Marco jurídico de la prescripción médica en odontología / Legal framework of medical prescription in odontology

La receta médica es la materialización del acto médico a través de la cual el profesional de la salud prescribe a su paciente los fármacos necesarios para aliviar su enfermedad. Existen numerosas sustancias o fármacos que, por sus efectos, no pueden ser ofrecidas al público en general si no es mediante la expedición de una receta médica; por tanto, existen numerosas legislaciones y normas que regulan la prescripción médica con el objetivo de tener un control sobre los fármacos prescritos. A su vez, la receta médica debe tener una estructura específica, misma que está establecida por numerosas leyes y reglamentos sanitarios y que interesantemente es ignorada por múltiples médicos u odontólogos. El objetivo del presente artículo es definir el concepto de prescripción médica, así como indagar en todas las leyes y normas vigentes que regulan la prescripción médica en México (AU)

The medical prescription is the materialization of the medical act through which the health professional prescribes to his patient the necessary drugs to alleviate his illness There are numerous substances or drugs that, due to their effects, cannot be offered to the general public, except through the issuance of a medical prescription, and therefore, there are numerous laws that regulate the medical prescription with the aim of having control over prescribed drugs. In turn, the medical prescription must have a specific structure, which is established by numerous health laws and regulations, and which, interestingly enough, is ignored by many doctors and dentists. The aim of this article is to define the concept of medical prescription as well as to investigate all the current laws and regulations that regulate the medical prescription in Mexico (AU)

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)

Sex Identification Based on Tooth Crown Trait Analysis Among the Mongoloid Race

Abstract Objective: To determine whether anterior and posterior tooth crown traits exhibit sexual dimorphism and identify traits characteristic to the Mongoloid race, especially among the Indonesian population. Material and Methods: This study cross-sectional study analyzed 108 dental casts from 36 males and 72 females. The traits analyzed included winging, shoveling, double shoveling, canine mesial ridge, canine distal accessory ridge, hypocone, metaconule, Carabelli's cusp, protostylid, metaconulid, enteconulid, and hypoconulid. All tooth crown traits were scored based on the ASUDAS scoring system. Descriptive statistics were used to calculate the absolute and relative frequencies. The Chi-square tests was used to determine significant differences in anterior and posterior tooth crown traits between males and females. Level of significance was set at 5%. Results: None of the traits showed sexual dimorphism. Moreover, the most common traits among the Mongoloid race were hypocone (94.4%) and shoveling (86.1%). Conclusion: Although none of the traits exhibited sexual dimorphism, most of them had a higher incidence among females than males. Nonetheless, further research including adequate samples and a similar number of females and males, is needed, especially for population studies.

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).

Computer-aided image analysis of crayfish bitemarks - reinterpreting evidence: A case report.

The discipline of forensic odontology is at a crossroads with the application of bitemark evidence in the court of law. In the last decade, the increase in the number of cases in which bitemarks were the 'smoking gun' to a conviction being appealed and verdicts reverse is alarming and due in a large part to the lack of validated rules and scientific rigor needed to evaluate this evidence objectively. In some cases, post-mortem trauma to human remains has been misinterpreted as human bitemarks. This case report illustrates how bitemarks misinterpreted as human-caused were reevaluated by a computerized imaging analytical method and determined to be consistent with those caused by crayfish scavenging on the remains. Fetal pigs were exposed to crayfish native to the crime scene for a period of 72 h. Crayfish bitemarks on the pigs were compared to marks on the victim and the bite width of the crayfish and found to be statistically the same. These findings led to the exoneration of the convicted individual. Such computer-aided pattern recognition protocols are necessary in traditional forensic identification sciences such as forensic odontology to minimize biased conclusions by extraneous evidence and preconceived assumptions and replace subjective guesswork with sound scientific protocols.

Status of Mandibular Third Molar Development as Evidence in Legal Age Threshold Cases.

The completion of the third molar roots has played an important role in ascertaining whether individuals may be at or over a legal threshold of age, often taken as 18 years. This study demonstrates that root apex completion in the third molar is relatively uninformative regarding the threshold of age 18 years in a sample of 1184 males, where mean age-of-attainment of root apex completion for third mandibular molars is about 19.4 years. This paper also considers the legal age threshold problem for cases where the third mandibular molar is not completely formed, and outlines the use of parametric models and Bayes' factors to evaluate dental evidence in statistically appropriate ways. It attempts to resolve confusion over age-within-stage versus age-of-attainment, likelihood ratios versus other diagnostic tests, and prior odds for a case versus the prior density for an age distribution.

Review of a forensic pseudoscience: Identification of criminals from bitemark patterns.

The forensic sciences are a combination of laboratory procedures and physical comparisons of objects associated with victims, perpetrators, and crime scenes. The former is largely university-based protocols adopted by crime labs. The latter is predominantly pattern-matching tools originally developed by police examiners or experts deemed by courts to be relevant to forensic matters. These Court accepted experts bring their reasoning and conclusions into the legal arena. This subgroup of forensics has undergone significant scrutiny in regards to its history of exaggerated claims and weak scientific foundations. This paper addresses the rise and fall of bitemark pattern analysis (i.e. "matching" bitemarks in human flesh to human teeth) in the environment of opposing interests and agendas.

Estudo da técnica de Hoshi na inclinação do processo mastoide como uma característica sexual / Hoshi techniques study in the slope of the mastoid process as a sexual characteristic

Sabe-se que o processo mastoide (PM) tem sido utilizado como uma característica diferencial entre crânios de espécies diferentes e mesmo entre os sexos. Muitos são os métodos utilizados para se diferenciar os processos mastoides masculinos dos femininos. Tal diferenciação é muito importante na antropologia física e na forense. Neste trabalho foi utilizada a metodologia empregada por Hoshi (1962) na qual classifica os PM segundo a sua curvatura. O objetivo deste trabalho foi verificar a aplicabilidade desta metodologia. Foram utilizados 305 crânios humanos identificados segundo o sexo, grupo étnico e idade, pertencentes ao Museu de Crânios da Disciplina de Anatomia Descriptiva e Topográfica da Escola Paulista de Medicina - UNIFESP. Os resultados obtidos foram submetidos à análise estatística (análise descritiva e teste quiquadrado) e constatou-se que as inclinações do tipo M (70,87%) são estatisticamente típicas do sexo masculino, enquanto as inclinações do tipo N (47,47%) e F (36,36%) são encontradas nos crânios femininos, sendo suas incidências estatisticamente significativas, demonstrando que as inclinações dos tipos N e F caracterizam, na amostra em questão, os crânios femininos. Os resultados alcançados demonstraram que o método desenvolvido por Hoshi é aplicável e de fácil execução(AU)

It is known that the mastoid process (PM) has been used as a differential feature among skulls of different species and even between the sexes. Many are the methods used to differentiate the male mastoids from the female ones. Such a difference is very important in physical anthropology and forensics. In this work we use the methodology used by Hoshi (1962) in which it classifies PM according to its curvature. The objective of this work was to verify the applicability of this methodology. 305 skulls were used, identified by sex, ethnic group and age, belonging to the Museum of Skulls of the Discipline of Anatomy at the Paulista School of Medicine - UNIFESP. The results obtained were submitted to statistical analysis (descriptive analysis and chi-square test) and it was verified that the M-type inclinations (70.87%) are statistically typical of the male sex, while the N-type inclinations (47.47%) and F (36.36% ) are found in female skulls, and their incidence is statistically significant, demonstrating that the N and F inclinations characterize female skulls in the sample. The results showed that the method developed by Hoshi is applicable and easy to implement(AU)

Epidermis and Enamel: Insights Into Gnawing Criticisms of Human Bitemark Evidence.

Critics describe forensic dentists' management of bitemark evidence as junk science with poor sensitivity and specificity and state that linkages to a biter are unfounded. Those vocal critics, supported by certain media, characterize odontologists' previous errors as egregious and petition government agencies to render bitemark evidence inadmissible. Odontologists acknowledge that some practitioners have made past mistakes. However, it does not logically follow that the errors of a few identify a systemic failure of bitemark analysis. Scrutiny of the contentious cases shows that most occurred 20 to 40 years ago. Since then, research has been ongoing and more conservative guidelines, standards, and terminology have been adopted so that past errors are no longer reflective of current safeguards. The authors recommend a comprehensive root analysis of problem cases to be used to determine all the factors that contributed to those previous problems. The legal community also shares responsibility for some of the past erroneous convictions. Currently, most proffered bitemark cases referred to odontologists do not reach courts because those forensic dentists dismiss them as unacceptable or insufficient for analysis. Most bitemark evidence cases have been properly managed by odontologists. Bitemark evidence and testimony remain relevant and have made significant contributions in the justice system.

Bite Mark Analysis in Foodstuffs and Inanimate Objects and the Underlying Proofs for Validity and Judicial Acceptance.

Even though one of the first bite mark cases was Doyle v. State in 1954 (a bitten cheese case), the research has focused on bite marks inflicted in human skin. As published Papers, Case Reports, or Technical Notes can constitute precedents which are relied upon in making the legal arguments and a considerable amount of case law exists in this area, we present a systematic review on bite mark analysis in foodstuffs and inanimate objects and their underlying proofs for validity and judicial acceptance according to Daubert rulings. Results showed that there is vulnerability in these procedures, and it is essential to demand for focus scrutiny on the known error rates when such evidence is presented in trials. These kinds of bite marks are well documented; however, there has been little research in this field knowing that the protocols of analysis and comparison are the responsibility of the forensic odontologists.

Procedimento de bichectomia: uma discussão sobre os aspectos éticos e legais em odontologia / Bichectomy procedure: a discussion on the ethical and legal aspects in odontology

Introdução: O procedimento denominado de bichectomia consiste na remoção parcial de uma estrutura adiposa na região das bochechas e ganhou recente popularidade entre a classe odontológica, que passou a executá-lo amplamente, com demandas predominantemente estéticas e, com isso, dúvidas e incertezas surgiram a respeito dos seus aspectos éticos e legais. Objetivo: O objetivo deste trabalho foi buscar legislações nacionais, bem como normativas e resoluções emitidas por conselhos profissionais, visando abordar tais controvérsias, alumiando os profissionais quanto à legitimidade do procedimento. Resultados: Verificou-se que desde 1978, os Conselhos Federais de Medicina e de Odontologia vêm emitindo resoluções para determinar limiares de atuação profissional, em especial, com enfoque na especialidade Cirurgia e Traumatologia Bucomaxilofacial, visto que é a especialidade odontológica clínica que mais se aproxima de campos de atuação médica. Com o tempo, estes Conselhos foram atualizando estas Resoluções, tendo em vista os avanços técnicos e científicos da área, porém todas as resoluções analisadas são unânimes em afirmar que a realização de bichectomia com finalidade estritamente estética é atribuição médica. Conclusão: Desta forma, com base nos documentos atualmente vigentes, verifica-se que o cirurgião-dentista que estiver disposto a realizar a cirurgia de bichectomia com finalidade exclusivamente estética estará incorrendo em transgressões administrativas e, consequentemente, tais interpretações podem ser vislumbradas em outras esferas (cíveis e criminais).

Introduction: Bichectomy consists of removing part of a fat structure in the region of the cheeks, and it recently gained popularity in the field of odontology, which began to widely perform the procedure, with predominantly aesthetic demands and, with that, doubts and uncertainties arose with respect to its ethical and legal aspects. Objective: The objective of this work was to seek national laws, as well as normative and resolutions issued by professional councils, aiming to address such controversies, enlightening professionals to the legitimacy of the procedure. Results: Since 1978, the Federal Councils of Medicine and Dentistry have issued resolutions to determine thresholds for professional performance, which particularly focused on Oral and Maxillofacial Surgery and Traumatology because it is the closest clinical dental specialty of medical practice. Over time, these Councils have been updating these resolutions, considering the technical and scientific advances of the area, but all the resolutions analyzed were unanimous in affirming that the accomplishment of bichectomy with a strictly aesthetic purpose is a medical attribution. Conclusion: Subsequently, based on the documents currently in force, it is verified that the dental surgeon who is willing to perform bichectomy surgery for aesthetic purposes will be incur administrative infractions and, consequently, such interpretations can be seen in other legal areas (civil and criminal).

[Matching bite marks using modeling wax plates].

Bite marks are rarely seen in forensic medical examinations. In most cases one can easily differentiate whether a bite mark is of human or animal origin due to the arched shape and crushed character of human bite marks. From a forensic point of view it is more interesting whether a dental imprint has been caused by an adult or a child, because children are often abused for a defensive statement. Two cases of bite injuries in children are presented. In the first case, a two-month-old infant was presented by pediatricians. The second case deals with a one-year-old boy who had allegedly been bitten several times by a two-year-old girl in a nursery school. A comparison could be performed between the bite mark impressions on the victim's skin (based on photographic documentation) and dental imprints of single teeth measuring the tooth width on the one hand and the intercanine distance on the other hand with the help of modeling wax plates. This procedure showed good correlations between the bite marks on the victim and the dental status of the biter. Especially for taking bite impressions on children, modeling wax plates are a simple, fast and cheap alternative to dental impression-taking.

[Stature estimation from teeth and jaw].

After the discovery of skeletonized human remains, the estimation of stature is an important element of the so-called "biological profile". Typically, long bone lengths are used in regression formulas. If long bones are not available, predictions of stature cannot be made. Human skulls are often the subject of forensic osteological examination, sometimes even detached. Therefore, it seems reasonable to search for skull measurements that have a sufficiently good correlation to stature. The aim of the study presented was to measure odonto-stomatological parameters using post-mortem CT data to check whether the esti- mation of stature was possible on this basis. Three classic tooth dimensions (MD, BL, ZL), two diagonal tooth dimensions (MBDL, DBML) first described by Lund and Mörnstad in 1999, two tooth dimensions defined for the first time in this study (MKDO, DKMO), the mesiodistal index (MDS) and also the palatal arch dimensions (arch length, arch width, molar length and dental length) - each at maxilla and mandible - were digitally measured on a total of 799 teeth of 48 virtual 3-D-reconstructed skulls (33 males and 15 females). For most of the aforementioned measurements no statistically significant relation to stature was found. There were positive correlations by Pearson at a significance level of 99 % (2-sided) at three measurements: ZL 15, MKDO 14 and MKDO 15. Positive correlations by Pearson at a significance level of 95 % (2-sided) could be determined for eight measurements, but an applicable regression formula could not be calculated for any of the parameters. Despite a statistical correlation of a few teeth parameters with body length, they must be considered unsuitable for estimating stature.

Identificação Humana Auxiliada por Comparação Prosopográfica: Relato de caso pericial / Human Identification Using the Comparative Prosopographic Technique: Case Report

A identificação humana pode ser realizada através de diferentes técnicas. Sendo o profissional em odontologialegal capaz de identificar cadáveres desconhecidos, ele pode optar pelo método que melhor preencha ascaracterísticas necessárias para o sucesso dessa identificação. Este artigo relata um estudo de caso utilizando atécnica comparativa prosopográfica no auxílio de uma identificação positiva

The human identification can be performed through different techniques. As the forensic dentists can identifyunknown corpses, he can choose the method that best meets the characteristics necessary for the success ofthis identification. This article reports a case using the comparative technique prosopographic in a positiveidentification

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.

[Orthodontic treatment failure: the advice of a forensic expert]. / Échec d'un traitement orthodontique : les conseils de l'expert judiciaire∗.

If patients consider that their orthodontic treatment is a failure, they can claim compensation from their practitioner. Most often, discontented patients call on their third-party liability insurance when they are covered for "legal expenses protection". The patient's insurance company will then get in touch with the practitioner's insurance firm. Three-quarters of all claims are dealt with by the insurance companies. However, if an agreement cannot be reached or if the practitioner's insurance company manages to establish that he/she is not at fault, the patient can apply to the Tribunal de Grande Instance, the French Regional Court. The judge appoints a forensic expert who will examine the patient and follow a very precise procedure involving a dozen different questions. The advice of the forensic expert is therefore very valuable to orthodontists, in particular regarding their duty to inform patients and the importance of the medical file in order to avoid being held accountable following a course of treatment.

Análise de lesões orofaciais registradas no Instituto Médico-Legal de São Luís (MA), no período de 2011-2013 / Analysis of orofacial injuries recorded in the Forensic Medicine Institute of São Luís (MA), from 2011 to 2013

Introdução: Os traumas são causas comuns de morbidades e mortalidade da população mundial. Um dos mais prevalentes é o bucomaxilofacial, pois a face é uma região muito exposta e pouco protegida.Traumas faciais podem resultar em lesões de tecidos moles e fraturas ósseas, causando graves complicações e até danos irreversíveis, e seu autor deve ser enquadrado corretamente segundo a legislação brasileira. Objetivo: Analisar o perfil das vítimas, as causas, as características das lesões orofaciais, bem como o profissional responsável pela perícia e a classificação da lesão de acordo com o artigo 129 do Código Penal Brasileiro. Método: Foram analisados laudos emitidos por médicos e odontolegistas do Instituto Médico Legal da cidade de São Luís (MA), no ano de 2011 à 2013 de vítimas acometidas por lesões orofaciais. Resultados: Os resultados demonstraram que o sexo masculino foi omais atingido (55,4%), a faixa etária mais envolvida foi 20-29 anos (40,3%), a etiologia principal foi agressão física (73,4%), a lesão mais frequente foi escoriação (25,3%) e a região mais acometida da facefoi a orbitária (26%). O profissional que mais emitiu laudos foi o médico-legista (90,8%). Das lesõesorofaciais qualificadas (39,8%), 23,0% resultaram em debilidade da função mastigatória, 4,5% emdebilidade da função mastigatória e estética e 22,3% em deformidade permanente. Conclusão: Conclui-seque é grande o número de lesões orofaciais registradas no IML de São Luís e que essas lesões foram avaliadas mais criteriosamente pelo odontolegista, ressaltando-se, com isso, a fundamental atuação desse profissional nas perícias dessa natureza.

Introduction: Traumas are common causes of morbidities and mortality in world's population. Maxillofacialtrauma is one of the most prevalent, because face is very exposed and unprotected. Facial trauma canresult in soft tissue injuries and bone fractures, causing serious complications and even permanen tdamages, making necessary the appropriate legal framework of attackers. Objective: To analyze theprofile of the victims, reason and the characteristics of orofacial lesions recorded in Forensic MedicineInstitute data, São Luís (MA), Brazil, between years of 2011 to 2013, as well as the professional responsible for expertise (doctors and dentists) and classifications in accordance with Article 129 of theBrazilian Penal Code. Methods: It were analyzed reports issued by doctors and dentistry in the period of2011 to 2013, for affected patients with orofacial injuries. Results: Results showed that male sex was themost affected (55,4%), age most involved was 20-29 years (40,3%), the main etiology was physicalaggression (73,4%), the most common injury was abrasion (25,3%) and the region most affected was theorbital (24,9%). The professional that issued more reports was the coroner (90,8%). Between the qualifiedorofacial lesions (39,8%), 23,0% resulted in weakness of masticatory function, 4,5% in weakness ofmasticatory function and aesthetics and 22,3% in permanent deformity. Conclusion: It was concluded that the number of orofacial injuries registered in the IML of São Luís data was great and these lesions wereevaluated more critically by forensics dentists, requiring their presence of this professional.

Ortodontia e a interpretação de sua natureza obrigacional: análise do potencial de impacto de uma decisão do Superior Tribunal de Justiça (STJ) / Orthodontics and the interpretation of its obligatory nature: analysis of the potential impact of a decision from the Supreme Court of Justice (STJ)

Introdução: A Ortodontia tem sido uma das áreas com maior número de processos na Justiça, por representar procedimentos onerosos, tratamentos longos e envolver conceitos de estética, que são subjetivos. Atualmente, a natureza da obrigação do ortodontista tem sido mal compreendida. A partir da associação do tratamento ortodôntico essencialmente à estética, tem-se entendido que as obrigaçõesdesta área/especialidade sejam de resultado ao invés de meios. Objetivo: Realizar análise da obrigação assumida pelo ortodontista, com vistas a uma discussão sobre seu enquadramento. Material e Métodos: Foi realizada análise de conteúdo de acórdão do Superior Tribunal de Justiça (STJ), revisão de literatura e comparação e contraposição a uma detida análise técnico-científica no campo da Odontologia.Resultados: Os aspectos biológicos de resposta orgânica são relevantes nos tratamentos ortodônticos,por envolverem estes a movimentação dental e, por conseguinte, haver alterações teciduais que precisamser conhecidas para melhor compreensão do tipo de terapêutica e, assim, de forma melhor embasada,posicionar-se um jurista quanto à natureza da obrigação assumida pelo profissional ou um julgador porocasião de solução de um litígio. O tratamento ortodôntico quando considerado, de maneira equivocada ereducionista, como sendo tratamento fundamentalmente estético, sem a ponderação sobre forma efunção, tende a ser associado com um compromisso de resultado. Conclusão: A Ortodontia não deve sertida como ciência exata, de resultados previsíveis, uma vez que depende, durante o tratamento proposto, de fatores biológicos inerentes ao indivíduo, como características ósseas, atividade fisiológica que diferede acordo com a idade e saúde do organismo. A decisão do STJ analisada representa jurisprudênciarelevante a ser debatida, por sua potencial influência nas decisões judiciais.

Introduction: Orthodontics has been one of the areas with the highest number of cases in court, due toinvolving expensive procedures, long treatments and aesthetic concepts, that are subjective. Currently, thenature of Orthodontist’s obligation has been misunderstood. Because of the association of orthodontic treatment primarily to aesthetics, it has been understood that the obligations of this area are related to aspecific result rather than a mean of treatment. Objective: To analyze the obligation undertaken by Orthodontists, inorder to debate its classification. Material and Methods: Content analysis was performedin a decision of the Superior Court of Justice (STJ), and also literature review and comparison and contrastto a detained technical and scientific analysis concerning dental aspects. Results: Biological aspects oforganic response are relevant in orthodontic treatments because they involve tooth movement and,therefore, tissue changes that need to be known in order to better understand the type of treatment and,thus, in a grounded way, jurists will be more able to establish position about the nature of the obligationundertaken by those professionals or a judge when deciding a law suit. Orthodontic treatment, whenconsidered, in a mistaken and reductionist way, as being fundamentally an aesthetic treatment, withoutconsideration of form and function, tends to be associated with a commitment to results. Conclusion:Orthodontics should not be taken as an exact science, of predictable results, since it depends, during theproposed treatment, of biological factors inherent to the individual, such as bone characteristics,physiological activity that differs according to the age and health of the body. The decision of the STJ isconsidered a relevant law case to be debated, because of its potential influence on judicial decisions.