Civil liability of orthodontists and aligner manufacturers in the treatment with orthodontic aligners.

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.

Civil liability of orthodontists and aligner manufacturers in the treatment with orthodontic aligners

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.

Uma alternativa simples e eficiente para correção de recidivas após 15 anos de tratamento ortodôntico ­ relato de caso / A simple and efficient alternative for the correction of relapses after 15 years of orthodontic treatment ­ case report

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)