Can mandibles be grown?
Sir, – Jonathan Sandler should have more respect for his general practitioner colleagues (British Dental Journal2000; 189: 468). They may not have his scientific background but they probably know more than he does about the long-term effects of orthodontic treatment. He dismisses ‘growth modification with functional appliances in Class II cases’, quoting Kevin O’Brien’s recent randomized clinical trial (RCT), which failed to show much skeletal change following their use. However, one should be cautious of drawing positive conclusions from negative evidence. It would not be difficult to design an experiment that failed to show that gravity existed!It is one thing to quote an RCT study that says that the treatment hardly changed the pattern of facial growth and quite another to say that it cannot be changed. Growth modification takes time, indeed, Professor O’Brien invited me to contribute some cases to his study, not one of which is yet completed but is speed paramount?RCTs are not part
