ABSTRACT
INTRODUCTION: The use of clear aligners as an alternative to fixed orthodontic appliances has become popular due to the aesthetic demands of adult patients seeking orthodontic treatment. However, orthodontists' lack of knowledge about the legal consequences of their activities, and the lack of solid scientific evidence raise concerns regarding civil liability in this type of treatment. Marketing campaigns of manufacturing companies often exaggerate promises of results, and ignore the lack of scientific evidence. Patients, as consumers, are protected by the Consumer Protection Code, whereas orthodontists are considered treatment providers. Therefore, they can be held liable for damage caused to patients, whether by subjective or objective fault. OBJECTIVE: This article aims to identify the civil responsibilities of orthodontists and aligner manufacturing companies, by means of a literature review, providing basic legal guidance to help professionals protect themselves from possible lawsuits related to treatment with orthodontic aligners. CONCLUSIONS: The study highlights the importance of knowledge of legal notions in treatments with orthodontic aligners by orthodontists, who should legally safeguard themselves through individual written contracts, avoiding obligation of results. In addition, in cases of legal claims, it is possible that the manufacturing companies are jointly and severally liable for possible damages claimed by the patient.
Subject(s)
Orthodontic Appliances, Removable , Orthodontists , Adult , Humans , Esthetics, Dental , Orthodontic Appliances, FixedABSTRACT
ABSTRACT Introduction: The use of clear aligners as an alternative to fixed orthodontic appliances has become popular due to the aesthetic demands of adult patients seeking orthodontic treatment. However, orthodontists' lack of knowledge about the legal consequences of their activities, and the lack of solid scientific evidence raise concerns regarding civil liability in this type of treatment. Marketing campaigns of manufacturing companies often exaggerate promises of results, and ignore the lack of scientific evidence. Patients, as consumers, are protected by the Consumer Protection Code, whereas orthodontists are considered treatment providers. Therefore, they can be held liable for damage caused to patients, whether by subjective or objective fault. Objective: This article aims to identify the civil responsibilities of orthodontists and aligner manufacturing companies, by means of a literature review, providing basic legal guidance to help professionals protect themselves from possible lawsuits related to treatment with orthodontic aligners. Conclusions: The study highlights the importance of knowledge of legal notions in treatments with orthodontic aligners by orthodontists, who should legally safeguard themselves through individual written contracts, avoiding obligation of results. In addition, in cases of legal claims, it is possible that the manufacturing companies are jointly and severally liable for possible damages claimed by the patient.
RESUMO Introdução: O uso de alinhadores transparentes como alternativa aos aparelhos ortodônticos fixos tem se tornado popular, devido às demandas estéticas dos pacientes adultos em busca de tratamento ortodôntico. No entanto, a falta de conhecimento dos ortodontistas sobre as consequências jurídicas de suas atividades, e a falta de evidências científicas sólidas levantam preocupações em relação à responsabilidade civil nesse tipo de tratamento. Muitas vezes, as campanhas de marketing das empresas fabricantes exageram nas promessas de resultados e desconsideram a falta de evidências científicas. O paciente, como consumidor, é protegido pelo Código de Defesa do Consumidor, e o ortodontista é considerado um fornecedor de tratamento. Portanto, ele pode ser responsabilizado por danos causados ao paciente, seja por culpa subjetiva ou objetiva. Objetivo: Identificar, por meio de uma revisão bibliográfica, as responsabilidades civis dos ortodontistas e das empresas fabricantes de alinhadores, fornecendo orientações jurídicas básicas para ajudar os profissionais a se protegerem de possíveis demandas judiciais relacionadas ao tratamento com alinhadores ortodônticos. Conclusões: O estudo destaca a importância do conhecimento de noções jurídicas em tratamentos com alinhadores ortodônticos, devendo o profissional resguardar-se juridicamente por meio de contratos individuais por escrito, prevenindo-se de assumir uma obrigação de resultado com o paciente. Além disso, em casos de demandas judiciais, é possível que as empresas fabricantes respondam solidariamente a possíveis danos reclamados pelo paciente.
ABSTRACT
Recidivas são frequentemente observadas após o tratamento ortodôntico e, com o objetivo de evitá-las e manter a estabilidade das posições dentárias após o tratamento, o uso de contenções superiores e inferiores é indicado. Entretanto, alguns pacientes não as usam de maneira correta, causando uma perda na estabilidade da posição dentária alcançada com o tratamento ortodôntico. Devido ao fato de os pacientes estarem mais preocupados com conforto e estética e o uso de alinhadores ortodônticos ser uma ferramenta viável para pequenas correções, o objetivo deste estudo foi descrever um caso clínico de correção de recidivas 15 anos após o fim do tratamento ortodôntico. As fotografias intraorais mostraram uma relação de má oclusão de Classe I com overjet e overbite satisfatórios, rotação do dente 23, extrusão do dente 11, desgaste incisal do dente 41 e apinhamento anteroinferior. Clinicamente, a paciente apresentava contato prematuro nos dentes 11 e 41 durante o movimento de protusão mandibular. O tratamento foi realizado com 4 alinhadores superiores e 10 alinhadores inferiores. Após este set de alinhadores, foram necessários mais 6 alinhadores inferiores, 2 por refinamento. Após 5 meses, a paciente apresentava boa oclusão, com guias laterais, protrusão sem interferência, além de alinhamento e nivelamento dentários. Esse caso clínico provou que o uso de alinhadores ortodônticos é eficiente em corrigir pequenas recidivas de tratamento ortodôntico.(AU)
Recurrences are frequently observed after orthodontics treatment, and in order to avoid them and keep the stability of dental positions after treatment, the use of maxillary and mandibular retainers are indicated. However, some patients do not use them properly causing the break of stability position obtained with the orthodontic treatment. As patients are more concerned with confort and esthetic and the use of clear aligners is a viable tool for small corrections, the aim of this study was to describe a case of relapse correction wich occurred after 15 years of orthodontic treatment with the use of clear aligners. The intraoral photographs showed a Class I maloclusion with satisfactory overjet and overbite, rotation of 23, extrusion of 11, incisal waste of 41, and mandibular anterior crowding, Clinically, the patient had premature contact with teeth 11 and 41 during protrusion movement. The entire treatment was done with 4 maxillary aligners and 10 mandibular aligners. After this set of aligners, it was necessary other 6 mandibular aligners, 2 per refinements. After 5 months, the patient presented good oclusion, with lateral guides, protrusion with no interferences, the teeth were aligned and leveled. This case report proved that clear aligners are efficient in correcting relapses.(AU)
Subject(s)
Humans , Female , Adult , Orthodontic Appliances, Removable , Recurrence , Orthodontic RetainersABSTRACT
Aim: Facial orthopaedic treatments based on the stimulation or restrictions of craniofacial bone growth are more effective when carried out during the pubertal growth spurt. The aim of this cross-sectional study was to evaluate the reproducibility of two cervical vertebrae methods (CVM) with manual tracing and direct visual inspection. Methods: A sample of 60 lateral cephalometric radiographs (10 of each of the 6 CVM stages) was randomly selected from 171 records. 5 orthodontists classified these radiographs according to the skeletal maturation stage in 2002 and 2005, and the application of both methods was conducted by direct visual inspection and evaluation through manual tracing. Results: The average reliability of the two methods determination and the two forms of evaluation was substantial. The direct visual inspection evaluation showed the highest reliability and agreement interexaminer values for both methods, as well as the intraexaminers evaluation. Conclusion: The reproducibility of CVM method was substantial, indicating its clinical use to determine the skeletal maturity and the ideal moment for treatment execution
Subject(s)
Bone Development , Cervical Vertebrae , Reproducibility of ResultsABSTRACT
A disseminação do Sars-CoV-2, agenteetiológicoda COVID-19, se tornou um problema de saúde pública de importância internacional. Dentre as medidas para conter seu espraiamento, está asuspensão das aulas em instituições de ensino.Assim, esta revisão integrativa objetiva apresentar um panorama sobre o impacto da pandemia no ensino da Odontologia nas instituições brasileiras.Foram realizadas buscas nas bases de dados Medline, LILACS e SciELO, utilizando-se descritores nas línguas inglesa e portuguesa. Foram recuperados 60 estudos, sendo 17 elegíveis para leitura integral. Destes, 4 estudos atenderam aos critérios de inclusão e exclusão. Observou-se que o modelo de Ensino Remoto Emergencial (ERE) por meio de ferramentas digitaisfoi a estratégia de ensino não presencial mais utilizada nas instituições brasileiras. O ERE permitiu que o impacto da pandemia de COVID-19 fosse sentido de maneira mais branda pela comunidade acadêmica brasileira, engajando alunos e diminuindo a ansiedade de alunos e professores. Por outro lado, a infraestrutura tecnológica deficiente no Brasil contribuiu para a dificuldade em substituir as atividades clínicas. Fato ainda exacerbado pela dificuldade de adequação da infraestrutura física das instituições durante o planejamento de retorno às atividades presenciais. Apesar de todas as estratégias de superação, desempenhadas pelas instituições brasileiras de ensino odontológico, estas não foram refletidas em literatura científica nas bases de dados indexadas.Assim, enfatiza-se a necessidade de trabalhos sobre esta temática, para que seja possível disseminar as experiências vividas durante o período pandêmico (AU).
The spread of SARS-CoV-2, the etiological agent of COVID-19, has become a public health problem of international importance. Among the measures to curb its spread is the suspension of classes in educational institutions. Thus, this integrative review aims to provide an overview of the impact of the pandemic on dentistry education in Brazilian institutions. The Medline, LILACS and SciELO databases were searched using descriptors in English and Portuguese.A total of 60 studies were retrieved, with17eligible for full reading. Of these, 4 studies met the inclusion and exclusion criteria. It was observed that the emergency remote education (ERE) model through digital tools was the most used remoteteaching strategy in Brazilian institutions. ERE allowed the impact of the COVID-19 pandemic to be felt more mildly by the Brazilian academic community, better engaging students and reducing the anxiety of students and teachers. On the other hand, the deficient technological infrastructure in Brazil contributed to difficulty inreplacing clinical activities. This fact is further exacerbated by the difficulty of adapting the physical infrastructure of the institutions whenplanning to returnto in-personactivities. Despite numerousstrategies employedby Brazilian dental education institutions, theywere not reflected in the scientific literature in the indexed databases.Thus, there is aneed for studies on this topic so that it is possible to disseminate the experiences lived during the pandemic period (AU).
