Searching for a needle in a haystack Kevin O’Brien. BOC 2021. Episode 137. October 6th 2021

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Hosted by
Farooq Ahmed

Searching for a needle in a haystack Kevin O’Brien


Join me for Kevin O’Brien’s lecture looking at research in orthodontics, the questions we ask and their relevance to patients.


Patient centred research has been described previously but still not addressed Shaw 1980

  • ‘Evidence for the justification of orthodontics is vague’


Kevin’s interest in consumer centred research

  • Orthodontist’s measure value minimal effects
  • What do patients understand about cephalometrics and PAR
  • Consumer based measures to research


Do Orthodontic research outcomes reflect patient values? Aliki and O’Brien systematic review 2014

  • Outcomes from orthodontic RCTs
    • Malocclusion 60%
    • Cost 25%
    • Adverse effects 25%
    • QOL <10%
    • Function <10%
    • Consequence <5%
  • Important measures infrequently measured in studies


Does malocclusion and orthodontic treatment impact oral health: A systematic review. Macey & O’Brien 2020

  • Aim what is the impact of malocclusion and orthodontics on oral health
  • Outcomes
    • Trauma more likely with increased overjet
    • Absence of evidence on other outcomes
  • Conclusions
    • Measuring orthodontic values
    • Missing effects of treatment



  • Oral health – comfortable and functional dentition which allows individuals to continue their lives



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