Fast Orthodontics - In Search of the Holy Grail

I recently wrote a review article in the Australian Dental Journal supplemental issue on accelerated orthodontic treatment. In it I discuss the many claims by manufacturers of several appliances and proponents of various techniques that claim to accelerate treatment. This appeals to both the patient’s and the clinician’s desire to ‘speed’ up and shorten their treatment, however how strong is the evidence or is it just marketing hype? I am a little concerned as it would appear that in some respects, advertising claims in orthodontics are following down the path of the exercise fads claiming rapid results with little or no effort - I certainly find some effort and restraint is required :-). Mechanically and biologically, many of the claims of accelerating orthodontic treatment just do not make sense (such as with self-ligating brackets which I have written about before) or are quite invasive and/or expensive (some of the surgical techniques are ~$5000 and the effect lasts only ~3 months). This is discussed in more detail in the article.

One of the clinical trials I have been conducting in our office on vibration and accelerated treatment was also published recently in the American Journal of Orthodontics and Dentofacial Orthopedics and I was asked to produce a short video on that article which can be found here.

This was included in the review article I wrote also. More recently we have just analysed the data on the 2nd part of this ongoing RCT when closing extraction spaces and I also found that there was no clinically or statistically significant difference in the rate of space closure – in other words, vibration had no effect. This is important for patient’s to be aware of as they can be asked to spend $500 - $1000 for various appliances which may have minimal or no effect. The problem with emerging techniques and methodologies is that there may be no trials examining their performance so we must then rely on our knowledge of biology and mechanics on whether we consider it ‘may’ have a positive effect or not. However, if we are unsure, then patient’s should be informed of this until research exists. They can then decide if they will gamble on the appliance/technique possibly working or stay with the current approach. So the Holy Grail of accelerated orthodontic treatment seems elusive and the honest answer about the various options to patients is ”There are many techniques and appliances claiming to accelerate orthodontic treatment but the current evidence is poor and some have been shown to have no effect”.