STATISTICS AND RESEARCH DESIGN
Statistics for orthodontists
Nikolaos Pandis, Associate Editor of Statistics and Research Design
Bern, Switzerland, and Corfu, Greece
I
n the next series of this column, I will cover key
biostatistics topics relevant to orthodontics. I will
discuss types of variables, statistical inferences,
and analytical approaches for qualitative and quantita-
tive data. The focus will be on selecting the appropriate
analysis depending on the data and objectives, and the
interpretation of the findings. Orthodontic examples
will be used throughout to help communicate the in-
formation.
When we use the term statistics, we usually mean 2
things: (1) the values (data points) we get when we mea-
sure (eg, amount of crowding) or count (eg, number of
failed brackets), and (2) the methods or the procedures
we follow to analyze the collected data, which can be
analyzed with descriptive and inferential approaches.
In most situations, analyzing data requires both
descriptive and inferential methods.
Descriptive methods describe a set of data. We use
descriptive statistics to organize, summarize, and pre-
sent data values using plots and tables.
Statistical inference uses methods of probability
theory to make inferences about a population with
data from a sample drawn from the target population.
Because it would be impossible to collect information
on the whole population of interest, we select a
random and representative sample from the popula-
tion, and we make inferences from the sample to the
population. The results from this sample are subject
to sampling variations, which means that if we did
the study again, the results would be slightly different
because of chance (random error). Statistics help us to
decide how much difference can be attributed to
chance and how much difference is the result of the
intervention or treatment. Statistical analysis is an
important part of our study; however, the methodology
is more important. Obviously, an incorrect analysis can
give the wrong results, but the data can be reanalyzed
correctly. On the contrary, it will probably be impos-
sible to repeat a study that was flawed at the design
stage.
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TYPES OF VARIABLES
Variables are the characteristics of subjects or objects
that can be either measured or placed into a category.
When the variables can take a number of different values
by chance, they are defined as random variables.
Variables are classified as either qualitative or quan-
titative. Qualitative (categorical) variables represent a
characteristic of the subjects or objects that cannot
be expressed naturally with a numeric value. Examples
of qualitative variables include sex, hair or eye color,
and type of adhesive used to bond brackets. Qualitative
variables can be defined as binary or dichotomous with
only 2 values (sex) or with more than 2 values in an or-
dered fashion (eg, pain perception after appliance
insertion, adhesive remnant index, plaque index), and
as nominal with unordered categories. Examples of
nominal variables include race (black, white, Asian),
Angle Class (Class I, Class II Division 1, Class II Division
2, Class III), and bracket type (conventional, lingual,
self-ligating).
Quantitative (numeric) variables are naturally ex-
pressed with a numeric scale; examples include age,
height, amount of dental crowding, and number of
days to complete a stage of orthodontic treatment.
Quantitative variables can also be further classified as
discrete or continuous. Discrete variables take only a
limited number of values, usually whole numbers (inte-
gers); examples are numbers of erupted permanent
teeth, bonded teeth, and quadrants in a patient's mouth.
Continuous variables take an infinite number of values,
which are usually expressed with decimals; examples are
age, height, and treatment time. Figure 1 displays a
common classification of categories of data collected
during a clinical trial.
SUMMARIZE AND DISPLAY CATEGORICAL DATA
Data displays with tables and graphs are easy and
efficient ways for describing and obtaining insight about
the available information before further statistical ana-
lyses.
Categorical variables are readily displayed in a fre-
quency table, with the counted observations in each
category tabulated. For example, the Table summarizes
the total bracket bond failures per arch and arch
405
406 Statistics and research design

Fig 1. Types of data.

Table. Distribution of failures per arch and segment

Location of failure Count (n) Percentage (%)
Maxilla 8 3.70
Mandible 11 5.09
Anterior (incisors, canines) 9 3.40
Posterior (premolars) 10 5.95

Fig 3. Bar chart showing the distributions of nonfailures

and bracket failures per arch and arch segment.

SUMMARIZING AND DISPLAYING CONTINUOUS

Fig 2. Pie chart showing the distributions of nonfailures
and bracket failures per arch and arch segment.
segment for 2 self-etching primers. This example in-
cludes 4 categories (maxilla, mandible, and anterior
and posterior segments), and the failures per category
are tabulated. The counts and percentages list the fre-
quencies and the relative frequencies (the denominator
was the total number of brackets bonded).
The pie chart (Fig 2) and the bar chart (Fig 3) are
alternative was of expressing the data in the Table.
VARIABLES
For quantitative variables, histograms can be used for
a quick visual data display. Figure 4 shows a histogram
of generated force frequencies by appliance type (labial
or lingual).
Another useful graph is the box and whiskers plot as
shown in Figure 5. On the x-axis are 2 categories, labial
and lingual appliances, and on the y-axis is the gener-
ated force. Figures 6-8 provide more information
about calculating the means, standard deviations,
medians, and 25% and 75% quartiles.1
REFERENCE
1. Kirkwood BR, Sterne JAC. Essential medical statistics. 2nd ed. Ox-
ford, United Kingdom: Blackwell; 2003. p. 14-41.

March 2015  Vol 147  Issue 3 American Journal of Orthodontics and Dentofacial Orthopedics
Statistics and research design 407

Fig 4. Force frequencies.

Fig 5. Box and whiskers plot.

Fig 6. Medians and quartiles.

American Journal of Orthodontics and Dentofacial Orthopedics March 2015  Vol 147  Issue 3
408 Statistics and research design

Fig 7. Calculating means and standard deviations.

Fig 8. Calculating medians and 25% and 75% quartiles.

March 2015  Vol 147  Issue 3 American Journal of Orthodontics and Dentofacial Orthopedics