The top 10 papers that have influenced my career?
I have been away lecturing in Italy and taking a short vacation this week, so I have not had time to write a new blog post. But I have decided to re-publish one of my earlier blogs that readers may have missed. This was a simple list and details of the top ten orthodontic papers that have influenced me and I hope that you find them interesting.
They may not be the best research papers, however, they are the papers that persuaded me to think carefully about the areas that they were addressing. You will see most of them are somewhat dated. But I think that it is very worthwhile for us to look back at studies that tend to challenge the thinking at that time.
Community Dent Oral Epidemiol. 1980 Feb;8(1):36-45.
Apart from this paper being a classic, it means a lot to me, because when I was applying to the orthodontic program at Manchester, one of the orthodontic registrars at Newcastle (where I was based) suggested that I should read it. This was because Bill Shaw had recently been appointed to Manchester and was bound to be interviewing me. So I got out the paper and read it on the train journey to Manchester. In fact, they did not ask me any questions about it! Even though I did not understand much of the subject area, I found it interesting. I have read this many times since then and it certainly is a classic paper, because it stated the case that the need for orthodontic treatment was not clear cut. Importantly, this work led to much of the work that developed IOTN and PAR. Interestingly, many of the questions that they raised in the paper are still unanswered today
Angle Orthod. 1978 Jul;48(3):175-86.
This is a paper which I still suggest all postgraduates and residents read. Again, this is somewhat dated, but timeless. In the paper Bill Proffit outlines the rationale behind the factors that influence the position of the teeth. While most of this is personal opinion, it is very hard to put forward an alternative hypothesis. This is still highly relevant paper as we still agonise over the need for retention.
Tulloch JF, Medland W, Tuncay OC.
Am J Orthod Dentofacial Orthop. 1990 Oct;98(4):340
This paper was one of the first systematic reviews into the effectiveness of orthodontic treatment and was the basis for the study into early orthodontic treatment carried out at the University of North Carolina. I felt that this was a fascinating paper because it made the orthodontic research community aware of the problems that were arising from our use of traditional retrospective methods. This paper is a ” must read” for all aspiring orthodontists.
Angle Orthod. 1972 Jul;42(3):200-11. and
This was a paper that help me start to understand cephalometrics and also develop a rather cynical viewpoint to their use. It also probably has the best start to any orthodontic paper that has been published.
“If one could sit on the moon and look at the activities of the 3500 different millions of humans each trying to obtain elbow room and food on a rather small planet in the third-rate solar system and ask himself “what have cephalometrics contributed?”.
A long-term comparison of non-extraction and premolar extraction edgewise therapy in “borderline” Class II patients.
Am J Orthod Dentofacial Orthop. 1992 Jul;102(1):1-14.
When I was starting on a rather evangelical point in my career and I had “discovered” clinical trials, I was putting a viewpoint forwards that the only type of research of value was a clinical trial. While this is still my opinion. I have mellowed and realised that other well-controlled studies, while not providing the same high level of evidence to a trial, may still help us reduce uncertainty about our treatment. This paper addresses a difficult question by careful selection of matched cases in a retrospective sample. This was also the first time I came across Lysle Johnston, and his very logical questioning approach to orthodontics.
The effect of early intervention on skeletal pattern in Class II malocclusion: a randomized clinical trial.
Tulloch JF, Phillips C, Koch G, Proffit WR.
Am J Orthod Dentofacial Orthop. 1997 Apr;111(4):391-400.
This paper is simply a classic. It was a preliminary report on the first large scale RCT in orthodontics. This led the way for many researchers to start using RCT methodology.
Anteroposterior skeletal and dental changes after early Class II treatment with bionators and headgear
Stephen D. Keeling, Timothy T. Wheeler, Gregory J. King, Cynthia W. Garvan, David A. Cohen, Salvatore Cabassa, Susan P. McGorray, Marie G. Taylor
American Journal of Orthodontics & Dentofacial Orthopedics
Volume 113, Issue 1 , Pages 40-50, January 1998
And so is this.
The lead author on this paper was Stephen Keeling. I met him when they were starting to analyse the data on this trial and he came to Pittsburgh so that I could show him how to use the Peer Assessment Rating. He very sadly died a couple of years later and he was one of the nicest people that I’ve ever worked with
Unae Kim Han, Katherine W.L. Vig, Jane A. Weintraub, Peter S. Vig, Charles J. Kowalski
American journal of orthodontics and dentofacial orthopedics September 1991 (volume 100 issue 3 Pages 212-219)
Again, this is a paper that questioned current dogma at that time and orthodontics. It still stands close scrutiny and its central message is still very relevant today, particularly with the development of CBCT
Relationships between skeletal maturity estimated from hand-wrist radiographs and the timing of the adolescent growth spurt.
Eur J Orthod. 1980;2(2):81-93.
Another paper from a great British orthodontist. I remember reading this when I was on the orthodontic programme and did struggle to understand it because it is rather complex. In effect Houston was illustrating that the hand wrist radiograph was of no value in assessing skeletal maturity. This paper probably resulted in less young people being exposed to unnecessary radiation. This is a considerable achievement
The stability of the lower labial segment.
Transactions of the British Society of Orthodontics. 1966 . 54:11 – 24
I add this paper for completeness. Unfortunately, I could not get a PDF. This was published a long time ago and is very dated. There is no real science in the paper, as Mills simply collected a convenience sample. However, it does provide us with a useful message that we probably cannot ignore as there is no other compelling evidence on the position that we should place the lower incisors at the end of orthodontic treatment.
That’s about it on these papers. I hope that you find time to read them and while you may not agree on my selection I hope that you enjoy looking back.