We are in the era of "evidence based medicine" in which our knowledge is stratified from top to bottom in a hierarchy of evidence. Many in the medical and dental communities highly value randomized clinical trials as the gold standard of care and undervalue clinical reports. The aim of this editorial is to emphasize the benefits of case reports in dental and oral medicine, and encourage those of us who write and read them.
Objective: To examine changes in mandibular incisor proclination and protrusion resulting from alleviation of crowding. Materials and Methods: Records of 96 patients from a private practice treated without extractions or interproximal enamel reduction in the mandibular arch were included. Pre-and post-treatment cephalograms and models were examined to determine changes in incisor proclination, protrusion and crowding. Results: For every millimeter of crowding alleviation, increases in incisor proclination (DIMPA) and protrusion (DL1 to A-Pog) of 0.5u and 0.2 mm, respectively, were found, on average. High variability was calculated for both linear variables (that can be reduced by incorporating other variables by multilinear regression). Conclusions: For every millimeter of crowding alleviated, 0.5u of proclination and 0.2 mm of protrusion are expected. Our results indicate that proclination is mulifactorial and cannot be explained solely by the amount of crowding alleviated during orthodontic treatment. These results may be a useful guiding principle rather than a prognostic tool. (Angle Orthod. 2016;86:727-733.)
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