Nikolaos Pandis holds a degree in dental surgery from the University of Athens, Greece and certificate and MS
in Orthodontics from The Ohio State University, USA. He completed a fellowship in craniofacial orthodontics at the University of Texas, Dallas, USA and a dr. med dent in orthodontic biomechanics at the University of Bonn, Germany. He is a diplomate of
the American Board of Orthodontics.
He received a Master’s in clinical trials from the London School of Hygiene & Tropical Medicine, UK, where he is also an external tutor for the international MS program in clinical
He received a PhD in Epidemiology from the University of Ioannina, Greece.
Dr Pandis completed his Habilitation at the University of Bern, Switzerland where he is currently assistant
professor at the orthodontic department.
He is an associate Editor in the American Journal of Orthodontics and Dentofacial Orthopedics and has published over 180 scientific publications in peer-reviewed biomedical journals
and 2 books in clinical orthodontics and clinical research methodology.
Title: Evidence based orthodontics
Although lingual orthodontics is based on sound biomechanical and biological principles, similarly to
labial appliances, there are significant differences that warrant research on numerous aspects of this technique. Clinical aspects that have not been adequately investigated include efficacy and efficiency, speech problems, demineralization risk, pain and
others. Answering such questions should be based on reliable and valid evidence. The well-known ‘pyramid’ of evidence assigns high value to randomized controlled trials (RCTs), which then customarily become the basis of systematic reviews and meta-analyses.
This viewpoint has led to the misconception that RCTs are invariably superior to all other study designs, and are a pre-requisite for answering every research query. However, different clinical questions in orthodontics may require other study designs.
In this two-part presentation we will describe the basic elements of evidence-based dentistry, and how this can be applied specifically to the lingual technique. The most common research
designs of randomized and non-randomized clinical studies will be briefly described and their advantages and disadvantages as well as applicability will be explained. We will present common problems facing patients and clinicians who practice lingual orthodontics
and discuss which research designs would be appropriate to provide useful evidence in each case. The key message of this presentation is that all study designs can effectively contribute to the evidence as long as their strengths and limitations are appropriately
considered when interpreting study findings.
Authors: Nikolaos Pandis, Demetrios J. Halazonetis