Evidence-Based Orthodontics

325 Pages·2011·7.255 MB·English

by  Greg J. Huang, Stephen Richmond, Katherine W. L. Vig

Evidence-Based Orthodontics
Evidence-Based Orthodontics
Edited by
Greg J. Huang, DMD, MSD, MPH
Stephen Richmond, BDS, DOrth RCS, MScD,
FDSRCS, PhD, FHEA
Katherine W.L. Vig, BDS, MS, DOrth RCS, FDSRCS
A John Wiley & Sons, Inc., Publication
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Library of Congress Cataloging-in-Publication Data
Evidence-based orthodontics / edited by Greg J. Huang, Stephen Richmond, Katherine W.L. Vig.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-8138-0614-3 (paperback : alk. paper) 1. Orthodontics. 2. Evidence-based
dentistry. I. Huang, Greg J., editor. II. Richmond, Stephen, editor. III. Vig, Katherine W.L., editor.
[DNLM: 1. Orthodontics. 2. Evidence-Based Dentistry. 3. Malocclusion–therapy. WU 440]
RK521.E975 2011
617.6'43–dc22
2010048237
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1 2011
Table of Contents
Foreword vii
Gordon Guyatt
Contributor List ix
Part 1 Principles 3
Chapter 1 A Historical Perspective of Evidence-Based Orthodontics 5
Katherine W.L. Vig
Chapter 2 Clinical Research Designs 15
Robert J. Weyant
Chapter 3 Electronic Searching for Clinical Trials Information 31
Anne Littlewood
Part 2 Selected Topics 47
Chapter 4 The Treatment of Class II Malocclusion—Have We the
Evidence to Make Decisions? 49
Kevin O’Brien and Jonathan Sandler
Chapter 5 External Root Resorption and Orthodontic Treatment—
Assessment of the Evidence 63
Belinda J. Weltman
Chapter 6 Malocclusion, Orthodontic Treatment, and
Periodontal Health—An Assessment of the Evidence 89
Anne-Marie Bollen
Chapter 7 Stability of Anterior Open Bite Correction—
An Assessment of the Evidence 97
Greg J. Huang and Geoffrey M. Greenlee
Chapter 8 Orthodontics and Temporomandibular Joint (TMJ)
Disorders 119
Friederike Luther and Fraser McDonald
Chapter 9 Self-Ligation 135
Padhraig S. Fleming
v
vi TABLE OF CONTENTS
Chapter 10 Prevention of Demineralization During Orthodontic
Treatment with Fluoride-Containing Materials or Casein
Phosphopeptide-Amorphous Calcium Phosphate 149
Philip E. Benson
Chapter 11 Invisalign Therapy—A Systematic Review of Lower
Quality Evidence 167
Jason M. Bressler, Stefanie Hamamoto, Gregory J. King,
and Anne-Marie Bollen
Chapter 12 Retention 181
Simon J. Littlewood, Declan T. Millett, David R. Bearn,
Bridget Doubleday, and Helen V. Worthington
Chapter 13 Quality of Outcome 191
Stephen Richmond and Alexei Zhurov
Chapter 14 Stability of Orthognathic Surgery 217
Donald R. Joondeph
Chapter 15 Orthodontic Treatment of the Transverse Dimension—
Assessment of the Evidence 233
Steven D. Marshall
Chapter 16 Class III Malocclusion—The Evidence on Diagnosis
and Treatment 247
Joseph G. Ghafari, Ramzi V. Haddad,
and Maria E. Saadeh
Part 3 Evidence-Based Orthodontics in Perspective 281
Chapter 17 Evidence-Based Care in Context 283
William Shaw
Chapter 18 Playing Doctor: Evidence-Based Orthodontics 293
Lysle E. Johnston, Jr.
Chapter 19 Refl ections on a Decade of Evidence-Based Dentistry 301
David L. Turpin
Index 307
Foreword
Evidence - based medicine (EBM) — or evidence - based surgery, or evidence - based ortho-
dontics (EBO)— i s about solving clinical problems. In particular, EBO provides tools for
using the relevant literature to determine the benefi ts and risks of alternative patient man-
agement strategies and to weigh those benefi ts and risks in the context of the individual
patient ’ s predicament.
T he term evidence - based medicine fi rst appeared in the medical literature in 1991; it
rapidly became something of a mantra. EBM is sometimes perceived as a blinkered adher-
ence to randomized trials or a health - care manager ’ s tool for controlling and constraining
recalcitrant physicians. In fact, EBM and EBO involve informed and effective use of all
types of evidence, but particularly evidence from the medical literature, in patient care.
E BM’ s evolution has included outward expansion— w e now realize that optimal
health - care delivery must include evidence - based nursing, physiotherapy, occupational
therapy, and podiatry — and specialization. We need evidence - based obstetrics, gynecol-
ogy, internal medicine, and surgery— a nd indeed, orthopedics, and neurosurgery. And of
course, we need evidence - based orthodontics.
Applying EBO to management decisions in individual patients involves use of a hier-
archy of study design, with high - quality randomized trials showing defi nitive results
directly applicable to an individual patient at the apex to relying on physiological rationale
or previous experience with a small number of similar patients near the bottom rung.
Ideally, systematic reviews and meta - analyses summarize the highest quality available
evidence. The hallmark of evidence - based practitioners is that, for particular clinical deci-
sions, they know the strength of the evidence and therefore the degree of uncertainty.
W hat is required to practice EBO? Practitioners must know how to frame a clinical
quandary to facilitate use of the literature in its resolution. Evidence- b ased orthodontic
practitioners must know how to search the literature effi ciently to obtain the best available
evidence bearing on their question, to evaluate the strength of the methods of the studies
they fi nd, and to extract the clinical message, apply it back to the patient, and store it for
retrieval when faced with similar patients in the future.
Traditionally, dental schools nor medical schools nor postgraduate programs have
taught these skills. Although this situation is changing, the biggest infl uence on how train-
ees will practice is their clinical role models, few of whom are currently accomplished
EBO practitioners. The situation is even more challenging for those looking to acquire the
requisite skills after completing their clinical training.
T his text primarily addresses the needs of both orthodontic trainees and specialist
orthodontists. Appearing 20 years after the term EBM was coined, the text represents a
landmark in a number of ways. It is the fi rst comprehensive EBO text. The book represents
a successful effort to comprehensively address the EBO- r elated learning needs of the
orthodontic community and summarize the key areas of orthodontic practice.
vii
viii FOREWORD
The current text goes on to provide evidence summaries to guide the practitioner in
each of the key common problems of orthodontic practice. Thorough and up- t o- d ate at the
time of writing, this text provides a defi nitive guide to evidence - based orthodontic practice
today. That evidence will, of course, change, and in some areas change quickly. Clinicians
must therefore use this book not only as a text for the present but also as a guide for
updating their knowledge in the future. That future will, it is hoped, hold the advent of an
evidence - based secondary journal similar to those that have been developed in other areas,
such as Evidence - Based Mental Health , Evidence - Based Nursing , and the A CP Journal
Club . These publications survey large numbers of journals relevant to their area and choose
individual studies and systematic reviews that meet both relevance and validity screening
criteria. These journals present the results of these studies in structured abstracts that
provide clinicians with the key information they need to judge their applicability to the
clinicians’ own practices. Fame and fortune await the enterprising group who applies this
methodology to produce evidence - based orthodontics.
Whatever the future holds for the increasing effi ciency of evidence - based practice, the
current text provides an introduction to a system of clinical problem solving that is becom-
ing a prerequisite for modern orthodontic practice.
Gordon Guyatt
Contributor List
EDITORS
G reg J. Hu ang, DMD, MSD, MPH, Associate Professor and Chair, Department of
Orthodontics, School of Dentistry, University of Washington, Seattle, WA
S tephen R ichmond, BDS, DOrth RCS, MScD, FDSRCS, PhD, FHEA, Professor
of Orthodontics, Dental School, University Dental Hospital of Wales, Heath Park,
Cardiff, UK
K atherine W.L. Vi g , BDS, MS, DOrth RCS, FDSRCS, Professor Emeritus, Division of
Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH
CONTRIBUTORS
D avid R. Be arn, PhD, MSc, BDS, MOrth RCS, FDS (Orth) RCPS, FDSRCS, FHEA,
Professor of Orthodontics, University of Dundee, Dundee, UK
P hilip E. Be nson, PhD, FDS (Orth) RCS, MOrth RCS, MSc, PhD, FHEA, Reader/
Honorary Consultant in Orthodontics, University of Sheffi eld School of Clinical Dentistry,
Sheffi eld, UK
A nne - M arie B ollen, DDS, MS, PhD, Professor of Orthodontics, Department of
Orthodontics, School of Dentistry, University of Washington, Seattle, WA
J ason M. Br essler , DDS, BS, Research Associate, Department of Orthodontics, School
of Dentistry, University of Washington, Seattle, WA
B ridget D oubleday , PhD, MDentSci, BDS, MOrth RCS, FDSRCPS, Consultant
Orthodontist, Forth Valley Royal Hospital, Stirlingshire, UK
P adhraig S. Fl eming , BDent Sc (Hons), MSc, MOrth RCS, FDS (Orth) RCS, Senior
Registrar, Department of Orthodontics, Royal London Dental Institute, London, UK
J oseph G eorge G hafari , DMD, Professor and Head, Orthodontics and Dentofacial
Orthopedics, American University of Beirut Medical Center
Professor of Orthodontics, Lebanese University, Beirut, Lebanon
Adjunct Professor of Orthodontics, New York University, New York, NY
G eoffrey M. Gr eenlee , DDS, MSD, MPH, Clinical Assistant Professor, Department of
Orthodontics, School of Dentistry, University of Washington, Seattle, WA
ix
x CONTRIBUTOR LIST
R amzi V. H addad , DDS, MS, Instructor, Orthodontics and Dentofacial Orthopedics,
American University of Beirut Medical Center, Beirut, Lebanon
S tefanie H amamoto , DDS, Department of Orthodontics, School of Dentistry, University
of Washington, Seattle, WA
L ysle E. Jo hnston , J r ., DDS, MS, PhD, FDSRCS, Professor Emeritus of Dentistry,
Department of Orthodontics and Pediatric Dentistry, The University of Michigan, Ann
Arbor, MI; Professor Emeritus of Orthodontics, Department of Orthodontics, Center
for Advanced Dental Education, Saint Louis University, St. Louis, MO
D onald R. Jo ondeph, DDS, MS, Emeritus Associate Professor of Orthodontics,
Department of Orthodontics, School of Dentistry, The University of Washington,
Seattle, WA
G regory J. Ki ng , DMD, DMSc , Moore Reidel Professor, Department of Orthodontics,
School of Dentistry, University of Washington, Seattle, UK
A nne L ittlewood , BA(Hons), MA, MCLIP, Trials Search Co - ordinator, Cochrane Oral
Health Group, Manchester, UK
S imon J. Li ttlewood , BDS, FDS(Orth)RCPS, MDSc, MOrth RCS, FDSRCS, Consultant
Orthodontist, Orthodontic Department, St. Luke ’ s Hospital, Bradford, UK
F riederike L uther, BDS (Hons), FDSRCS, DOrth RCS, MOrth RCS, MSc, PhD, FHEA,
Department of Orthodontics, Leeds Dental Institute, University of Leeds, Leeds, UK
S teven D. Ma rshall , DDS, MS, Visiting Associate Professor, Department of
Orthodontics, University of Iowa College of Dentistry, Iowa City, IA
F raser M c D onald , BDS, MSc, PhD, FDSRCS, FFDRCSI, Senior Lecturer and Honorary
Consultant Orthodontist, Department of Orthodontics, King ’ s College London Dental
Institute, King ’ s College, London, UK
D eclan T. M illett, BDSc, DDS, FDSRCPS, DOrth RCS, MOrth RCS, Professor of
Orthodontics, Dental School, University College Cork, Cork, Ireland
K evin O ’ B rien , BDS, FDS, DOrth RCS, PhD, Professor of Orthodontics, School of
Dentistry, University of Manchester, Manchester, UK
M aria E. Sa adeh , DDS, MS, Clinical Associate, Orthodontics and Dentofacial
Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon
Clinical Instructor, Lebanese University, Beirut, Lebanon
J onathan S andler, BDS (Hons), MSc, FDSRCPS, MOrth RCS, Consultant Orthodontist,
Chesterfi eld Royal Hospital, Chesterfi eld, UK
W illiam S haw , BDS, MScD, PhD, FDSRCS, DOrth RCS, DDOrth RSCP, University
Dental Hospital of Manchester, Manchester, UK
D avid L. T urpin , DDS, MSD, Moore/Riedel Professor of Orthodontics, Department of
Orthodontics, School of Dentistry, University of Washington, Seattle, WA
B elinda J. W eltman , BHsc, MSc, BDent, MS (Orth), FRCD(C), Vancouver, BC
CONTRIBUTOR LIST xi
R obert J. We yant, MS, DMD, DrPH, Professor and Chair, Department of Dental Public
Health and Information Management, School of Dental Medicine, University of Pittsburgh,
Pittsburgh, PA
H elen V. Wo rthington , BSc, MSc, PhD, Professor of Evidence Based Care, School of
Dentistry, The University of Manchester, Manchester, UK
A lexei Z hurov , PhD, Research Offi cer, Dental School, Cardiff University, Cardiff, UK