Dichtung und Wahrheit in der Kieferorthopädie

Zusammenfassung

Klinische Forschung wurde lange Zeit ohne ausreichendes methodisches Rüstzeug durchgeführt. Viele Lehrmeinungen beruhen letztlich auf Einzelfallbeschreibungen, der schwächsten Form des klinischen Beweises. Bisher liegen in der Kieferorthopädie nur wenige randomisierte kontrollierte Studien vor, mit deren Hilfe sich dogmatische Ansichten überprüfen lassen. Die Zahl solcher Untersuchungen wächst allerdings fast täglich. Bisher liegen noch keine stichhaltigen Beweise dafür vor, dass eine kieferorthopädische Behandlung Kiefergelenkerkrankungen positiv oder negativ beeinflussen könnte, dass eine fachgerechte Extraktionsbehandlung das Gesichtsprofil negativ verändern könnte oder dass sich das Gesichtswachstum mit irgendeiner Apparatur signifikant beeinflussen ließe.

Abstract

Clinical research has previously lacked good methodology and much opinion was based on anecdote which is widely regarded as the weakest form of clinical evidence. There are few randomised control trials in orthodontics which support or refute areas of dogma. The number of randomised control trials is increasing significantly. There is currently however no good evidence that orthodontics causes or cures temporomandibular joint dysfunction, that appropriate extractions in orthodontics ruin patients' profiles, or that the orthodontist is able to significantly influence facial growth with appliances.

Schlüsselwörter

Evidenzbasierte Kieferorthopädie

Key words

Evidence-based orthodontics

1 Dieser Artikel erschien im englischen Original in: British Dental Journal 2004; 196 (3): 143-148

Literatur

• 1 Sackett D L, Rosenberg W M, Gray J A, Haynes R B, Richardson W S. Evidence based medicine: what it is and what it isn't.  BMJ. 1996;  312 71-72
• 2 Richards D, Lawrence A. Evidence based dentistry.  Br Dent J. 1995;  179 270-273
• 3 Harrison J E, Ashby D. Orthodontic treatment for posterior crossbites. Cochrane Database Syst Rev 2001; 1: CD000979
• 4 Burke S P, Silveira A M, Goldsmith L J, Yancey J M, Van Stewart A, Scarfe W C. A meta-analysis of mandibular intercanine width in treatment and postretention.  Angle Orthod. 1998;  68 53-60
• 5 Proffit W. Contemporary Orthodontics. 3rd ed. Mosby-Yearbook, St. Lewis 1999
• 6 Witzig J W, Spahl T J. The Clinical Management of Basic Maxillofacial Orthopaedic Appliances. Vol. 2: Diagnosis. PSG Publishing, Boston 1987; 221-224
• 7 Roth R H. Temporomandibular pain-dysfunction and occlusal relationships.  Angle Orthod. 1973;  43 136-153
• 8 Ren Y F, Isberg A, Westesson-PL. Condyle position in the temporomandibular joint. Comparison between asymptomatic volunteers with normal disk position and patients with disk displacement.  Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;  80 101-107
• 9 Luecke P E, Johnston L E. The effect of first premolar extraction and incisor retraction on mandibular position: testing the central dogma of “functional orthodontics”.  Am J Orthod Dentofacial Orthop. 1992;  101 4-12
• 10 Gianelly A A, Cozzani M, Boffa J. Condylar position and maxillary first premolar extraction.  Am J Orthod Dentofacial Orthop. 1991;  99 473-476
• 11 Luther F. Orthodontics and the temporomandibular joint: where are we now? (2 parts).  Angle Orthod. 1998;  68 295-318
• 12 Bush F M. Malocclusion, masticatory muscle, and temporomandibular joint tenderness.  J Dent Res. 1985;  64 129-133
• 13 DiPietro G J. A study of occlusion as related to the Frankfort-mandibular plane angle.  J Prosthet Dent. 1977;  38 452-458
• 14 Andrews L F. The six keys to normal occlusion.  Am J Orthod. 1972;  62 296-309
• 15 Kattner P F, Schneider B J. Comparison of Roth appliance and standard edgewise appliance treatment results.  Am J Orthod Dentofacial Orthop. 1993;  103 24-32
• 16 Lloyd T G, Stephens C D. Spontaneous changes in molar occlusion after extraction of all first premolars: a study of Class II division 1 cases treated with removable appliances.  Br J Orthod. 1979;  6 91-94
• 17 Little R M, Riedel R A, Artun J. An evaluation of changes in mandibular anterior alignment from 10 to 20 years postretention.  Am J Orthod. 1988;  93 423-428
• 18 James R D. A comparative study of facial profiles in extraction and nonextraction treatment.  Am J Orthod Dentofacial Orthop. 1998;  114 265-276
• 19 Paquette D E, Beattie J R, Johnston L E. A long term comparison of nonextraction and premolar extraction edgewise therapy in “borderline” Class II patients.  Am J Orthod Dentofacial Orthop. 1992;  102 1-14
• 20 Bishara S E, Jakobsen J R. Profile changes in patients treated with and without extractions: assessments by lay people.  Am J Orthod Dentofacial Orthop. 1997;  112 639-644
• 21 Staggers J A. A comparison of results of second molar and first premolar extraction treatment.  Am J Orthod Dentofacial Orthop. 1990;  98 430-436
• 22 Gooris C G, Artun J, Joondeph D R. Eruption of mandibular third molars after second-molar extractions: a radiographic study.  Am J Orthod Dentofacial Orthop. 1990;  98 161-167
• 23 Richardson M E. Lower molar crowding in the early permanent dentition.  Angle Orthod. 1985;  55 51-57
• 24 Lagerstrom L O, Nielsen I L, Lee R, Isaacson R J. Dental and skeletal contributions to occlusal correction in patients treated with high pull headgear-activator combination.  Am J Orthod Dentofacial Orthop. 1990;  97 495-504
• 25 McNamara J A, Bookstein F L, Shaughnessy T G. Skeletal and dental changes following functional regulator therapy on class II patients.  Am J Orthod. 1985;  88 91-110
• 26 DeVincenzo J P. Changes in mandibular length before, during, and after successful orthopedic correction of Class II malocclusions, using a functional applianc.  Am J Orthod Dentofacial Orthop. 1991;  99 241-257
• 27 Bishara S E, Ziaja R R. Functional appliances: a review.  Am J Orthod Dentofacial Orthop. 1989;  95 250-258
• 28 Sugawara J, Asano T, Endo N, Mitani H. Long term effects of chincap therapy on skeletal profile in mandibular prognathism.  Am J Orthod Dentofacial Orthop. 1990;  98 127-133
• 29 Ngan P, Yiu C, Hu A, Hagg U, Wei S H, Gunel E. Cephalometric and occlusal changes following maxillary expansion and protraction.  Eur J Orthod. 1998;  20 237-254
• 30 Chate R A. The burden of proof: a critical review of orthodontic claims made by some general practitioners.  Am J Orthod Dentofacial Orthop. 1994;  106 96-105

1 Dieser Artikel erschien im englischen Original in: British Dental Journal 2004; 196 (3): 143-148