There was insufficient evidence to assess the effect of bonding modality on demineralization rates .
CONCLUSIONS There is weak evidence indicating higher odds of failure with self-etch primer than acid etch over 12 months in orthodontic patients , and there is strong evidence that a self-etch primer is likely to result in a modest time savings ( 8 minutes for full bonding ) compared with acid etch
INTRODUCTION The use of self-etch primers has increased steadily because of their time savings and greater simplicity ; however , overall benefits and potential disadvantages and harms have not been assessed systematic ally .
In this study , we review ed r and omized controlled trials to assess the risk of attachment failure , bonding time , and demineralization adjacent to attachments between 1-stage ( self-etch ) and 2-stage ( acid etch ) bonding in orthodontic patients over a minimum follow-up period of 12 months .
Bias in Systematic Reviews?
At an orthodontic meeting in recent years , a colleague recounted to me that when a presenter had finished their presentation on a systematic review , the person beside leaned over and said to my colleague ‘ not another systematic review where it ’s not possible to draw any firm conclusions ’ . So an element of frustration was clear based on the screening of a large volume of evidence to arrive at such a low point for a conclusion . This , however , is now a familiar outcome for many orthodontic systematic review s. In this short editorial , I have attempted to give a brief outline of the proposed benefits of systematic review s but more importantly , to highlight , some issues we all need to bear in mind in their regard . The increasing focus on evidence -based healthcare , including orthodontics , has shunned the narrative review and spawned the systematic review . Aim ing to identify , evaluate and summarize the findings of all relevant studies on a specific topic , its exacting systematic approach should minimize bias and provide conclusions based on reliable findings . Meta-analyses of r and omized clinical trials with low risk of bias are considered the highest level of evidence available for evaluating the effects of an intervention . Systematic review s are also important tools in setting the research agenda via their recommendations for future research and authors can alert research ers to the most pertinent outcomes in clinical practice . But systematic review s like any other study type are not without their variability , both in dentistry in general and specifically in orthodontics . Large differences have also been observed in the quality of reporting of several characteristics between Cochrane and non-Cochrane systematic review s. A key question that must be asked when looking at all Cochrane review s is whether the review has been undertaken in a way to avoid bias and whether the data and results from the included studies are valid . Conclusions may be distorted if bias is introduced to the review process at any stage . For example , incomplete search ing for all relevant studies may lead to publication bias ; there is strong association between publication and studies reporting significant or positive findings in medicine and also within orthodontics . With regard to studies included within the review , these need to be assessed to ensure that they are undertaken and reported in a manner that is free of bias ( systematic error ) . Outcome reporting bias ( ORB ) may also be relevant , e.g. in a study identified as relevant to a review , where data exist on the outcome of interest but only selected findings have been given based on the results . Although systematic review s have emphasized ‘ assessment of method ological quality ’ of included studies , the Cochrane h and book recommends a focus on ‘ risk of bias assessment ’ instead . The justifications are four-fold : it targets whether the results of included studies should be credible ; despite being carried out to the highest st and ards , a study may have risk of bias due to , e.g. impracticality/impossibility of blinding of participants / study personnel ; some quality markers , e.g. a power calculation is unlikely to directly affect risk of bias ; it overcomes ambiguity between quality of reporting and quality of the underlying research
There was insufficient evidence to assess the effect of bonding modality on demineralization rates .
CONCLUSIONS There is weak evidence indicating higher odds of failure with self-etch primer than acid etch over 12 months in orthodontic patients , and there is strong evidence that a self-etch primer is likely to result in a modest time savings ( 8 minutes for full bonding ) compared with acid etch
INTRODUCTION The use of self-etch primers has increased steadily because of their time savings and greater simplicity ; however , overall benefits and potential disadvantages and harms have not been assessed systematic ally .
In this study , we review ed r and omized controlled trials to assess the risk of attachment failure , bonding time , and demineralization adjacent to attachments between 1-stage ( self-etch ) and 2-stage ( acid etch ) bonding in orthodontic patients over a minimum follow-up period of 12 months .