Key Points
-
There is no good evidence that orthodontics cures or causes temporomandibular joint dysfunction
-
Extracting teeth does not inevitably result in an altered profile
-
There is a need for better quality research in many of the controversial areas in orthodontics
Key Points
Orthodontics
-
1
Who needs orthodontics?
-
2
Patient assessment and examination I
-
3
Patient assessment and examination II
-
4
Treatment planning
-
5
Appliance choices
-
6
Risks in orthodontic treatment
-
7
Fact and fantasy in orthodontics
-
8
Extractions in orthodontics
-
9
Anchorage control and distal movement
-
10
Impacted teeth
-
11
Orthodontic tooth movement
-
12
Combined orthodontic treatment
Abstract
Clinical research has previously lacked good methodology and much opinion was based on anecdote which is widely regarded as the weakest form of clinical evidence. There are few randomised control trials in orthodontics which support or refute areas of dogma. The number of randomised control trials is increasing significantly. There is currently however no good evidence that orthodontics causes or cures temporomandibular joint dysfunction, that appropriate extractions in orthodontics ruin patients' profiles, or that the orthodontist is able to significantly influence facial growth with appliances.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Haynes RB, Richardson WS . Evidence based medicine: what it is and what it isn't. Br Med J 1996; 312: 71–72.
Richards D, Lawrence A . Evidence based dentistry. Br Dent J 1995; 179: 270–273.
Harrison JE, Ashby D . Orthodontic treatment for posterior crossbites (Cochrane Review). Cochrane Database Syst Rev 2001; 1: CD000979.
Burke SP, Silveira AM, Goldsmith LJ, Yancey JM, Van Stewart A, Scarfe WC . A meta-analysis of mandibular intercanine width in treatment and postretention. Angle Orthod 1998; 68: 53–60.
Proffit W . Contemporary Orthodontics. 3rd ed. St Lewis: Mosby-Year book, 1999.
Witzig JW, Spahl TJ . The clinical management of basic maxillofacial orthopaedic appliances. Vol 2 Diagnosis. pp221–224. Boston: PSG Publishing, 1987.
Roth R . Temporomandibular pain-dysfunction and occlusal relationships. Angle Orthod 1973; 43: 136–153.
Ren YF . et al. Condyle position in the temporomandibular joint. Comparison between asymptomatic volunteers with normal disk position and patients with disk displacement. Oral Surg, Oral Med, Oral Path, Oral Radiol, Endo 1995; 80: 101–107.
Lueke PE, Johnston LE . The effect of first premolar extraction and incisor retraction on mandibular positions: testing the central dogma of 'functional orthodontics'. Am J Orthod Dentofac Orthop 1992; 101: 4–12.
Gianelly AA . et al. Condylar position and maxillary first premolar extraction. Am J Orthod Dentofac Orthop 1991; 99: 473–476.
Luther F . Orthodontics and the temporomandibular joint: Where are we now? Angle Orthod 1998; 68: 295–317.
Bush FM . Malocclusion, masticatory muscle and temporomandibular joint tenderness. J Dent Res 1985; 64: 129–133.
DiPetro GJ . A study of occlusion as related to the Frankfort-mandibular plane angle. J Prosthetic Dent 1977; 38: 452–458.
Andrews LF . The six keys to normal occlusion. Am J Orthod 1972; 62: 296–309.
Kattner PF, Schneider BJ . Comparision of Roth appliance and standard edgewise appliance treatment results. Am J Orthod Dentofac Orthop 1993; 103: 24–32.
Lloyd TG, Stephens CD . Changes in molar occlusion after extraction of all first premolars: A follow up study of Class II division 1 cases treated wth removable appliances. Br J Ortho 1990; 6: 91–94.
Little RM . An evaluation of changes in mandibular anterior alignment from 10 to 20 years postretention. Am J Orthod 1988; 93: 423–428.
James RD . A comparative study of facial profiles in extraction and nonextraction treatment. Am J Orthod Dentofac Orthop 1998; 114: 265–276.
Paquette DE et al. A long term comparison of nonextraction and premolar extraction edgewise therapy in 'borderline' Class II patients. Am J Orthod Dentofac Orthop 1992; 102: 1–14.
Bishara SE, Jakobsen J R . Profile changes in patients treated with and without extractions: Assessments by lay people. Am J Orthod Dentofac Orthop 1997; 112: 639–644.
Staggers JA . A comparison of second molar and first premolar extraction treatment. Am J Orthod Dentofac Orthop 1990; 98: 430–436.
Gooris CGM . et al. Eruption of third molars after second molar extractions: A radiographic study. Am J Orthod Dentofac Orthop 1990; 98: 161–167.
Richardson ME . Lower molar crowding in the early permanent dentition. Angle Orthod 1985; 55: 51–57.
Lagerstrom L . Dental and skeletal contributions to occlusal correction in patients treated with high pull headgear-activator combination. Am J Orthod Dentofac Orthop 1990; 97: 495–504.
McNamara JA . Skeletal and dental changes following functional regulator therapy on class II patients. Am J Orthod 1985; 88: 91–110.
De Vincenzo J P . Changes in mandibular length before, during and after successful orthopaedic correction of Class II malocclusion using a functional appliance. Am J Orthod Dentofac Orthop 1991; 99: 214–257.
Bishara SE . Functional Appliances: A review. Am J Orthod Dentofac Orthop 1989; 95: 250–258.
Suagawara J . Long term effects of chincap therapy on skeletal profile in mandibular prognathism. Am J Orthod Dentofac Orthop 1990; 98: 127–133.
Ngan P . Cephalometric and occlusal changes following maxillary protraction and expansion. Eur J Orthod 1998; 20: 237–254.
Chate RA . The burden of proof: a critical review of orthodontic claims made by some general practitioners. Am J Orthod Dentofac Orthop 1994; 106: 96–105.
Author information
Authors and Affiliations
Corresponding author
Additional information
Refereed Paper
Rights and permissions
About this article
Cite this article
Williams, P., Roberts-Harry, D. & Sandy, J. Orthodontics. Part 7: Fact and fantasy in orthodontics. Br Dent J 196, 143–148 (2004). https://doi.org/10.1038/sj.bdj.4810935
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.bdj.4810935
This article is cited by
-
United Arab Emirates dentists’ perceptions about the management of broken down first permanent molars and their enforced extraction in children: a questionnaire survey
European Archives of Paediatric Dentistry (2020)
