Evidence-Based Approaches in Clinical Orthodontics: A Narrative Review

Evidence-based practice in clinical orthodontics combines scientific research, clinical experience, and patient values to enhance treatment outcomes. This narrative review is based on evidence primarily from systematic reviews and randomized controlled trials, supplemented by relevant high-quality studies. Articles were selected to emphasize higher levels of clinical evidence in orthodontic practice, highlighting evidence-supported approaches in orthodontic care. Functional appliances such as Twin Block and MARA are effective for Class II malocclusion, promoting skeletal changes during growth and improving airway dimensions. Early treatment of Class III malocclusions using rapid maxillary expansion with facemasks, especially with skeletal anchorage, improves maxillary advancement. Orthognathic surgery, including the surgery-first technique and digital planning, efficiently addresses severe discrepancies. Temporary anchorage devices improve anchorage and allow for precise, complex movements using three-dimensional guidance. Airway improvements are noted following orthodontic and surgical interventions in children. Orthodontic treatment shows a neutral effect on temporomandibular disorders, though functional appliances may help. Clear aligners provide aesthetic and periodontal benefits but have limitations in complex cases. The future of orthodontics depends on the integration of evidence-based decision-making, developing technology, and interdisciplinary collaboration.