Major Orthodontic Journals Research Articles

Exploring publications in 3 major orthodontic journals: A comparative bibliometric analysis of two 10-year periods (2002-2011 and 2012-2021)

This study aimed to perform a bibliometric analysis examining contributing countries and collaborative networks, authors and collaborative relationships, the performance of the institutions, and cocited journals and references in 3 major orthodontic journals (American Journal of Orthodontics and Dentofacial Orthopedics, European Journal of Orthodontics, and Angle Orthodontist) over two 10-year periods (2002-2011 and 2012-2021). In this study, 4432 publications in the first decade and 4012 publications in the second decade were quantitatively analyzed and visualized using visualization software such as VOSviewer (Leiden University, Leiden, Netherlands), CiteSpace (Drexel University, Philadelphia, Pa), and Scimago Graphica (SCImago Lab, Spain). Institutions in the United States had the highest number of publications through the 2 decades, whereas Brazil, South Korea, and China achieved significant improvements in performance in the second decade compared with the first. Closer collaborative networks among scholars were revealedin the second decade. The cocitation analysis of the journals showed that highly cited journals included more professional orthodontic journals in the second decade than in the first decade. Bibliometric analysis of publications in 3 major orthodontic journals over two 10-year periods revealed a trend of diversification in countries and institutions participating in publishing, international collaborations, and collaboration networks among authors in the field of orthodontics during the 2 decades.

Alveolar Bone and Gingival Changes in Mandibular Anterior Region Following Herbst Appliance Therapy: A Systematic Review and Meta-analysis.

To assess the alveolar bone changes and gingival recession following Herbst appliance therapy. Electronic databases such as PubMed, Ovid, Cochrane Library, Lilacs, Scopus, Web of Science, and Embase were searched until August 2022. Hand-searching of major orthodontic journals was performed to identify all peer-reviewed articles potentially relevant to the review. The quality of the selected studies was ranked using the revised Cochrane risk of bias tool for nonrandomized trials-Risk of Bias In Nonrandomized Studies (ROBINS) 1. Five relevant articles (all nonrandomized studies) were considered for qualitative analysis. The risk of bias was low for four studies and moderate for one. The reduction in the vertical alveolar bone height was 0.13 ± 0.07 mm, with the Herbst appliance. The mean difference in the loss of buccal cortical thickness between the Herbst appliance and untreated control group was 0.22 mm [95% confidence interval (CI) of -0.62-0.18]. Subsequent to Herbst appliance therapy, in the mandibular anterior region 0.1 ± 0.5 mm of gingival recession was observed. Herbst appliance treatment produces a negligible reduction in the buccal cortical thickness, vertical alveolar bone height, and gingival recession. Though the changes produced by the Herbst appliance were minimal, they are clinically important considering the young age of the patients warranting periodic periodontal assessment. Kumar MV, Kannan A, Kailasam V. Alveolar Bone and Gingival Changes in Mandibular Anterior Region Following Herbst Appliance Therapy: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2024;17(1):114-120.

Gender-specific treatment effects and outcomes reported in orthodontic research. A cross-sectional empirical study.

To identify practices of assessment of gender effects in research articles in orthodontics and detect whether there were significant differences in the treatment effects on outcomes according to gender. Four major orthodontic journals were sought over a 3-year period to identify publications which included assessment of gender effects on outcomes in their reporting. Data were extracted on the following characteristics: journal, year of publication, region of authorship, and study design. For the studies including reporting of gender effects, whether a significant effect existed was further documented. Additionally, for these studies, data were extracted on population, sample size per gender, treatment, comparison, outcome type, and nature and whether gender analysis was based on subgroup testing or included as a main effect. Descriptive statistics, cross-tabulations, univariable, and multivariable regression models were utilized as appropriate. A total of 718 research articles were eligible for inclusion out of a pool of 1,132 screened articles. Of those, 95 reported on any type of analysis on gender effects (95/718; 13.2%). In the 95 studies that reported assessment of gender effects, it was clear that the majority did not detect significant gender-related differences across the documented outcomes (range of frequency distribution for significant gender differences across all outcomes: 0-50%). Twenty-two articles overall (22/95; 23.2%) described a significant gender effect classified by outcome, 12 favoring female and 10 favoring male participants. Patterns of efficacy and adverse outcomes were schemed either favoring female (root resorption: 4/10; 40.0%, periodontal outcomes: 3/11; 27.3%) or male (cephalometric/growth changes following orthodontic treatment: 4/17; 23.5%) patients across the 22 studies with significant effects. Appropriately designed and adequately powered statistical analyses, with gender effect assessment as a main effect in a multivariable regression model was associated with 6.53 times higher odds for identifying significant gender effects (OR = 6.53; 95% CI: 2.15, 19.8; P = .001). A very small proportion of research studies included gender effect assessment in their analyses. Of those, a quarter described significant effects. Nevertheless, careful analysis planning and strategies should be prioritized to allow for any meaningful interpretation.

Bibliometric analysis of research publications in three major orthodontic journals during 2012–2021

Objectives: This study conducted a comprehensive bibliometric analysis of articles published from 2012 to 2021 in three orthodontic journals: The American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), The Angle Orthodontist (AO), and European Journal of Orthodontics (EJO). Material and Methods: Eligible articles published from 2012 to 2021 in AJODO, AO, and EJO were retrieved from the Web of Science Core Collection database and subsequently processed using CiteSpace software to generate their characteristics, including authorship, institution, geographic origin, keywords, and citation profiles. Results: The three orthodontic journals published 4001 articles from 370 institutions in 95 countries from 2012 to 2021. The AJODO published the most articles (45.5%) followed by AO (31.3%) and EJO (23.2%). The most prolific country was the United States (US), followed by Brazil, South Korea, China, and Turkey. The authors from the US were heavily engaged in international collaborations, especially with South Korea and Brazil. The country and institutions with the highest citation counts per publication were Italy and the University of Bern (Switzerland), respectively. Pandis N was the most prolific author, and Proffit W was the most-cited author in the 4001 publications. The keywords that emerged most frequently were “children” followed by “orthodontic treatment” and “malocclusion.” Four of the 10 most-cited articles were related to digital dental technology. Conclusion: This bibliometric analysis provides a complete picture of the research published in three major orthodontic journals over the past decade. It comprehensively analyzes the authorship, country of origin, institutions, keywords, and citation profiles of the articles.

The Effectiveness of Conventional and Accelerated Methods of Orthodontic Traction and Alignment of Palatally Impacted Canines in Terms of Treatment Time, Velocity of Tooth Movement, Periodontal, and Patient-Reported Outcomes: A Systematic Review.

The objective of the current review was to evaluate the effectiveness of traditional and accelerated methods of palatally impacted canine's (PIC) traction in terms of treatment duration, velocity, periodontal, and patient-reported variables.An electronic search for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) published between January 1990 and October 2021 was conducted in nine databases. Five major orthodontic journals were hand searched for additional studies. The participants were patients with unilateral or bilateral PICs who received conventional or accelerated orthodontic treatment with fixed appliances. Cochrane’s risk of bias tool (RoB 2 tool) for RCTs and ROBINS-I tool for CCTs were used to assess the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines were used to assess the overall quality of the evidence.Nine articles (eight RCTs and one CCT) were included in this review (371 patients). There was no clarity in most studies about the possible effect of the mechanical traction method on treatment outcomes. The treatment duration decreased (about three to six months) when the open surgical method was used with traditional techniques and the traction velocity increased significantly (about 1-1.5 mm/month) when acceleration methods were used. No significant differences were found between the conventional intervention groups, as well as between the traditional and accelerated groups, in terms of most periodontal variables (p > 0.005).No significant differences were found in the pain levels associated with traditional PICs' traction when comparing different exposure methods in the short-term follow-up (1-10 days), while contradictory results were found in the pain incidence between these methods. The relationship between the pain/discomfort levels and the type of mechanical traction method was not evaluated. According to the GRADE, the quality of evidence supporting these findings ranged from low to very low.The combination of the open surgical technique with various designs of either superelastic wires or elastic traction means can lead to a reduction in the orthodontic treatment duration of PICs. The use of direct anchorage by miniscrews to move the PICs away from the adjacent teeth roots can lead to a reduction in root resorption and shorten the treatment duration. The evidence supporting these findings ranged from low to very low. The use of different types of mechanical means for conventional PICs' traction, with the use of open or closed traction techniques, does not lead to significant differences in periodontal outcomes between intervention groups. Contradictory results exist regarding the severity of the perceived pain in relation to the surgical exposure type, and the relationship between this variable and the mechanical traction method is still unclear. The use of accelerated methods for PICs' traction can lead to an increase in the velocity of traction movement with no significant differences in periodontal outcomes between accelerated and conventional methods. The evidence supporting these findings ranged from low to very low. More high-quality randomized CCTs are needed to establish good evidence in this field.The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021274476) during the first stages of this review.

Gender gap in authorship within published orthodontic research. An observational study on evidence and time-trends over a decade.

To assess the representation of female authors in senior and leading positions in orthodontic research publications, as well as the fraction of women participating in the publication reports, for over a decade. In addition, association of women representation in orthodontic research and characteristics such as journal of publication, year, study design/topic, and others, were sought. Electronic search was performed within three major orthodontic journals, namely the European Journal of Orthodontics (EJO), the American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), and the Angle Orthodontist (ANGLE) to identify all types of research articles published within two distinct year cohorts, the 2008-10 and the 2018-20. The outcomes of interest pertained to proportion of women in senior (last) and leading (first) position, and fraction of overall participation in the author list. A total of 2539 articles were eligible for inclusion, with an overall number of contributing authors being 11 608, of which 34.4% were female. For seniority in authorship, 30.1% (312/1038) of the publications within 2018-20 were attributed to female authors, while 25.8% (388/1501) was identified in 2008-10. Publication timeline, geographic region, and thematic topic of publication were determined as significant predictors. For leading (first) authorship, the respective percentages were 44.7% (464/1038) within 2018-20, and 34.7% (521/1501) in 2008-10. Dissemination timeline, geographic region and journal of publication were identified by the multivariable analysis, as revealing evidence of association with female leading publication authorship. Overall, the median proportion of female authors within the author list was 33.0%. A gender gap related to Orthodontic research publications is persistent, with participation of women either as senior, or as leading authors, being suboptimal. Consistent efforts should be set in place, to facilitate more equal representation of women in research publishing, being supported by academia.

Product advertisements in orthodontic journals: Are they evidence-based?

Previous research has suggested orthodontic advertisements are poorly supported by evidence. The primary aim of this study was to identify the type and quality of evidence supporting advertisement claims in leading orthodontic journals. A cross-sectional study was undertaken to assess all advertisements published between January 2015 and December 2017 in 6 major orthodontic journals. Only advertisements implying superior product performance in clinical practice or patient care were selected for further evaluation. Study variables were collected using a prespecified data collection form. In the presence of a supporting citation, the reference article was obtained, and the quality was assessed in duplicate. Associations between advertisement variables and quality of evidence were explored using contingency tables (Fisher exact test). A total of 1753 advertisements were identified. After the application of eligibility criteria, 124 were included in the final analysis. Advertisements promoting bracket systems predominated. Of these, 34.7% were supported by evidence, of which 10.5% (n=13) included accessible references. Only 6 out of 13 studies involved orthodontic patients. Primarily expert opinion and observational study types were referenced. Less than 2% of advertisements were supported by high-value evidence. There was an association between the quality of evidence in advertisements and the product category (P=0.003). There is a lack of both references and high-value evidence cited in orthodontic manufacturers' advertisements. Without critical appraisal of references cited in advertisements, clinicians need to be cautious before implementing manufacturers' recommendations in clinical practice. Efforts should be made to ensure appropriate high-value evidence is cited in advertisements to support manufacturers' claims.

A study of the reporting of patient and public involvement and engagement (PPIE) in orthodontic research.

Introduction:Patient and public involvement and engagement (PPIE) in research is an essential component of high-quality research. Patients and the public can identify which research topics are most relevant to them, contribute to study design, and interpretation and dissemination of findings. While inclusion of PPIE is widely adopted in medical research, awareness within the dental research community is more limited.Aim:To examine patient and public involvement and engagement in orthodontic research activity.Design:Identification and appraisal of use of PPIE in orthodontic research reporting and funding applications using a systematic approach.Methods:Three sources of information were examined: (1) research articles published between September 2018 and September 2019 in four major orthodontic journals. Articles were examined for reported PPIE; (2) common funding bodies for orthodontic research were assessed to establish whether PPIE was mandated (National Institute for Health Research, Medical Research Council, Wellcome Trust, Chief Scientist Office (Scotland), Health and Care Research Wales, British Orthodontic Society Foundation, Royal College of Surgeons and CLEFT); and (3) publication guidance for authors in these journals was examined to identify whether reporting of PPIE was included.Results:Of the 363 research articles, 2 (0.6%) mention patient/public involvement. None of the 363 research articles mention patient/public engagement. Of nine funding bodies, 2 (22%) request evidence of patient/public involvement as a condition of receiving funding with one (11%) expecting evidence of public engagement to be provided as a condition of receiving funding. None of the four major orthodontic journals include patient/public involvement and/or engagement in their guidance for authors.Conclusion:There is currently: (1) a notable lack of reporting of PPIE in orthodontic research; (2) variability in the requirements of funding bodies for researchers to include PPIE in funding applications and throughout the research process; and (3) no stipulation in journals’ instructions for authors.

Relationship between European postgraduate programme accreditation and national research output: The case of the Network of Erasmus-Based European Orthodontic Postgraduate Programmes (NEBEOP) in orthodontics. A bibliometric study.

To assess in each European country the correlation between the number of Network of Erasmus-Based European Orthodontic Postgraduate Programmes (NEBEOP) members and orthodontic research activity. Secondary objectives were to describe and quantify Europe's orthodontic research. Articles published between 2014 and 2018 in 4 major orthodontic journals (American Journal of Orthodontics and Dentofacial Orthopedics, European Journal of Orthodontics, The Angle Orthodontist, Orthodontics and Craniofacial Research) and oral presentation abstracts of five European Orthodontic Society (EOS) congresses were analysed. For each European country, the total number of orthodontic programmes and NEBEOP memberships were collected. Descriptive statistics were performed, and Spearman correlation coefficients and risk ratios were calculated. 2039 articles and 261 oral presentation abstracts were included. Correlation coefficients between national number of publications, oral presentations, sum of these, all adjusted for population, and number of NEBEOP members in each country were 0.64, 0.65 and 0.62, respectively. Risk ratios were all above 1 and statistically significant for number of NEBEOP memberships per country, indicating positive associations with national orthodontic research productivity. Europe accounted for 30.5% of publications and 68.6% of oral presentations at EOS congresses during this period. European orthodontic research was not evenly distributed, since 9 countries were responsible for around 80% of the output. A positive association was found between number of NEBEOP programmes and national research activity. These results could be an additional argument to support similar pan-European initiatives and guidelines for postgraduate education, not only in orthodontics but in all other dental specialties.

Heterogeneity in Cochrane and non-Cochrane meta-analyses in orthodontics

ObjectivesHeterogeneity describes the percentage of variability across the study effects that can be attributed to between-study differences in a meta-analysis. The aim of this project was to explore the magnitude of heterogeneity in Cochrane and non-Cochrane meta-analyses in orthodontic research and to identify possible associations between heterogeneity (I2) and a number of study characteristics including number of studies, type of outcome and type of analysis. MethodsThe contents of five major orthodontic journals and the Cochrane Database of Systematic Reviews were electronically searched from January 2000 to December 2017 to identify Systematic Reviews (SRs) with at least one meta-analysis. Included records were screened for reporting of I2 classified into four categories: 0%, 1–29%, 30–59%, 60–100%. Associations between I2 and review-level and synthesis-level characteristics were tested. Univariable and multivariable mixed effects ordinal logistic regression was used to identify significant predictors for statistical heterogeneity. ResultsA total of 72 SRs comprising 391 meta-analyses were included with the majority based on non-Cochrane reviews (n = 54, 75%). Overall, 125 meta-analyses (32%) reported heterogeneity explained by chance (I2 = 0%), whereas high values of I2 (∼60–100%) were seen in 152 syntheses (39%). In the multivariable analysis, inclusion of each additional study within the synthesis presented 20% higher odds for substantial/considerable heterogeneity compared to lower heterogeneity categories (OR = 1.20; 95%CIs: 1.09, 1.31; p < 0.001). Use of fixed effect analysis (OR = 0.25; 95%CIs: 0.12, 0.55; p = 0.001) was associated with significantly lower odds. Cochrane versus non-Cochrane meta-analyses were not associated with higher odds for substantial/considerable heterogeneity (OR = 2.81; 95%CIs: 0.53, 14.91; p = 0.22). ConclusionsSubstantial statistical heterogeneity is present within a considerable number of orthodontic meta-analyses. Further efforts should be made to improve understanding of decisions to undertake meta-analyses and selection of studies eligible for inclusion. Clinical significanceThe consistency of meta-analyses could be improved with more careful consideration of individual study characteristics. Reduced heterogeneity in meta-analyses will ensue more solid evidence based decisions for clinical practice

Evaluation of Treatment Outcomes of En masse Retraction with Temporary Skeletal Anchorage Devices in Comparison with Two-step Retraction with Conventional Anchorage in Patients with Dentoalveolar Protrusion: A Systematic Review and Meta-analysis.

Objective:The main objective is to evaluate the effectiveness of en masse retraction with temporary skeletal anchorage devices (TSADs) versus two-step retraction with conventional anchorage (CA) in terms of the skeletal, dental, and soft-tissue variables, as well as the duration of retraction or overall orthodontic treatment.Materials and Methods:An electronic search of PubMed and nine other major databases for prospective, randomized controlled trials (RCTs) and clinical controlled trials (CCTs) was carried out between January 1990 and April 2018. The bibliography in each identified article was checked out. In addition, manual searching was performed in the same time frame in five major orthodontic journals. Adult patients undergoing fixed orthodontic treatment with extraction of maxillary premolars followed by an en masse retraction in the experimental group and two-step retraction of upper anterior teeth in the control group. Methodological index for nonrandomized studies for CCTs and Cochrane's risk of bias tool for RCTs were applied.Results:Four articles (two RCTs and two CCTs) were included in this review and all articles were appropriate for the quantitative synthesis. There was no significant difference between the en masse retraction and two-step retraction groups in terms of SNA, SNB, ANB, and MP-SN angles. Using TSADs gave significantly better results in terms of posterior anchorage and incisors inclination, and greater anterior teeth retraction in comparison with CA (standardized mean difference [SMD] = –3.03 mm, P < 0.001; SMD = 0.74°, P = 0.003; SMD = –0.46 mm, P = 0.03, respectively). En masse/TSAD combination caused a significantly greater increase in nasolabial angle, higher decrease in facial convexity angle, and greater lower lip retraction in comparison with two-step/CA combination (weighted mean difference = 4.73°, P = 0.007; P = 0.0435; SMD = –0.95 mm, P = 0.01, respectively).Conclusion:There is weak-to-moderate evidence that using either en masse/TSAD combination or two-step/CA combination would lead to similar skeletal improvement. There is a very weak-to-moderate evidence that using TSADs with en masse retraction would cause better posterior anchorage and incisors inclination, and greater anterior teeth retraction than using CA with two-step retraction. There is weak-to-moderate evidence that using en masse/TSAD combination would lead to a better improvement in the facial profile. According to the quality of evidence, we confirm the need for more well-conducted RCTs in the en masse retraction field.

Trends in Contemporary Orthodontic Research Publications: Evaluation of Three Major Orthodontic Journals

Background In this study, we aimed to evaluate the inclination of orthodontic research published in original articles in three of the most popular and recognized orthodontic journals with high impact factor; American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), the Angle Orthodontist (AO), and European Journal of Orthodontics (EJO) published in a 5-year duration time frame (2010–2014). Materials and Methods Online search with supplementary hand searching was undertaken for original research articles in these three orthodontic journals from 2010 to 2014. Classification of data was completed autonomously by manual and direct appraisal of the manuscript of each journal. Results and Conclusion Three thousand one hundred and forty articles published in AJODO, AO, and EJO in the particular time period were selected, out of which 1783 original research study articles (56.78%) were appraised for classification in their various respective knowledge domains. AO (82.73%) and EJO (76.99%) were relatively more committed toward publication of research work in comparison to AJODO (34.55%). Research articles based on perception and questionnaires (12%), temporary anchorage devices (11%), cone-beam computed tomography (8%), invisible orthodontics (lingual orthodontics, clear aligners, esthetic brackets, and wires) (5%), and airway examination (5%) were the five most recurrently selected subjects of interest (41%) in these three journals during the observation period. The total number of research articles published in the three journals reduced statistically significantly in 2014 when compared to 2010.

Malocclusion Characteristics as Risk Factors for Temporomandibular Disorders: Lessons Learned from a Meta-Analysis

The objective of this meta-analysis was to evaluate the association of various malocclusion characteristics with temporomandibular disorders (TMDs). Two reviewers identified articles through database searches of MEDLINE (Ovid) and LILACS and hand searches of major orthodontic journals and selected references. Random-effects models were used to calculate weighted pooled odds ratio (OR) estimates of malocclusion exposures. Six articles qualified for inclusion in the final quantitative analysis. Our study found that static occlusal factors had no significant association with TMD. Of the dynamic occlusal factors assessed, only the absence of canine guidance, laterotrusive interferences, and retruded contact position to maximal intercuspation slide length ≥2 mm demonstrated significant ORs. These results should be viewed with caution, as reporting biases were difficult to assess, and heterogeneity estimates may have been underestimated due to the limited number of studies within each comparison. TMD is a term that encompasses a broad group of dysfunctions, and meta-analyses should only synthesize studies with similar diagnostic criteria. At the present, there is a paucity of studies available that could be properly synthesized to answer the research question posed. Individual studies have too much variability among their methods, and researchers need to clearly define and state their TMD factor definition.

Risk of bias and magnitude of effect in orthodontic randomized controlled trials: a meta-epidemiological review.

To assess the risk of bias (RoB) in a subset of randomized controlled trials (RCTs) published in orthodontic journals using the Cochrane RoB tool and to identify associations between domain RoB assessment and treatment effect estimates. Fifty consecutive issues of four major orthodontic journals were electronically searched to identify RCTs. The quality of the included studies was assessed using the Cochrane RoB tool, which involves seven domains rated as 'low', 'unclear' or 'high': random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, and selective outcome reporting, and other threats to internal validity. Estimates and confidence intervals (CIs) were recorded or calculated where possible for binary and continuous outcome measures. Meta-regression models were employed to assess the impact of RoB per domain on the magnitude of treatment effect. One hundred and one eligible studies involving 128 pair-wise comparisons were retrieved. Blinding of outcome assessors and incomplete outcome data were frequently judged as 'high' for RoB both for studies with binary and continuous outcome (42.9 and 48.8 per cent, respectively). For binary outcomes, high RoB regarding random sequence generation [odds ratio (OR): 5.97, 95% CI: 2.03, 17.63, P-value: 0.002] and incomplete outcome data (OR: 4.07, 95% CI: 1.03, 16.15, P-value: 0.05) were more likely to provide exaggerated effect estimates. There is a need for improved clinical trial methodology and reporting, in order to avoid inflated associations and erroneous conclusions.

The evidence from systematic reviews and meta-analyses published in orthodontic literature. Where do we stand?

To analyse meta-analyses included in systematic reviews (SRs) published in leading orthodontic journals and the Cochrane Database of Systematic Reviews (CDSR) focusing on orthodontic literature and to assess the quality of the existing evidence. Electronic searching was undertaken to identify SRs published in five major orthodontic journals and the CDSR between January 2000 and June 2014. Quality assessment of the overall body of evidence from meta-analyses was conducted using the Grading of Recommendations Assessment, Development and Evaluation working group (GRADE) tool. One hundred and fifty-seven SRs were identified; meta-analysis was present in 43 of these (27.4 per cent). The highest proportion of SRs that included a meta-analysis was found in Orthodontics and Craniofacial Research (6/13; 46.1 per cent), followed by the CDSR (12/33; 36.4 per cent) and the American Journal of Orthodontics and Dentofacial Orthopaedics (15/44; 34.1 per cent). Class II treatment was the most commonly addressed topic within SRs in orthodontics (n = 18/157; 11.5 per cent). The number of trials combined to produce a summary estimate was small for most meta-analyses with a median of 4 (range: 2-52). Only 21 per cent (n = 9) of included meta-analyses were considered to have a high/moderate quality of evidence according to GRADE, while the majority were of low or very low quality (n = 34; 79.0 per cent). Overall, approximately one quarter of orthodontic SRs included quantitative synthesis, with a median of four trials per meta-analysis. The overall quality of evidence from the selected orthodontic SRs was predominantly low to very low indicating the relative lack of high quality of evidence from SRs to inform clinical practice guidelines.

Reporting quality of randomized controlled trials in orthodontics--what affects it and did it improve over the last 10 years?

Objectives were to investigate the factors affecting the overall reporting quality and the reporting quality trend of each item over the last 10 years for orthodontic randomized controlled trials (RCTs). MEDLINE, The Cochrane Library, and EMBASE databases were searched (2003-12) to retrieve studies. Four major orthodontic journals and reference list of included articles were hand searched to identify additional RCTs. The overall reporting quality for all included RCTs (2003-12) was assessed using CONSORT, 2001 (ORQs 2001, score 0-20). In addition, CONSORT, 2010 (ORQs 2010, score 0-27), was used for RCTs published after 2010. Generalized estimated equations (GEEs) model was used for analysis (ORQs 2001 and ORQs 2010). Cochran-Armitage trend test was used to evaluate the reporting quality trend of each individual item based on the CONSORT, 2001. Totally 309 relevant studies were identified, out of which 86 were published after 2010. The median for total ORQs 2001 and ORQs 2010 was 9 (interquartile range 7-12) and 12 (interquartile range 9-15), respectively. Year and journal of publication were significant predictors for both ORQs 2001 and ORQs 2010. Location, sample size, and multicentre trials were significant predictors only for ORQs 2001, and not for ORQs 2010. Trend test showed that reporting quality of four items, namely identification of trial as randomized, sample size, blinding, and randomization has improved significantly with time. There is an improvement in the reporting quality. However, it is still suboptimal. To improve the reporting quality, the CONSORT guidelines should be followed strictly.

Exploring the publications in three major orthodontic journals: A comparative analysis of two 5-year periods

To analyze the types of articles and authorship characteristics of three orthodontic journals--American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), The Angle Orthodontist (AO), and European Journal of Orthodontics (EJO)--published between 2008 and 2012 and to assess the differences in content within this period and an earlier period of 1998 to 2002. Each journal's content was accessed through the web edition. From each article, the following parameters were recorded: article type, number of authors, number of affiliations, source of article (referring to the first author's affiliation), and geographic origin. Descriptive statistics were performed and selected parameters were analyzed with the Pearson chi-square or Fisher exact test for independence at the .05 level of significance. Review of differences between the two periods showed that the number of publications was almost double. The percentages of multi-authored articles increased. Fewer studies derived from the United States/Canada and European Union countries. Increases for articles from non-European Union countries, Asia, and other countries were found. Characteristics of the second period showed that the EJO and AO published more research articles, whereas the AJODO regularly published case reports and other articles. Approximately 75% of all studies derived from orthodontic departments. The publications from 1998-2002 and 2008-2012 were significantly different both in terms of numbers and characteristics. Within 2008-2012 there were notable differences between the three journals concerning the type and origin of the publications.

Cochrane and non-Cochrane systematic reviews in leading orthodontic journals: a quality paradigm?

The aims of this study were to assess and compare the methodological quality of Cochrane and non-Cochrane systematic reviews (SRs) published in leading orthodontic journals and the Cochrane Database of Systematic Reviews (CDSR) using AMSTAR and to compare the prevalence of meta-analysis in both review types. A literature search was undertaken to identify SRs that consisted of hand-searching five major orthodontic journals [American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, European Journal of Orthodontics, Journal of Orthodontics and Orthodontics and Craniofacial Research (February 2002 to July 2011)] and the Cochrane Database of Systematic Reviews from January 2000 to July 2011. Methodological quality of the included reviews was gauged using the AMSTAR tool involving 11 key methodological criteria with a score of 0 or 1 given for each criterion. A cumulative grade was given for the paper overall (0-11); an overall score of 4 or less represented poor methodological quality, 5-8 was considered fair and 9 or greater was deemed to be good. In total, 109 SRs were identified in the five major journals and on the CDSR. Of these, 26 (23.9%) were in the CDSR. The mean overall AMSTAR score was 6.2 with 21.1% of reviews satisfying 9 or more of the 11 criteria; a similar prevalence of poor reviews (22%) was also noted. Multiple linear regression indicated that reviews published in the CDSR (P < 0.01); and involving meta-analysis (β = 0.50, 95% confidence interval 0.72, 2.07, P < 0.001) showed greater concordance with AMSTAR.

Does published orthodontic research account for clustering effects during statistical data analysis?

In orthodontics, multiple site observations within patients or multiple observations collected at consecutive time points are often encountered. Clustered designs require larger sample sizes compared to individual randomized trials and special statistical analyses that account for the fact that observations within clusters are correlated. It is the purpose of this study to assess to what degree clustering effects are considered during design and data analysis in the three major orthodontic journals. The contents of the most recent 24 issues of the American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), Angle Orthodontist (AO), and European Journal of Orthodontics (EJO) from December 2010 backwards were hand searched. Articles with clustering effects and whether the authors accounted for clustering effects were identified. Additionally, information was collected on: involvement of a statistician, single or multicenter study, number of authors in the publication, geographical area, and statistical significance. From the 1584 articles, after exclusions, 1062 were assessed for clustering effects from which 250 (23.5 per cent) were considered to have clustering effects in the design (kappa = 0.92, 95 per cent CI: 0.67-0.99 for inter rater agreement). From the studies with clustering effects only, 63 (25.20 per cent) had indicated accounting for clustering effects. There was evidence that the studies published in the AO have higher odds of accounting for clustering effects [AO versus AJODO: odds ratio (OR) = 2.17, 95 per cent confidence interval (CI): 1.06-4.43, P = 0.03; EJO versus AJODO: OR = 1.90, 95 per cent CI: 0.84-4.24, non-significant; and EJO versus AO: OR = 1.15, 95 per cent CI: 0.57-2.33, non-significant). The results of this study indicate that only about a quarter of the studies with clustering effects account for this in statistical data analysis.

Stability of treatment for anterior open-bite malocclusion: A meta-analysis

Anterior open-bite (AOB) treatment is considered challenging because of difficulties in determining and addressing etiologic factors and the potential for relapse in the vertical dimension after treatment. In this review, we compiled evidence on the long-term stability of the major therapeutic interventions for correcting AOB. Our objective was to review and compile evidence for the stability of surgical and nonsurgical therapies for AOB malocclusion. Our data sources were PubMed, EMBASE, Cochrane Library, limited gray literature search, and hand searching. A search was performed of the electronic health literature on the stability of AOB after treatment. Hand searching of major orthodontic journals and limited gray literature searching was also performed, and all pertinent abstracts were reviewed for inclusion. Full articles were retrieved for abstracts or titles that met the initial inclusion criteria or lacked sufficient detail for immediate exclusion. Studies accepted for analysis were reviewed and their relevant data retrieved for pooling. The long-term stability estimates were pooled into nonsurgical and surgical groups, and summary statistics were generated. One hundred five abstracts met the initial search criteria, and 21 articles were included in final analyses. Rejected articles failed to exhibit follow-up times of 12 months or more, did not include measurements of overbite (OB), or did not meet inclusion criteria. All included articles were divided into a surgical group (SX) with a mean age of 23.3 years and a nonsurgical group (NSX) with a mean age of 16.4 years. All studies were case series. Random-effects statistical models were used to pool the mean OB measures before and after treatment and also at the long-term follow-up. The pretreatment adjusted means of OB were -2.8 mm for the SX and -2.5 mm for the NSX. AOB closures up to +1.6 mm (SX) and +1.4 mm (NSX) were achieved. Relapse in the SX group during the mean 3.5 years of follow-up reduced the OB to +1.3 mm; the NSX group relapsed to +0.8 mm in the mean 3.2 years of follow-up. Pooled results indicated reasonable stability of both the SX (82%) and NSX (75%) treatments of AOB measured by positive OB at 12 or more months after the treatment interventions. In the included case series publications, success of both the SX and NSX treatments of AOB appeared to be greater than 75%. Because the SX and the NSX were examined in different studies and applied to different clinical populations, no direct assessment of comparative effectiveness was possible. The pooled results should be viewed with caution because of the lack of within-study control groups and the variability among studies.