Consideraciones normativas y legales del expediente clínico electrónico en odontología / Normative and legal considerations of the electronic clinical record in odontology

La elaboración del expediente clínico es una actividad rutinaria dentro del consultorio dental, éste es la materialización del acto médico, a tra- vés del cual se registra el estado de salud inicial del paciente, así como toda la información relativa al tratamiento recibido. Desde hace algunos años comenzó a promocionarse el expediente clínico electrónico como una herramienta alternativa y novedosa para elaborar este importante documento; sin embargo, la implementación de esta herramienta electrónica no ha podido lograrse en México, dada la gran cantidad de dudas que los odontólogos tienen respecto al conjunto de leyes y normas que regulan al expediente clínico, lo cual genera renuencia por parte de los odontólogos para utilizar esta modalidad de expediente dentro de su consulta diaria. El objetivo del presente artículo es realizar una revisión de la literatura, así como de las leyes y normas vigentes que regulan el expediente clínico en México para esclarecer así la viabilidad de implementarlo dentro del consultorio dental

The preparation of the electronic medical record is a routine activity in the dental office, this is the materialization of the medical act, through which the initial health status of the patient is recorded, as well as all the information related to the received treatment. A few years ago, the electronic clinical record began to be promoted as a novel alternative tool to prepare this important document, however, the implementation of this electronic tool has not been achieved in Mexico, given the large number of doubts that dentists have regarding the set of laws thar regulate the clinical record, which generates reluctance on the part of dentists to use this record modality within their daily consultation. The aim of this article is to carry out a review of the literature, as well as the current laws that regulate the clinical record in Mexico, in order to clarify the feasibility of implementing it within the dental office

Conocimiento sobre odontología legal y la normativa sanitaria por parte de los odontólogos y estomatólogos de la Comunidad Valenciana / Knowledge of legal dentistry and of health regulations by the Dentists and Stomatologists of the Valencian Community

Objetivos: el objetivo principal de este estudio es analizar los conocimientos que poseen los odontólogos y los estomatólogos colegiados en Alicante, Castellón y Valencia, las 3 provincias que conforman la Comunidad Valenciana, acerca de odontología legal y sobre la legislación y normativa sanitaria actual, e intentar cuantificar la relación entre el nivel de formación, la especialidad, la experiencia laboral, el lugar y la figura en el trabajo con el grado de conocimiento.Material y métodosse diseñó y validó una encuesta anónima, de 33 preguntas tipo test. Esta encuesta incluía cuestiones sobre el perfil profesional y preguntas clave acerca del derecho dental actual, ciencias forenses y peritación.Resultadosel nivel de conocimiento es moderado, con solo el 63% de las preguntas respondidas correctamente. Ni el nivel de formación ni la experiencia laboral se correlacionan significativamente con el grado de conocimiento. Los dentistas especializados en odontología general y estética resultaron ser más conocedores de cuestiones éticas. Con respecto al lugar de trabajo, los docentes universitarios tienden a diferenciarse del resto de profesionales en cuanto a los conocimientos legales y éticos, mientras que el perfil de autónomo y empleado muestra un nivel de conocimientos inferior que el resto de la muestra.Conclusioneslas conclusiones obtenidas de este estudio ponen de relieve la necesidad que tienen los dentistas de completar y actualizar sus conocimientos en materia legislativa sanitaria actual y en odontología legal, pues un buen conocimiento significa una garantía para evitar posibles problemas legales, lo que no solo supone una mejor defensa del odontólogo, sino una garantía para la adecuada atención al paciente. (AU)

Objectives: The main objective of this study is to analyze the knowledge of the dentists and stomatologists registered in Alicante, Castellón and Valencia, the three provinces that make up the Valencian Community, in Spain, with regard to legal dentistry and the current health legislation and regulations, and to quantify the relationship between level of training, specialization, work experience, position and workplace with the degree of knowledge.Material and methodsAn anonymous survey was designed and validated, consisting of thirty-three multiple-choice questions. The survey included questions regarding their professional profile and key questions regarding current dental law, forensic science and expertise.ResultsThe level of knowledge is moderate, with only 63% of the questions answered correctly. Neither their level of training nor work experience correlates significantly with their degree of knowledge. Dentists specialized in General and Aesthetics Dentistry were found to be more knowledgeable about ethical issues. Regarding the workplace, those working as university teachers tended to stand out from the other professionals in terms of legal and ethical knowledge whilst self-employed and employee dentists show a lower level of knowledge than the rest of the sample.ConclusionsThe conclusions obtained from this study highlight the need for dentists to complete and update their knowledge of legal dentistry and current health legislation, as having proper knowledge is a means of avoiding possible legal problems, which not only means better legal protection for the dentist but is also a means of guaranteeing adequate patient care. (AU)

La seguridad social: Un derecho y una obligación para el odontólogo y sus trabajadores / Social security: A right and obligation for the dentist and his workers

La seguridad social es un derecho encaminado a asegurar el bienestar de los ciudadanos que forman parte de una comunidad, y su objetivo principal es brindar a las personas aseguradas un conjunto de medidas públicas que ayuden a la protección de su salud por accidentes de trabajo o enfermedad laboral, desempleo, invalidez, vejez o muerte. De acuerdo con nuestra legislación, toda persona que preste servicios laborales a otro, tiene derecho a ser registrado ante el seguro social para que, en caso de accidente o enfermedad laboral, exista una ins- tancia que asista al trabajador afectado a recuperar su salud sin afectar su economía familiar. Es bastante frecuente que el odontólogo tenga trabajadores a su cargo, quien al fungir como patrón tiene obligaciones específicas ante el Instituto de Seguridad Social que de no cumplir, puede traer consigo sanciones y amonestaciones al profesional. El objetivo del presente artículo es informar al odontólogo sus derechos y obligaciones ante el seguro social mediante una revisión de las normas y leyes que lo imponen (AU)

Social security is a right aimed at ensuring the well-being of citizens who are part of community, and its main objective is to provide insured persons with a set of public measures that help protect their health, due to accidents at work and occupational disease, unemployment, disability, old age or death. In accordance with our legislation, any person who provides labor services to another has the right to registered with the social security so that, in the event of an accident or occupational disease, there is an instance that assists the affecter worker to recover his health without affecting his familiar economy. It is quite common for the dentist to have workers under his charge, who, acting as an employer, have specific obligations with the Social Security Institute, which, if not fulfilled, can bring sanctions and reprimands to the professional. The aim of this article is to inform dentists about their rights and obligations with the Social Security Institute through a review of the laws that impose it (AU)

Conocimiento sobre deberes y obligaciones que rigen la práctica odontológica en el Paraguay

RESUMEN La atención odontológica requiere del cumplimiento de todas las normas legales referente al protocolo de atención, ya que tanto el profesional como el paciente deben estar protegidos previendo cualquier conflicto que pudiera surgir. El objetivo de este trabajo fue evaluar el nivel de conocimiento sobre deberes y obligaciones en la práctica odontológica en el Paraguay. El estudio fue observacional descriptivo de corte transversal, con una muestra total de 100 odontólogos del Hospital Central de Policía Rigoberto Caballero. El cuestionario constó de 20 preguntas de las cuales 4 fueron sobre características sociodemográficas y académicas, 13 preguntas de conocimiento sobre deberes y obligaciones en la práctica odontológica, 1 sobre capacitación recibida en legislación, 1 sobre cumplimiento de obligaciones tributarias y 1 sobre barreras de protección usadas contra rayos X. El nivel de conocimiento fue clasificado teniendo en cuenta el porcentaje de respuestas correctas: insuficiente (<60%) y suficiente (≥60%). Ochenta por ciento de los encuestados fueron del sexo femenino con edad promedio de 40 años. El nivel de conocimiento general sobre deberes y obligaciones que rigen la práctica odontológica fue suficiente en el 71% de los odontólogos encuestados. No se encontraron diferencias significativas entre el nivel de conocimiento según la universidad (p=0,21) y año de egreso (p=0,34). El nivel de conocimiento sobre deberes y obligaciones que rigen la práctica odontológica en el Paraguay fue suficiente, sin embargo, algunos aspectos específicos como conocimiento tributario, documentaciones que rigen las leyes, recibo de comisiones y notificaciones de enfermedades transmisibles deben ser todavía más explorados, estudiados y difundidos.

ABSTRACT Dental care requires compliance with all legal regulations regarding the care protocol, since both the professional and the patient must be protected anticipating any conflict that may arise. The objective of this study was to evaluate the level of knowledge about duties and obligations in dental practice in Paraguay. The study was descriptive, cross-sectional, observational, with a total sample of 100 dentists from the Rigoberto Caballero Central Police Hospital. The questionnaire had 20 questions of which 4 were about knowledge on sociodemographic and academic characteristics, 13 on duties and obligations in dental practice, 1 on training received on legislation, 1 on compliance with tax obligations and 1 on barriers used for protection againts X-ray. The level of knowledge was classified considering the percentage of correct answers: insufficient (<60%) and sufficient (≥60%). Eighty percent of those surveyed were female with an average age of 40 years. The level of general knowledge about duties and obligations that govern dental practice was sufficient in 71% of the surveyed dentists. No significant differences were found between the level of knowledge according to university (p = 0.21) and year of graduation (p = 0.34). The level of knowledge about duties and obligations that govern dental practice in Paraguay was sufficient, however, some specific aspects such as tax knowledge, documentations that govern the laws, receipt of commissions and notifications of communicable diseases must be even more explored, studied and disseminated.

Aspectos legales del consentimiento informado en odontología / Legal aspects of informed consent in dentistry

El consentimiento informado forma parte de los elementos que constituyen el expediente clínico. Por su importancia informativa sobre posibles riesgos y complicaciones inherentes al tratamiento a realizar, su elaboración resulta de vital importancia. Existen numerosas legislaciones y normatividades que regulan este notable documento; sin embargo, resulta alarmante que muchos profesionistas omiten su realización o lo elaboran erróneamente, poniéndolos en riesgo de sufrir problemas legales. Además, es una realidad que el consentimiento informado es un documento mal entendido por la mayoría de los profesionistas, pudiendo incurrir en numerosos errores por desconocimiento. El objetivo del presente artículo es informar al cirujano dentista sobre los verdaderos alcances del consentimiento informado con fundamento en la legislación vigente en México (AU)

Informed consent is part of the elements that make up the clinical record. Due to its informative importance on possible risks and complications inherent to the treatment to be carried out, its preparation is of vital importance. There are numerous laws and regulations that regulate this remarkable document, however, it is alarming that many professionals omit its elaboration or wrongly elaborate it, putting them at risk of suffering legal problems. In addition, it is a reality that informed consent is a document misunderstood by most professionals, and may incur numerous errors due to ignorance. The aim of this article is to inform the dental surgeon about the true scope of informed consent based on current legislation in Mexico (AU)

La importancia de la formación del odontólogo para actuar en el rol de perito / The importance of the dentist´s training to perform the forensic expert role

Este artículo está dirigido a aquellos profesionales odontólogos que tengan inquietudes en el aspecto legal de nuestra profesión. El trabajo principal del odontólogo es restaurar la salud bucal y la función de la cavidad oral. Sin embargo, los profesionales dentales también pueden participar en actividades médicas legales como odontólogos forenses o ser testigos expertos para testificar en casos de responsabilidad profesional, accidentes automovilísticos y lesiones relacionadas con el trabajo. Se puede desarrollar esta actividad siendo perito de parte en forma privada o como perito judicial siendo auxiliar de justicia. Para ello es muy importante la capacitación del profesional, que brinda las herramientas para un desempeño ético y competente en la confección de informes periciales, que permiten al juez emitir un dictamen (AU)

This article is aimed to those dental professionals who have concerns about the legal aspect of our profession. The main job of the dentist is to restore oral health and function of the oral cavity. However, dental professionals may also participate in legal medical activities such as forensic dentists or be expert witnesses to testify in cases of professional liability, car accidents, and work-related injuries. You can develop this activity as a Private Auxiliar or as a Judicial Expert as an Assistant to the Justice. Therefore, the training of the professional turns into very important tool, which provides the experience for an ethical and competent performance in the preparation of expert reports, which allow the judge to issue an opinion (AU)

Análise da evolução do preenchimento de prontuários clínicos institucionais com a implantação de uma gestão de risco / Evolution analysis of institutional clinical record filling after the implementation of risk management

Este estudodocumental, longitudinal e quantitativo foi realizado com o objetivo de avaliar a evolução documental dos prontuários clínicos institucionais após a implantação da gestão de risco. No ano de 2017, o Grupo de Estudos de Orientação Profissional e OdontologiaLegal (GEOPOL), da Universidade Estadual de Maringá (UEM) com o intuito de melhorar a produção documental e reduzir riscos. A presente pesquisa considerou 660 prontuários analisados pelo GEOPOL (Análise 1)no período de março de 2017 aabril de 2018. Entre maio e setembro de 2018,foram avaliados 422 prontuários(Análise 2), após a implantação da gestão de risco. Ambas as análises tiveram por base um check-listexclusivo, desenvolvido pelo GEOPOL para esta finalidade. Os dados foram processados em planilhas eletrônicas e os resultados foram apresentados de modo descritivo e analítico. Os resultados demonstraram que,no geral, as variáveis apresentaram um preenchimento melhor na Análise 2, demonstrando eficácia nos processos de gestão doGEOPOL. Conclui-se que houve evolução nopreenchimento documental dos prontuários clínicos após a implantação da gestão de risco (AU).

This documentary, longitudinal and quantitative study was carried out in order to evaluate the documentary evolution institutional clinical records after the implementation of risk management. In 2017, Legal Dentistry and Professional Orientation Study Group (GEOPOL), from State University of Maringá (UEM) in order to improve document production and reduce risks. The present study considered 660 records analyzed by GEOPOL (Analysis 1) from March 2017 to April 2018. Between May and September 2018, 422 records were evaluated (Analysis 2), after the implementation of risk management. Both analyzes were based on an exclusive checklist, developed by GEOPOL for this purpose. Data were processed in electronic spreadsheets and results were presented in a descriptive and analytical way. The results showed that, in general, the variables presented a better filling in Analysis 2,demonstrating effectiveness in GEOPOL management processes. It was concluded that there was an evolution in documentary filling of clinical records after the implementation of risk management (AU).

Legal and Ethical Knowledge Applied to Implantodontics / Conhecimento Legal e Ético Aplicado à Implantodontia

Knowing the large demand for treatments with implants and prostheses over implants and the lawsuits that involve these procedures, the aim of this study was to verify the knowledge of dental surgeons who perform dental implants about professional responsibility. The sample comprised 62 dental surgeons who perform dental implants in their practice and agreed to attend this research. All participants signed a Consent Form, were interviewed and answered a questionnaire applied individually. The validated questionnaire was divided into five sections: professional profile, professional conduct and procedural issue, structure of the workplace, ethical and legal issues, dental documentation. About 76% of professionals interviewed were male, 93,5% cited the Brazilian Dentistry Code of Ethics, 82,3% reported that offer more than one treatment option, 79% of the professionals were not responding or had not responded to a civil / criminal / ethical lawsuit or had a complaint in Consumer Protection and Defense Program (PROCON), 64.5% performed the surgical guide for certain cases, 58% had medical records and informed consent for all patients, 80.6% had appropriate practices and structures for patient care. Most of the study professionals act according to the ethical and legal aspects of professional responsibility, but there is a lack of knowledge of current legislation and need to be aware of the documentation of medical records, terms and contracts. (AU)

Sabendo da grande demanda por tratamentos com implantes e próteses sobre implantes e ainda, as ações na justiça que envolvem esses procedimentos, o objetivo deste estudo foi verificar o conhecimento dos profissionais que atuam com implantes na região Noroeste do Paraná, sobre o tema responsabilidade profissional. A amostra foi constituída por 62 profissionais que realizam implantes e aceitaram participar da pesquisa. Os participantes assinaram um termo de consentimento livre e esclarecido e responderam a um questionário validado aplicado individualmente em forma de entrevista. O questionário continha questões divididas em cinco variáveis: perfil profissional; conduta profissional e experiência processual; estrutura do local de trabalho; aspectos éticos e legais; e documentação odontológica. Estas foram divididas por categorias. O perfil profissional evidenciou que 76% dos entrevistados eram do sexo masculino, 93,5% citou o Código de Ética Odontológico na legislação aplicada, 82,3% relataram propor mais de uma opção de tratamento ao paciente, 79% dos profissionais não estavam respondendo ou não havia respondido algum processo cível/criminal/ético ou tiveram reclamação no Programa de Proteção e Defesa do Consumidor (PROCON), 64,5% realizavam o guia cirúrgico para determinados casos, 58% possuíam prontuário e termo de consentimento para todos os pacientes, 80,6% apresentavam consultórios e estruturas adequadas para o atendimento ao paciente. A maioria dos profissionais do estudo atua de acordo com os aspectos éticos e legais de responsabilidade profissional, porém existe desconhecimento da legislação vigente e precisam atentar-se quanto à documentação de prontuários, termos e contratos. (AU)

Odontologia legal: avaliação dos currículos dos cursos de graduação das faculdades de Minas Gerais / Forensic dentistry: curriculum evaluation of the graduation courses from Minas Gerais Universities

Introdução: O ensino da disciplina de Odontologia Legal nos cursos de graduação em Odontologia é extremamente importante na formação acadêmica. Por isso, em 2014, a Associação Brasileira de Odontologia Legal (ABOL) criou diretrizes de apoio ao ensino da disciplina no Brasil, orientando as Instituições de Ensino Superior (IES) a conduzir esta ciência nas grades curriculares. Objetivo: Esta pesquisa visou descrever como a disciplina de Odontologia Legal está sendo ofertada, nas IES do Estado de Minas Gerais, a fim de verificar se as diretrizes da ABOL estão sendo implementadas. Metodologia: Estudo descritivo de análise documental, realizado no ano de 2018. Para coleta de dados, acessaram-se os sites de todas IES de MG na busca dos documentos: projeto político pedagógico, matriz curricular e ementário. A partir desses documentos, identificaram-se quantas disciplinas da área de Odontologia Legal são ofertadas, o período de oferta das disciplinas, a carga horária, o momento do curso em que é ofertada e a nomenclatura das disciplinas. Resultados: No total, 33 (100%) IES ofertam disciplinas da área de Odontologia Legal em seu currículo. Dessas, apenas duas (6,2%) instituições ofertam disciplinas em momentos distintos, priorizando a disciplina de Ética antes das práticas clínicas e a disciplina de Odontologia Legal no final da graduação. Com relação à carga horária mínima, 11 (33,33%) instituições ofertam a disciplina com 60 horas. Conclusão: A maioria das IES de MG ainda não adequou seus currículos as diretrizes sugeridas pela ABOL.

Introduction: The teaching of Legal Dentistry is extremely important in academic training. That is why, in 2014, the Brazilian Association of Legal Dentistry (ABOL) created guidelines to support the instruction of this subject in Brazil, orienting the Higher Education Institutions (IES) to conduct this science in curricular grades. Objective: This research aimed to describe how the discipline of Legal Dentistry is being offered at the IES of the State of Minas Gerais, in order to verify if the ABOL guidelines are being implemented. Methodology: Descriptive study of documentary analysis, accomplished in the year of 2018. For the collection of data, all the MG's IES websites were accessed in the searching for the following documents: political pedagogical project, curriculum and the course syllabus. From these documents, it was identified how many subject in the Legal Dentistry area were offered and the name that they hold. Results: In total, 33 (100%) IES offer subjects in the Legal Dentistry area in their curriculum. Between those, only two (6,2%) institutions offer the subject in distinct moments, prioritizing Ethics as a subject before the clinical practices and Legal Dentistry at the end of the course. Concerning the minimum workload, 11 (33,33%) of the institutions offer 60 hours. Conclusion: Most of the MG's IES have not yet adjusted their curriculum to the ABOL's suggested guidelines.

Deoxyribonucleic Acid Extraction and Quantification from Human Saliva Deposited on Foods with Bitemarks.

AIM: The aim of this study is to evaluate the potential of deoxyribonucleic acid (DNA) recovery from bite marks in foods, in different collection types, from DNA quantification. MATERIALS AND METHODS: The sample consisted of 80 swabs, obtained from 20 cheese pieces, bitten by the same person, using the double-swab technique in the center and the periphery of the bite. A statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS) statistical software version 20.0, with values of p < 0.05 being considered statistically significant. RESULTS: The DNA was recovered in all cheese pieces, regardless of the collection types and the bite region. However, the comparative analysis of DNA recovery potential in the four swabs allowed us to infer that the collections in the central region of the bite (DC and WC) were the ones that presented better precision, in addition to extracting a higher DNA concentration, the dry swab being in the center of the bite which presented better results. CONCLUSION: The results proved the effectiveness of the double-swab technique for collecting genetic materials in bite marks; however, in the food used, a single collection at the center of the bite would be enough, optimizing the resources and time needed for the analysis. CLINICAL SIGNIFICANCE: Due to the difficulties of physically comparing a site of a skin lesion and the dental arches of the suspect, the evidence of DNA in saliva has been used to indicate the perpetrator of the bite. In addition, the collection, preservation, and isolation of saliva DNA can be done at low cost and provide flexibility for clinical and laboratory workflow.

Dental and medical advertising: comparative analysis of the rules of professional conduct / Publicidade odontológica e médica: análise comparativa das normas profissionais

ABSTRACT In health care professional activities, advertising is an issue that raises serious discussions and is the cause of some ethical suits in professional entities, since every advertising should follow the provisions of the Code of Professional Responsibility. Therefore, this research study aimed at analyzing, comparing and discussing articles related to advertising and marketing, considering the current regulations from dental and medical entities. In Dentistry, this subject is ruled by the Code of Professional Conduct, Chapter XVI, 'From advertising and marketing'. In Medicine, information is found in two regulations and in several chapters of the Code of Medical Ethics and in Resolution No. 1.974/2011 of the Federal Council of Medicine, which establishes the guiding criteria for medical advertising. The three regulations present articles that refers to participation in mass media, required information in advertisements, use of sensationalism and self-promotion, and publishing of unproven specialties and titles, highlighting the importance of these topics. The medical regulation also includes participation in publishing ads of manufacturing companies and an exclusive committee to deal with advertising and marketing issues, topics that are not considered in the dental regulation.

RESUMO Analisar, comparar e discutir os artigos relacionados ao tópico sobre propaganda e publicidade nas legislações vigentes e emanadas das classes odontológica e médica, a partir da consulta a essas legislações. Na Odontologia, este assunto é regido pelo Código de Ética Odontológica, no Capítulo XVI, "Do anúncio, da propaganda e da publicidade". Na Medicina, encontram-se informações em duas legislações sobre o tema, em diversos capítulos do Código de Ética Médica e na Resolução nº 1.974/2011 do Conselho Federal de Medicina, que estabelece os critérios norteadores da propaganda médica. As três legislações apresentam artigos que dizem respeito à participação em meios de comunicação em massa, informações mínimas presentes em anúncios, utilização de sensacionalismo e autopromoção e anúncio de especialidades e títulos não comprovados, destacando a importância desses tópicos. A legislação médica traz, também, da participação em anúncios de empresas comerciais relacionadas à sua profissão e sobre uma comissão exclusiva para tratar de assuntos de divulgação, tópicos desconsiderados na legislação odontológica.

Evaluation of the mandibular notch angle in three-dimensional virtual models as a parameter for determining age and sexual dimorphism / Avaliação do ângulo da incisura mandibular em modelos virtuais tridimensionais como parâmetro para estimativa de idade e dimorfismo sexual

Objective: The objective of this study was to analyze the opening of the mandibular notch angle (MNA) as a possible tool for predicting sex and estimating age so as to contribute to forensic anthropological studies. Material and Methods: For this, 60 cone beam computed tomographs (CBCT) belonging to the UNESP ICT Radiology archive, were selected: 5 female and 5 male for each decade of life, beginning on twenties until there seventies, totalizing 30 female and 30 male. Three-dimensional models were generated for each exam and measurements were performed with three-dimensional angular measuring tools using OnDemand 3D software (Cybermed Inc., Tustin, CA, USA) on the MNA. The MNA was measured considering the posteriormost portion of the coronoid process, the lowest point of the mandibular notch, and the anteriormost point of the condylar process of the mandible. The MannWhitney test was performed with the intention of establishing the possible comparative relationships between the values of angular measurements and sex. Results: No statistically significant differences were found between mandibular incision measurements in both sexes, as well as when comparing the angular measurements of the mandibular incisions and the different age groups studied, when a Kruskall-Wallis test was performed. Conclusion: It was concluded that the structure being evaluated did not appear to be an instrument capable of contributing to forensic anthropology evaluations. (Au)

Objetivo: O objetivo deste estudo foi analisar o ângulo de abertura da incisura mandibular (AIM) como uma possível ferramenta para predição sexual e estimativa de idade, de modo a contribuir com estudos antropológicos forenses. Materiais e Métodos: Para tanto, foram selecionadas 60 tomografias computadorizadas de feixe cônico (TCFC) pertencentes ao arquivo de Radiologia das ICT/UNESP: 30 do sexo feminino e 30 do sexo masculino, contendo 5 exames para cada sexo na 2ª, 3ª, 4ª, 5ª, 6ª e 7ª décadas de vida. Foram gerados modelos tridimensionais para cada exame e as medições foram realizadas com ferramentas de medição angular tridimensionais usando o software OnDemand 3D (Cybermed Inc., Tustin, CA, EUA) nos AIMs. O AIM foi medido considerando a porção mais posterior do processo coronoide, o ponto mais baixo da incisura mandibular, e o ponto mais anterior do processo condilar da mandíbula. O teste de Mann-Whitney foi realizado com o intuito de estabelecer as possíveis relações comparativas entre os valores das medidas angulares e sexo, que não foram encontradas diferenças estatisticamente significantes entre as medidas de incisão mandibular em ambos os sexos, assim como quando comparamos as medidas angulares da incisões mandibulares e as diferentes faixas etárias estudadas, foi realizado o teste de Kruskall-Wallis. Resultados: Em relação à reprodutibilidade das medidas, verificou-se que houve reprodutibilidade entre as medidas repetidas. Conclusão: Concluiu-se que a estrutura avaliada não parece ser um instrumento capaz de contribuir para as avaliações antropológicas forenses. (AU)

Roles y responsabilidades del odontólogo como auxiliar de la justicia / Dentists´ roles and responsibilities as auxiliaries to justice

La ciencia odontológica cuenta con diversas metodologías a la hora de brindar auxilio a la Justicia, tanto en la resolución de casos criminales como en procedimientos de índole civil y laboral. La odontología legal requiere de un trabajo interdisciplinario con las otrasespecialidades odontológicas. En ese contexto, el rol capital del perito odontólogo es contribuir al esclarecimiento de la identidad de unapersona. El diente es susceptible de variantes fisiológicas y patológicas en sus estructuras, como así también estigmas inherentes a los tratamientos restauradores, hechos que confiere información dental que individualiza a una persona. Las piezas dentarias pueden ser utilizadas como un arma en determinadas circunstancias, brindando información relevante sobre los caracteres odontológicos de la víctimay/o del agresor, pudiendo entonces desempeñar la odontología legal un importante rol en la investigación de situaciones de agresión sexual yabuso en todas las edades. El odontólogo en su tarea asistencial tiene la responsabilidad de labrar y documentar de manera fiel y completasu devenir profesional, pudiendo ser requerido por las autoridades encargadas de administrar Justicia en casos de responsabilidad profesional, negligencia, fraude, abuso, e identificación de restos humanos.

Dental science has various methodologies when providing aid to justice, both in solving criminal cases and civil procedures and labor issues.Legal Dentistry requires interdisciplinary work with other dental specialties. In this context, the principal role of the dentist expert is helpclarify the identity of a person. The tooth is subject to physiological and pathological variations in their structures, as well as inherentstigmas restorative treatments, facts which confers dental individualized information to a person. The teeth can be used as a weapon incertain circumstances, providing relevant information about dental characteristics of the victim and/or perpetrator can then LegalDentistry play an important role in investigating cases of sexual assault and abuse in all the ages. The dentist in their care task isresponsible for faithfully document and complete their professional procedure that may be required by the authorities responsible foradministering justice in cases of professional liability, negligence, fraud, abuse, and identification of human remains.

Importância pericial dos sistemas de notação dental – revisão de literatura / Forensic importance of the dental notation systems – a review

Em algumas circunstâncias, o conhecimento de sistemas de notação dentais utilizados internacionalmente pode ser importante para a avaliação dos documentos odontológicos apresentados. O objetivo desse trabalho é revisar a literatura, exemplificando e descrevendo os principais sistemas,permitindo a sua identificação e compreensão. Com as informações apresentadas será possível atranscrição de prontuários que utilizem sistemas diferentes dos encontrados no Brasil. Devido àsemelhança entre os sistemas e sua utilização restrita aos profissionais da odontologia, recomenda-seque sempre seja avaliado o sistema presente nas documentações como etapa inicial. Também deve serdescrita, de maneira objetiva, qual a notação dental utilizada em laudos e pareceres.

In some circumstances, the knowledge of dental numbering that are in use internationally maybe useful when analyzing dental charts presented. The objective of this study is to review theliterature, to give examples and to describe the main numbering systems, allowing itsidentification and comprehension when necessary. With this information it will be possible toread and transcribe the dental records that present other numbering system than the onesfound in Brazil. Due to similarity between systems, and it’s restrict use by dental professionals, itis recommended that one always analyze the notation system as a first step. In addition, thesystem is in use should be clearly described, when writing forensic reports.

Responsabilidad Civil del Cirujano-Dentista: Análisis de las Demandas Presentadas en el Municipio de Ribeirão Preto-São Paulo, Brasil / Civil Liability of Dental Surgeon: Legal Proceedings Analysis in the City of Ribeirao Preto, São Paulo State, Brazil

El objetivo del trabajo fue realizar una revisión de los procesos judiciales que involucran demandas de responsabilidad civil interpuestas contra cirujanos-dentistas en el Forum de Ribeirão Preto, Estado de São Paulo, Brasil. Fue realizada una búsqueda nominalde profesionales y clínicas, debidamente inscritos en el Consejo Regional de Odontología de São Paulo, involucrados en procesos civiles en el municipio de Ribeirão Preto - São Paulo. Como resultado fue observado un significativo aumento (73,3%) en el número de demandas presentadas en los últimos cinco años, siendo la especialidad de prótesis dental (35,6%) la más involucrada. Se puede concluir que es importante el conocimiento por parte del profesional en cuanto al aumento de divergencias en la relación profesional/paciente y algunas medidas son necesariaspara su prevención, para que los cirujanos-dentistas busquen una práctica profesional más segura.

The objective of this study was to conduct a review of the legal proceedings involving liability lawsuits filed against dentists in Ribeirão Preto, São Paulo, Brazil. A search was carried out of professionals duly registered with the Regional Council of Dentistry of São Paulo seeking professionals and clinics involved in civil proceedings in Ribeirão Preto - São Paulo. The results noted a significant increase (73.3%) in the number of lawsuits filed in the last five years, with the specialty in dental prostheses (35.6%) being the most frequent. It can be concluded that it is important for professionals to have information in reference to the increasing number of lawsuits in professional/patient relationship and that prevention measures are necessary for a safer dental practice.

Minimally legally invasive dentistry.

One disadvantage of the rapid advances in modern dentistry is that treatment options have never been more varied or confusing. Compounded by a more educated population greatly assisted by online information in an increasingly litigious society, a major concern in recent times is increased litigation against health practitioners. The manner in which courts handle disputes is ambiguous and what is considered fair or just may not be reflected in the judicial process. Although legal decisions in Australia follow a doctrine of precedent, the law is not static and is often reflected by community sentiment. In medical litigation, this has seen the rejection of the Bolam principle with a preference towards greater patient rights. Recent court decisions may change the practice of dentistry and it is important that the clinician is not caught unaware. The aim of this article is to discuss legal issues that are pertinent to the practice of modern dentistry through an analysis of legal cases that have shaped health law. Through these discussions, the importance of continuing professional development, professional association and informed consent will be realized as a means to limit the legal complications of dental practice.

A importância dos arcos dentários na identificação humana / The importance of the dental arches in human identification

O trabalho objetiva analisar e discutir a importância da Odontologia na identificação humana através dos arcos dentários. Além do aspecto preventivo e o curativo, o aspecto legal procura normatizar o próprio exercício da profissão nos seus vários ângulos, no diagnóstico de danos com vistas ao seu ressarcimento ou, mais especificamente, a própria identificação de indivíduos. O aspecto pericial se desdobra em diversas espécies de exames possíveis tendo como base a cavidade oral, desde o exame direto de um arco dentário até a pesquisa de DNA das amostras colhidas nessa cavidade natural, mesmo as marcas de mordida, ocorridas em áreas da superfície corpórea, trazem detalhes dos arcos que a provocaram, contribuindo no processo de identificação.

The work aims to analyze and discuss the importance of the dentistry in human identification through dental arches. In addition to the preventive aspect and the bandage, the legal aspect seeks to standardize the practice of the profession in their various angles, the diagnosis of damage to your compensation or, more specifically, the identification of individuals. The forensic aspect unfolds in several species of possible examinations based on the oral cavity, since the direct examination of a dental arch to the DNA of the samples taken in this natural cavity, even the bite marks, occurred in areas of the body surface, bring details of the bows that provoked, contributing in the identification process.

Estudo sobre o aspecto financeiro da clínica integrada de um curso de odontologia / Study on the financial aspect of an integrated clinical course of dentistry

Objetivo: a analisar as razões que motivaram os pacientes a solicitar o ressarcimento financeiro por tratamentos realizados nas Clínicas do Curso de Odontologia do Centro Universitário da Fundação Educacional de Barretos (UNIFEB), São Paulo, Brasil. Material e métodos: foi realizado um levantamento nos prontuários que envolviam custos financeiros nos procedimentos odontológicos executados nas disciplinas de Clínicas Integradas. Duzentos prontuários que envolviam procedimentos odontológicos com custos enquadraram-se no estudo. Desses prontuários foram obtidas informações de procedimentos odontológicos realizados e solicitação de ressarcimento financeiro. Resultados: do total de prontuários levantados na clínica odontológica, 16 (8%) dos pacientes solicitaram ressarcimento financeiro. Todos os prontuários apresentavam a prótese dentária como à especialidade predominante na solicitação dos pacientes para ressarcimento financeiro. As justificativas dos usuários para solicitação dos ressarcimentos financeiros concentrou-se predominantemente no descumprimento do prazo de finalização do trabalho protético 6 (37%), na alteração do planejamento do tratamento 5 (32%), no estado não funcional das próteses 4 (25%) e as condições sistêmicas alteradas do usuário 1 (6%). Conclusão: essa pesquisa proporcionou um melhor entendimento sobre os aspectos financeiros que envolvem as devoluções em espécie por trabalhos protéticos realizados pelos alunos sob supervisão docente. Os dados apontam a conscientização do paciente em relação aos seus direitos, enquanto consumidores.

Objective: to examine the reasons for patients to ask for financial compensation for treatments performed in the Clinical Course of Dentistry of the University Center of the Educational Foundation of Barrie (UNIFEB), São Paulo, Brazil. Material and methods: We performed a survey in the medical records involving financial costs on dental procedures performed in the disciplines of Integrated Clinics. Two hundred medical records involving dental procedures cost framed in the study. These planning 5 (32%), non-functional state of the prosthesis 4 (25%) and systemic conditions changed the user 1 (6%). Conclusion: This research provided a better understanding of the issues involving the financial returns in kind prosthetic work performed records were collected from dental procedures carried out and request for financial compensation. Results: the total number of records collected in the dental clinic, 16 (8%) patients asked for financial compensation. All had the dental records as the predominant specialty of patients in the request for financial compensation. The reasons for requesting the users of financial remedies was predominantly concentrated in breach of the term of completion of the prosthetic work 6 (37%), changes in treatment by students under supervision. The data point to the patient's awareness regarding their rights as consumers.

Palatal rugoscopy as a method of human identification / Rugoscopia palatina como método de identificação humana

Test the applicability of the formula in palatoscopy.Methodology: three observers examined 30 plaster models of the upper arch, obtained from dentistry students at the Universidade Federal da Paraiba (UFPB). Rugae were classified as simple and composed and as line, curve, angle, circle, sinuous and point.Results: the intra-observer examination of simple and compound rugae showed a higher coincidence percentage for composed rugae (53.3 to 56.7%), as did inter-observer examinations (43.3% to 55.0%), compared to the 5% - 23.3% obtained for simple rugae. Analysis of the main types revealed that circular rugae showed the highest coincidence percentage (95.0% to 96.7%), followed by angular (61.7% to 66.7%). The line rugae demonstrated the lowest coincidence percentage (11.7% to 45.0%). Inter-observer coincidences were highest in the circle rugae (93.3% to 96.7%) and lowest in the line rugae, with percentages between 16.7% and 15.0%. The higher percentage of composed rugae reflected its good visualization. The high observer agreement in relation to circular rugae is due to the classification of their absence, since this rugae is seldom found, in contrast to line rugae, which are mistaken for wavy rugae and vice versa, often present in the palate. It can be observed that palatal rugae as a method has a large number of classifications, but with low practicability, storage difficulties and absence of universal standards...

Testar a aplicabilidade da fórmula na rugoscopia palatina.Metodologia: três avaliadores examinaram 30 modelos em gesso do arco superior, obtidos de estudantes de Odontologia da UFPB. As rugosidades foram classificadas em simples e compostas e em reta, curva, angular, circular, sinuosa e ponto.Resultados: o exame das rugas simples e compostas, intra avaliador, demonstrou maior percentual de coincidência para as rugas compostas (53,3 a 56,7%), assim como nos exames inter avaliadores, com acertos entre 43,3% e 55,0%, confrontando com os 5,0% e 23,3% obtidos nas rugas simples. Na análise dos tipos fundamentais observa-se que as rugas circulares apresentaram maior percentual de coincidências (95,0% a 96,7%), seguida das angulares (61,7% a 66,7%). A ruga reta demonstrou menor percentual de coincidências (11,7% a 45,0%). As coincidências inter avaliadores foi maior nas rugas circulares (93,3% a 96,7%) e menor nas rugas retas, com percentual entre 16,7% e 15,0%. O maior percentual das rugas compostas demonstra a sua boa visualização. A alta concordância dos avaliadores quanto a rugas circulares ocorre em virtude da classificação de sua ausência, pois raramente se encontra esta ruga, diferente das retas, que se confundem com as sinuosas e vice-versa, frequentemente presentes no palato. Nota-se que a rugosidade palatina como método possui uma grande quantidade de classificações, porém, com praticabilidade baixa, de difícil arquivamento e ausência de padrão universal.Conclusão: a classificação das rugosidades palatinas, por meio da fórmula rugoscópica, não é aplicável devido à subjetividade do método...

La informática en el consultorio odontológico y el uso de los registros digitales / Information technology in the dental clinics and the use of digital record

La utilización de ordenadores en las clínicas odontológicas ha traído muchos beneficios a los cirujanos dentistas, auxiliándolos en varios aspectos técnicos, administrativos y legales. Este estudio tuvo como objetivo verificar si los cirujanos dentistas, alumnos del curso de postgrado en Ortodoncia e Implantodoncia de la Asociación Brasileña de Odontología (ABO), regional de Araçatuba-SP, hacen uso de ordenador y de la documentación digital en la practica clínica. Fueron invitados a participar del estudio todos los 60 alumnos matriculados en los cursos de Ortodoncia e Implantodoncia de aquella Institución, en el año de 2007 y los que consintieron (n=52) respondieron a un cuestionario auto administrable con preguntas abiertas y cerradas sobre el tema. En cuanto al perfil de los participantes, el 64,5% son del género masculino; un 51,9% tienen entre 30-39 años de edad y el 48,1% se graduaron en los años 90. Un 69,3% afirmaron no haber recibido cualquier noción de informática durante los estudios y el 67,3% utilizan el ordenador en el consultorio, principalmente para la administración del mismo (34,3%). En cuanto al uso del prontuario electrónico un 55,8% relataron utilizar esta tecnología, sin embargo un 44,2% negaron. El 32,7% no creen que los documentos electrónicos que tienen puedan servir como prueba judicial y un 35,7% creen que el prontuário electrónico debe ser archivado por 20 años. Se concluyó que la mayoría de los profesionales hacen uso del ordenador en el consultorio y también el prontuario digital, no obstante no se sienten seguros cuanto a la validad jurídica de este tipo de documentos, desconociendo, hasta el tiempo adecuado para archivar.

The use of computers in dental clinics has brought many benefits to dentist, helping them in various technical, administrative and legal. This study aimed to verify whether dentist, students of the post-graduate course in Orthodontics and Implantodontia of the Brazilian Association of Dentistry (ABO), regional Araçatuba-SP, using computers and digital documentation in clinical practice. They were invited to participate in the study all 60 students enrolled in courses of Orthodontics and Implantodontia of those institutions, in the year 2007 and those who consented (n = 52) answered a questionnaire containing questions open and closed on the subject . As the profile of the participants, 64.5% are male, 51.9% are between 30-39 years of age and 48.1% completed the graduation in the 90th. A 69.3% said they didn’t receive any notion of computing during graduation and 67.3% use the computer in the office, mainly for management of the same (34.3%). Regarding the use of electronic record 55.8% reported using this technology, while 44.2% denied. 32.7% do not believe that electronic records that can serve as proof of judicial and 35.7% believe that the electronic records should be archived for 20 years. It follows that most professionals use the computer in the office and also the digital records, but does not feel secure about the legal validity of such documents, unknown, including the appropriate time of its filing.