Evidence-based orthodontics: has it something to do with your patient?

This section will be led in order to provide the clinician with support for comprehension and critical analysis of scientific articles, with elucidation of the main types of scientific studies, specific methodology and statistical analysis for clinical practice based in scientific evidence. The objective is to approximate clinician and science, easing the comprehension of the intricate scientific methods. The scientific and technological innovation observed in the last decades in Orthodontics is undeniable. Obviously, we, orthodontists, want to offer the latest and most efficient treatment to our patients. However, how should our patients be submitted to these innovations? In other words, how should the orthodontist securely change the clinical conduct adopting new appliances, techniques or materials? In recently published research, American orthodontists claimed to modify the treatment of their patients based, primarily, on the opinion of an expert, followed by consultation of published clinical cases, advice from colleagues and literature reviews, respectively. However, would it be wise to change the treatment of a patient based on the opinion of an expert? In order to scientifically answer the clinical issues in Health, the concept of clinical practice based in scientific evidence initially appeared in Medicine, in the 90s. 2 It consists in the search and applicability of the best and most current scientific evidence, in order to contribute on the decision making about the care in Health. 3,4 Nowadays, facing the substantial offer of information , the process of search and identification of the best and most reliable scientific results, capable to guide the evidence-based clinical practice, comprises both hierarchy of scientific articles and the adequate interpretation of these results. According to the hierarchy of scientific evidence, the systematic reviews and meta-analyses are found at the highest level of scientific evidence (Fig 1). Differently from the traditional literature reviews, in which the choice of scientific articles depended fundamentally on the authors, on systematic reviews the selection of scientific articles uses a rigorous scientific methodology , that must be understandable and reproducible. 3 Moreover, a detailed analysis of the quality of the studies must be done, as well as an exhaustive search of all selected articles, according to strict inclusion and exclusion criteria, emphasizing the importance of the insertion of randomized clinical trials. When the results of these scientific studies selected on a systematic review can be grouped and statistically analyzed, this is a meta-analysis. Thus, the meta-analysis increases the general size of …