Orthodontics research gains global recognition and shows promise for patients

Adams School of Dentistry researchers have been making strides in orthodontic research, and the work has been recognized both by peers and on a global stage. ASOD’s Laura Jacox, DMD, PhD, MS, and Kelly Mitchell, DDS, MS, successfully presented new findings from two different UNC studies at the 2024 European Orthodontic Society (EOS) meeting in Athens, Greece. Their abstracts were among the top 20% of submissions accepted for oral presentation at the prestigious event.

Mitchell’s presentation featured the work of Jay Patrick, DDS, a recent ASOD Orthodontics graduate whose master’s project studied the consequences of treating moderate crowding without tooth extractions when second molars are still erupting. The research examines whether the decision to avoid premolar extractions compromises second molar eruption, and it has garnered significant attention in the field.

“We initiated the study because it was a question I was asking myself in private practice,” Mitchell said. “I felt good about sparing patients the extractions, but often I found that it was at the expense of the second molars. It’s a commonly observed problem and a dilemma we face in orthodontics.”

In addition to the oral presentation, the study was recently published in the American Journal of Orthodontics and Dentofacial Orthopedics, the leading publication in orthodontic research. Within two weeks, the paper was highlighted in Dr. Kevin O’Brien’s well-respected orthodontic blog, a platform widely followed by professionals around the world.

Jay Patrick, DDS

“[O’Brien] selects papers that are relevant to the community, so it highlights that these findings are important to clinicians and for people making treatment decisions,” Jacox said.

Under the mentorship of Mitchell and Jacox, Patrick was recognized for his work on the study and has been nominated for the Thomas M. Graber Award of Special Merit, which honors outstanding research by orthodontic residents. The winner of the award will be announced at next year’s American Association of Orthodontists (AAO) meeting.

Jacox’s orthognathic surgical speech study was also featured at the EOS meeting in Greece, and she was subsequently invited to present this work at the prestigious Consortium for Orthodontic Advances in Science and Technology (COAST) meeting at UCLA’s Lake Arrowhead Lodge. The COAST meeting is for leading orthodontic researchers and is dedicated to accelerating the translation and utilization of novel discoveries in orthodontic health care.

Jacox’s studies follow patients undergoing jaw surgery for anatomical disproportions, who often pursue treatment due to speech disorders stemming from their abnormal orofacial anatomy. In her investigations, Dr. Jacox evaluates whether jaw surgery and orthodontics improve these patients’ articulation problems.

A potential benefit of the study relates to insurance coverage of surgery to correct severe jaw disproportions. These jaw procedures are considered cosmetic by many insurers, necessitating that oral surgeons resubmit cases numerous times with more and more documentation before some surgeries are approved. Patients are left in limbo during this lengthy process, which is stressful and time-consuming for patients and providers.

“Dr. Jacox’s data suggest that surgical correction provides benefits to patients’ speech and jaw function. What’s frustrating is that insurers use arguments that are not supported by science, asking patients to go through temporomandibular joint (TMJ) evaluations or treatment with the idea that intractable TMJ symptoms are a justification for jaw surgery, but there is not good evidence to support that,” Mitchell said. “Laura is really working on providing sound scientific evidence for the functional benefit of jaw surgery and surgical orthodontic treatment to guide patient care.” Jacox’s data evaluating speech before and after jaw surgery indicate significant improvement in consonant articulation among certain patient groups with jaw disproportions.

“I am excited by our findings, and we are expanding our work to include other craniofacial anomaly and jaw disharmony groups. My team and I hope to inform treatment recommendations and develop diagnostic tools for clinicians to use when caring for these patient populations,” Jacox said. “Our goal is to improve treatment for patients with jaw disharmonies and speech disorders.”