The role of computer simulation methods in avoiding orthodontic malpractice

Before the beginning of any dental treatment, the patients or their legal representatives should be completely informed about the medical procedures and potential risks and sign an informed consent. In dentistry, orthodontics is unique, as it usually extends over a long period of time and can generate disagreements with the patients based on esthetic or functional results. Therefore, the knowledge of abnormal accumulation of stress induced by an orthodontic force of excessive intensity, allows the intervention with timely therapeutic methods to avoid the iatrogenic effects. The aim of this paper is to present the use of computer-aided simulation technique, the Finite Element Method, in the evaluation of real biological phenomena specific to orthodontic treatment. We simulated the use of orthodontic forces 5 times higher than normal and studied their iatrogenic effects on the dental supporting tissues. The results showed that computer simulations can be used with considerable success in all clinical orthodontic patients, increasing their confidence in the proposed treatment plan, providing an ethical support for the dentist and a positive feedback on patient responses. The maximum stress distribution with iatrogenic effect on dental and periodontal anatomical structures has been emphasized. In conclusion, the transposition of clinical reality through the computer simulation requires continuous development of the IT systems in this field and opens new research directions and applicability regarding the iatrogenic effects of orthodontic forces.