Are You an Evidence-based Orthodontist?

A Guest Blog Post by Dr. Alexandre da Veiga Jardim, DDS; Clinical Professor at Universidade Paulista – Goiânia, Brazil.

As part of a series of guest blog posts by various orthodontic colleagues from around the world, I’m grateful today to my colleague Dr. Alexandre da Veiga Jardim from Brazil, for taking the time to share with us here at The Orthodontic Notefile, his thoughts and personal views on a very important and current topic;  Evidence-based Orthodontics. I’ll leave you to read his guest post below.


“Science doesn’t exist to be admired, but to be questioned”

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Spotting The Evidence: How to Develop Evidence-based Dentistry Skills

“That which can be asserted without evidence, can be dismissed without evidence.”   ~ Christopher Hitchens

As dental professionals interested in life-long learning and improvement, developing our competency in assessing the “evidence” presented in various dental research articles, journals and texts that we may encounter – and in fact, should be seeking ourselves! – is an essential and indispensable skill.

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“Rapid” Orthodontics.. Is There Such A Thing.. Yet?

“I’m in no hurry: the sun and the moon aren’t, either. Nobody goes faster than the legs they have. If where I want to go is far away, I’m not there in an instant.”
Alberto Caeiro, The Collected Poems of Alberto Caeiro

In certain orthodontic marketing circles, the answer would be: Well, Of course there is!

© Shadi Samawi
© Shadi Samawi

However, as always, what we are really concerned with is scientific evidence rather than pure marketing talk. In this post, I would like to highlight some of the biological factors and limitations that are known to exist and this should make us think twice before flatly accepting such claims of faster tooth movement.

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The 3 Pillars of Orthodontic Passive Self-ligation

“In the fields of observation, Chance only favors the prepared mind.”  ~ Louis Pasteur

Continuing on the themes of simplicity and efficiency, I would like to talk a little bit today about Orthodontic Self-Ligation, and more specifically about Passive Self-Ligation (PSL).  The claimed advantages of much-reduced or “zero” friction and the resulting light forces that can lead to more efficient tooth movement are currently being regularly researched and investigated, and although many of the the proposed effects are not being entirely and consistently corroborated by clear scientific evidence to date, this treatment modality is certainly a very tempting proposition to any orthodontist.

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Thoughts on Orthodontic Treatment with Clear Aligners

“Remember that all is opinion.” – Marcus Aurelius

The topic of orthodontic treatment using clear aligners has long been subject to heated debate. It remains so to this day. (Warning: this will be a long post!)

On the one hand, a number of clinicians regularly claim achieving what they describe as “excellent” results using such appliances, claiming a reduction in chair side time and even overall treatment time, while many others do not really subscribe to the idea that they are an effective nor efficient method of treatment. Unfortunately, the research surrounding the efficacy and efficiency of clear aligner treatment is still very much lacking to date. A search for the term “clear aligner” on PubMed merely brings up a couple of pages of various case reports, editorials, and only a handful of trials that cannot be considered by any means as comprehensive nor conclusive. As such, the debate rages on and probably will continue for a long time, and at the moment, only clinical experience can be sought upon in an attempt to reach a meaningful conclusion, however prone to personal bias that may prove to be.

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