Dear Sir, We would like to thank Prof. Linder-Aronson very much for his kind words regarding the design of our systematic review, ‘Impact of adenotonsillectomy on the dentofacial development of obstructed children: a systematic review and meta-analysis’, that was published in the European Journal of Orthodontics 2017, p. 509–518 (1). We are honoured with his comments, not only because Prof. Linder-Aronson is a specialist in this field, but also because many of the relevant articles in our review were (co-)authored by him. We agree with Prof. Linder-Aronson that the value of systematic reviews helps the reader to catch up with the present knowledge of a topic. The purpose of our review was therefore to inform readers about the current literature regarding the association between adeno- and/or tonsillectomy and dentofacial deformity in children (as stated in the introduction of our review). Subsequently, we have attempted to assess the body of evidence in order to provide a nuanced interpretation to the readers. As stated in the review (pp. 509 and 517) and emphasized by Prof. Linder-Aronson in his letter, several similar studies show consistent patterns after surgery in obstructed children. These patterns include normalization of upper and lower incisor inclination, transverse dental improvement, and normalization of the horizontal mandibular growth pattern. In the review, we were able to pool the quantitative data of the ML-SNL measurements showing horizontal catch-up growth after adeno-/tonsillectomy (p. 516). We did, however, also find considerable diversity, especially in the intra-oral orthodontic outcomes of the different studies. Great diversity was furthermore present with regard to the methods of the different studies. The studies that were included in the review were well executed and of high value. Nevertheless, the nature of this type of aetiological studies does not allow a high quality research setting and we found it necessary to mention this as well on pp. 510 and 517. In our review, we have attempted to represent and respect the current evidence on the impact of adeno-/tonsillectomy on dentofacial development in children. We do however believe that there is still more to learn and think that the full scope of this subject is not yet completely clear. That is why we have been cautious in phrasing the conclusions. We thank Prof. Linder-Aronson for his valuable comments and hope that this correspondence can contribute to clarify the conclusions of the review. Conflict of interest None declared. Reference 1. Becking , B.E. , Verweij , J.P. , Kalf-Scholte , S.M. , Valkenburg , C. , Bakker , E.W.P. and van Merkesteyn , J.P.R . ( 2017 ) Impact of adenotonsillectomy on the dentofacial development of obstructed children: a systematic review and meta-analysis . European Journal of Orthodontics , 39 , 509 – 518 . Google Scholar CrossRef Search ADS PubMed © The Author(s) 2018. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: firstname.lastname@example.org This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
The European Journal of Orthodontics – Oxford University Press
Published: Aug 1, 2018
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