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Evidence-based orthodontics for the 21st century.

Marc Ackerman1

  • 1Ackersmile@aol.com

Journal of the American Dental Association (1939)
|March 10, 2004
PubMed
Summary

Early orthodontic treatment for Class II malocclusion shows no significant benefit over later treatment. Rapid palatal expansion offers limited advantages for resolving crowding without a crossbite.

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Class II Skeletal Growth Modification Treatment: Has Hope Triumphed Over Evidence?

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The way it was, the way it ought to be, the way it is, and the way it will be.

American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics·2018
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E-space preservation.

The Angle orthodontist·2011

Area of Science:

  • Orthodontics
  • Evidence-based dentistry
  • Clinical decision-making

Background:

  • Data-driven advances are influencing clinical orthodontics.
  • Decision-making processes in orthodontics are evolving.

Purpose of the Study:

  • To examine data-driven advances in orthodontics.
  • To assess their influence on clinical decision-making.
  • To evaluate two long-standing orthodontic controversies: one-phase vs. two-phase Class II malocclusion treatment and extraction vs. nonextraction for arch perimeter deficiencies.

Main Methods:

  • Review of the first randomized clinical trial in orthodontics.
  • Survey of current orthodontic literature.
  • Analysis of data on early vs. late treatment for Class II malocclusion.
  • Evaluation of rapid palatal expansion (RPE) for arch perimeter increase.

Main Results:

  • No difference in occlusal outcomes or need for orthognathic surgery between early and late treatment for Class II malocclusion.
  • Rapid palatal expansion (RPE) can increase maxillary arch perimeter by 3-4 mm, aiding incisor alignment.
  • The benefit of RPE in non-crossbite cases is difficult to ascertain.

Conclusions:

  • Integrating scientific evidence into clinical practice is crucial for 21st-century orthodontics.
  • Evidence challenges traditional approaches to Class II malocclusion and arch crowding management.

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