Spyridon Papageorgiou is a Clinic Coordinator and Deputy Director at the Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine of the University of Zurich (Switzerland) and a Visiting Senior Lecturer in King’s College (London). He graduated from Aristotle University of Thessaloniki (Greece), while he completed his orthodontic specialty training & doctorate (Summa Cum Laude) from the University of Bonn (Germany). In 2021 he received his Habilitation (Venia Legendi) and in 2022 a Certificate of Advanced Studies in Orthognathic Surgery – both from University of Zurich, while he completed a MSc on Medical Research Methodology from Aristotle University of Thessaloniki. He has published over 170 papers in international peer-reviewed journals and over 10 chapters (4500 citations; h-index: 40; i10-index: 91), acts as a reviewer (>30 journals), academic editor (3 journals), statistical advisor (1 journal), (co-)supervisor / examiner over 10 theses/dissertations for 4 universities. He worked on basic science, clinical trials, and evidence-based research funded by the German Research Foundation (2013), the Greek & German State Scholarship Foundations (2015), and the European Orthodontic Society (2016). His work has received multiple awards, including the David L. Turpin Award for Evidence-Based Research (2012) and the B.F. and Helen E. Dewel Award for Clinical Research (2018) from the American Association of Orthodontists, the W.J.B. Houston Award (2017) from the European Orthodontic Society, the Chapman Prize (2018) from the British Orthodontic Society, and the Best Research Award (2015) from the Greek Orthodontic Society. He has been invited to participate in consensus-meetings for the development of clinical recommendations from the European Academy of Osseointegration (2018), the Osteology Foundation (2022), and the European Federation for Periodontology (2022). His research focuses on the clinical outcome, duration, or side-effects of orthodontic treatment, evidence-based methods including randomized trials and meta-analysis, methods to identify bias in orthodontic clinical research, open / transparent research practices, and the effect of systematic diseases on the biology of orthodontic tooth movement.
Prove it to me and I still won't believe it: separating truth from bias and wishful thinking in orthodontics
“Evidence-based” is a term that can be found in all aspects of orthodontics— from scientific papers published in peer-reviewed journals, to posters or presentations in scientific congresses, and even claims of clinical benefits of a particular appliance / technique / adjunct from commercial companies or key opinion leaders. However, its meaning is often inadvertently (or intentionally) misconstrued, which might lead to a false sense of conviction over the clinical effects that can be expected for the average patient. Such examples include friction-less brackets, skeletal anchorage reinforcement, orthodontic adjuncts based on vibration or laser, surgical assistance in terms of osteo-perforations / osteotomies / corticotomies, effects of dentofacial orthopedics on airways or breathing, and treatment of adult patients with periodontally-compromised dentitions. For clinical recommendations to be evidence-based, usually robust clinical trials are needed, but planning, conducting and monitoring a clinical trial is an arduous task that requires considerable time, effort and money – hence only a handful of researchers tackle this research type in orthodontics. On the other hand, small trials might lack the needed statistical power, each trial can be directly applicable only to populations similar to the one recruited, and synthesis of trial settings / populations is needed to form clinical recommendations. Evidence synthesis is ideally done with meta-analyses within the framework of a systematic review, which enables a transparent, objective, and reproducible format to appraise the entirety of existing research around a scientific question, while also increasing statistical power, shedding light on observed heterogeneity, assessing the influence possible associated factors, and ultimately forming the basis for trustworthy clinical practice guidelines. Aim of the present lecture is to shed light on areas of particular clinical interest in orthodontics and whether the proposed benefits of various examples of appliances, techniques, or adjuncts are truly based on sound evidence and can be trusted.