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Editorial |
The FEO award of the European Federation of Orthodontics has been created to recognize a scientific paper that has made a significant contribution in research and clinical investigation, and that has advanced orthodontics and dentofacial orthopedics. This year, the winner, judged to have been the best paper published in a National Journal of a FEO member orthodontic society, is entitled: ‘A randomized controlled trial comparing the quadhelix and the expansion arch for the correction of crossbite’ published in the Journal of Orthodontics by M. R. McNally (main author), D. J. Spary and W. P. Rock (co-authors).1
This is obviously excellent news, both for the authors and the Journal of Orthodontics. This Journal aims to publish high quality, evidence-based, clinically orientated and clinically relevant original research papers, which we anticipate will be of interest to orthodontists around the world. Our priority is to strengthen the evidence base by publishing reports on prospective research into different treatment methods and techniques, as well as systematic reviews, meta-analyses and studies that will stimulate interest in new developments.
As clinicians, we now understand that we must base decisions on an evidence-based approach to all areas of Dentistry and Medicine as far as is possible. However, much of what we do is still based on low-level evidence (case series and the like) and many papers are still published that have little relevance to orthodontic practice, let alone orthodontic clinical practice. True, the studies that are likely to improve the situation, particularly in orthodontics, are difficult and time-consuming to undertake, but why should that put us off? In order to directly affect progress and, above all, improve clinical practice, it is imperative to undertake studies such as randomized clinical trials (RCTs). We owe it to our patients. Despite orthodontic researchers and clinicians having had this knowledge for many years, the randomized clinical trial remains the rarity in the orthodontic literature, rather than the norm.
Furthermore, as highlighted by Kevin O’Brien in his 2004 Northcroft Memorial Lecture, and published in the Journal of Orthodontics,2 in much orthodontic research the patient’s point of view is often forgotten. This shortcoming of research is now also changing, as clearly demonstrated in the study by McNally et al.1 comparing the quadhelix and expansion arch.
The RCT cannot answer every question under the sun, but it is a huge step forward. So, ask yourself: how do you like your evidence? If you like your evidence to be perhaps a bit less biased and, for example, based on sample sizes that stand a chance of demonstrating a difference (should one exist), ‘prospective’, involving patients and volunteers who are ‘randomly allocated’ and generally a bit more ‘controlled’, then please keep reading the Journal of Orthodontics. We know we aren’t perfect but we are trying!
References
1 McNally MR, Spary DJ, Rock WP. A randomized controlled trial comparing the quadhelix and the expansion arch for the correction of crossbite. J Orthod 2005; 32(1): 29–35.
2 O’Brien K. Northcroft Memorial Lecture 2004 Consumer centred research ... What do they think? J Orthod 2005; 32(3): 187–90.
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