Leafing through the October 2009 issue of the AJO-DO , I recognized the apparatus and illustrations in the article, “Three-dimensional orthodontic force measurements” (Badawi HM, Toogood RW, Carey JPR, Heo G, Major PW. Am J Orthod Dentofacial Orthop 2009;136:518-28). The images had been presented months ago to my orthodontic residents by the representative of a popular supplier of orthodontic materials, with the representative’s claim that “Now we have scientific proof that our bracket is superior.”
Although I am not an engineer, the apparatus seems to be elegant and innovative in design and might provide much useful information of benefit to our specialty in the future. I am positive that the equipment was quite costly, and I understand that financial support is always needed for research. What concerns me is the linkage between a supplier’s financial support and the results, which just so happen to show that the bracket system—heavily marketed by that company—are “proven” to be superior. The lead author is described as a consultant to that very company, and the orthodontic department that supported the project is noted at the end of the article as the recipient of contributions from the company for student scholarships for future research.
I am not impugning the professional competence of the orthodontists and engineers who participated in this project or the department’s motives. In an ideal world, money would play no part in experimental design or data gathering, but call me cynical—money does talk in the real world. Readers of the article could justifiably wonder whether financial support would be forthcoming from the company if the results had shown its product to be inferior. Unlike the physical sciences, where experiments are repeated to verify claims (remember cold fusion), our experiments cannot be repeated because either the equipment is closely held or the human or animal sample can never be exactly duplicated. In the biologic sciences, there is a greater need to work at arms length from industry because of the repeatability problem and to eliminate any appearance of commercial influence.
Orthodontists are not alone in expressing concern for bias in research that is too tightly linked to business. Check out the October 23, 2009, New York Times article, “Research uproar at a cancer clinic” by Duff Wilson. Also, read the November 4, 2009, New York Times article, “Health bills aim a light on doctors’ conflicts” by Natasha Singer. Or search out the numerous articles about Medtronic and its “consultant” who submitted and had published a bogus article favorable to one of Medtronic’s products in the medical literature.
Once refereed journals publish research, it becomes gospel. We must be ever alert that our precious specialty literature not be infused with advertising disguised as scientific inquiry. Claims of superiority for bracket and wire systems need to be dialed down, because there are many variables involved in tooth movement.