Evidence-based therapy: An orthodontic dilemma

e The advent of evidence-based therapy has created a dilemma in orthodontics because the evidence is apparently often ignored in practice. For example, it is well established that increases in the mandibular intercanine dimension are not stable. The conclusion derived from a meta-analy of 26 studies involving 1233 patients was that the postretention intercanine dimension approximates the initial width. The unambiguous advisory was that the intercanine dimension should not be increased substantially during treatment. Additionally, the decrease that follows an expansion in intercanine dimension was associated with an increase in incisor irregularity in some analyses. 2-5