From June 20-24, I had the great pleasure of attending my first Congress of the European Orthodontic Society (EOS). It was a distinct honor for me to have been invited, on behalf of JCO, as one of the keynote speakers for this 100th-anniversary celebration of the EOS, held in conjunction with the 80th annual scientific meeting of the German Orthodontic Society--the Deutsche Gesellschaft fur Kieferorthopadie. I'm grateful to Professor Dr. Rainer-Reginald Miethke and the organizing committee for this invitation.
Since the meeting was, in effect, the 100th birthday party for the EOS, Dr. Miethke wanted the keynote speakers to depart from their customary scientific lectures and make bold statements about the successes and failures of orthodontics over the past century. I'll summarize my own presentation in next month's issue.
One clear theme sounded by many of the keynote and memorial lectures, however, was the evolution of evidence-based orthodontic practice. Dr. Fraser McDonald, editor of the European Journal of Orthodontics since 1993, and his colleague, Dr. Neil Pender, focused on the contributions that EJO has made to that development. Frans van der Linden, in his Sheldon Friel Memorial Lecture, "Myths and Legends in Orthodontics", pointed out that fewer than 25% of the concepts and procedures generally accepted in medicine are evidence-based, and that the percentage is even lower in orthodontics. Dr. David Turpin, in a cogent lecture called "The Evidence Becomes King", noted that 100 years ago, Edward Angle found a supportive environment for the development of orthodontics as a health-care profession in what has been called the "Era of the Expert", when he and other individual pioneers dominated theory and practice. This was followed, about 50 years ago, by the "Scientific Era", in which research findings were more likely to be supported by our educational institutions. Dr. Turpin pointed out, from his vantage point as editor of AJO, that the times once again are changing. Clinical protocols, he said, will now be based on the study of treatment outcomes, in what he termed the "Era of Evidence".
Similar articles from the archive:
- THE EDITOR'S CORNER The Problems with Bonding Studies April 2007
- THE EDITOR'S CORNER The Search for Stability January 2006
- THE EDITOR'S CORNER The Weight of the Evidence March 2004
Dr. Robert J. Isaacson, editor of the Angle Orthodontist, presented a remarkable paper on "The Impact of the Digital Age on Orthodontics", in which he explored some of the failings of a diagnostic tool that has been held in high regard by all of us since the time of Angle--the study model. As Dr. Isaacson explained, even with the digital substitutes we now have for the plaster cast, the process of model analysis is still filled with subjective decisions; two entirely competent orthodontists can get different information from the same set of models. He described a new, almost completely automated model analysis that will give everyone the same objective score for any given set of problems.
The subject of excellence in orthodontics was emphasized by other invited lecturers, including Dr. Birte Melsen, one of JCO's Associate Editors, in her presentation, "What Has Changed Over the Past 100 Years?" She noted that the roots of dentistry and orthodontics can be traced back to the blacksmith, the village doctor, and the barber--three professions that dealt with the mechanics, biology, and esthetics that still underlie all of orthodontics. Dr. Melsen's unique ability to cut to the quick with respect to unsubstantiated claims and principles prompted us all to do a bit of soul searching about the basis for modern orthodontic dogmas, "gurus" and marketing of orthodontic "philosophies".
One of our former Contributing Editors, Dr. Rohit Sachdeva, took us on an extraordinary exploration of "Curing Orthodontic Care: Changing Mental Models in the Pursuit of High Performance". Dr. Sachdeva noted that orthodontics is witnessing rapid changes driven by "disruptive technologies", with the breakdown of the specialty niche and the rise of both the rejuvenation marketplace and the informed consumer. He stated, "The very core of our practice model is being challenged by these forces and driving us to reinvent our vision toward the unprecedented levels of performance in the care of our patients." He issued a clarion call for us both to accelerate and improve our orthodontic delivery model.
The last, and one of the most memorable, keynote lectures I witnessed was given by my old friend and colleague from the University of Tennessee, Dr. James Vaden. Provocatively titled "Orthodontics--Is the Benefit Worth the Burden?", Dr. Vaden's lecture strongly condemned what he called "transitory orthodontics", in which practitioners treat children continuously from age 7 to age 14, followed by "tune-ups" two or three times during adult life. He disparaged the concept of "permanent retention", insisting that "we must go back to where we started, examine ourselves and our work, and see if a lifetime of work for many, many patients has given society something of lasting value."
All in all, the 100th-anniversary celebration of the EOS was an overwhelming success. In addition to the invited lectures I've discussed, numerous outstanding presentations, lectures, and posters were given over the course of five days. The theme of absolute excellence in service to our patients, born of deep, introspective study of our own treatment philosophies and a sound body of clinical evidence, rang out loud and clear.
RGK