Prof. Demetrios J. Halazonetis
Dr. Demetrios Halazonetis received his dental education at the National and Kapodistrian University of Athens, School of Dentistry and his orthodontic training at the Orthodontic Dept. of Tufts University, where he also completed a Master’s of Science course. He has been in private practice of orthodontics in Athens, Greece since 1987 and is currently Associate Professor of Orthodontics and Head of the Orthodontic Dept. at the University of Athens. Dr. Halazonetis has published more than 50 scientific research papers. He is the author of the Viewbox cephalometric software and Associate Editor of the Am J Orthod Dentofacial Orthop. His research interests and areas of expertise include cephalometrics, computed tomography applications, geometric morphometrics and facial aesthetics.
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