a draft questionnaire addressing indications, diagnosis, treatment planning, appliances, benefits, restrictions, and complications of molar distalization was prepared. After that, content and face validity of the questionnaire was assessed by 10 expert orthodontists through two rounds. Items with an Item-level Content Validity Index (I-CVI) of less than 0.78 were excluded and overlapping items were modified or merged. At the next step, test-retest reliability was evaluated among 10 orthodontists. The modified questionnaire was finally applied among Iraqi orthodontists. An initial 24-item-questionnaire was modified based on expert panel review. Six items with low content validity (I-CVI < 0.78) were deleted, two groups of items were combined, and answer choice was changed giving rise to 15-item-final-questionnaire. In the second validation round, all kept items passed criteria of content validity (I-CVI > 0.78) with excellent scale level content validity (S-CVI/Ave = 1.00). Test–retest reliability was good enough, with minimal Cohen’s kappa coefficient of 0.70. Most of them have used molar distalization procedure (76.66%). They have indicated Class II malocclusion as the main indication of using molar distalizers (60%). Devices used for molar distalization in skeletal anchorage were chosen by most of respondents (45%). Patient non-compliance and biological reasons (slow tooth movement) were regarded as the main failure reasons from their perspective (20.84% and 30% respectively). A 15 item-online-questionnaire was constructed. The content validity and test–retest reliability was found to be good enough. Most Iraqi orthodontists like using distalizers for correction of Class II malocclusions in permanent dentition. Skeletal anchorage intra-alveolar molar distalization devices are more preferred. Such results offer insight into reported clinical preferences and practices among Iraqi orthodontists. Hence, they should be interpreted within this landscape.