Attention has been focused on the position of the lower incisors in treatment planning. Determination of a stable incisor position around which to plan treatment is an important consideration. In the light of increasing use of fixed appliances in this country it is felt of value to present in detail the various methods available for planning lower incisor position. A brief appraisal of each is given and the literature relating to them discussed. It is concluded that whilst no particular method is ideal, the use of Ricketts' A—Po line in giving an indication of permitted direction of movement, tempered by a cautious approach as advocated by Mills should achieve a compromise between improved aesthetics and stability in most cases. A detailed study is required to assess more fully their practical application.
Clinical research has previously lacked good methodology and much opinion was based on anecdote which is widely regarded as the weakest form of clinical evidence. There are few randomised control trials in orthodontics which support or refute areas of dogma. The number of randomised control trials is increasing significantly. There is currently however no good evidence that orthodontics causes or cures temporomandibular joint dysfunction, that appropriate extractions in orthodontics ruin patients' profiles, or that the orthodontist is able to significantly influence facial growth with appliances.
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