I appreciate the opportunity to respond to Dr. Solomon’s commentary regarding my article on evidence-based orthodontics. In the structured abstract, I explained that the focus of the review was to present evidence specifically pertaining to one-phase versus two-phase treatment of Class II malocclusion, and extraction versus non-extraction treatment of arch perimeter deficiencies.
These two hotly debated clinical modalities have been discussed ad nauseam in the current peer-reviewed and refereed literature, with little attention to the most appropriate evidence. Dr. Solomon rightly argues that one should not paint with broad strokes when assessing the merits of a particular treatment approach with regard to individual treatment response.
However, as discussed in my article, the technique or treatment philosophy advanced by the clinician should be rigorously tested against the principles of efficacy and efficiency in a controlled sample. Although Dr. Solomon presents some interesting theories regarding orthodontics and jaw growth/position, I find his data leave much to be desired in the way of evidence. Dr. Solomon advances the concept of "bring[ing] a child to an orthodontic and orthopedic state of normalcy as early as possible," without presenting any evidence related to its efficacy and efficiency.
