• Unmet patient expectations, poor communication, and long treatments drive orthodontic claims. • Lack of periodontal assessment and inadequate consent increase risk of malpractice claims. • Clear aligner therapy linked to unrealistic promises and legal vulnerability. • Incomplete records and poor follow-up increase litigation risk for orthodontists. • Education, documentation, and transparency key to reducing medico-legal liability. Malpractice claims in orthodontics are a growing concern, with rising patient expectations and heightening legal awareness. Identifying the underlying causes of such claims is crucial for improving risk management and reducing liability. This scoping review aimed to map the available evidence about the causes of malpractice claims in orthodontics. A comprehensive search was conducted in PubMed, Scopus, Web of Science, and Google Scholar. Eligible studies were peer-reviewed articles from the last 10 years reporting on malpractice claims in orthodontics. This review followed the PRISMA for Scoping Review (PRISMA-ScR) guidelines. Seven studies met the inclusion criteria. The most recurrent drivers of litigation involved periodontal complications, aesthetic dissatisfaction, and failures in documentation or informed consent. Additional contributors included root resorption, tooth injury, ineffective communication, and inadequate professional training, including cases managed by general dentists without orthodontic expertise. Emerging modalities such as aligner-based treatments introduced distinct medico-legal issues, particularly unrealistic aesthetic expectations and reliance on digitally guided workflows. Overall, evidence suggests that both clinical complications and medico-legal shortcomings contribute to orthodontic litigation, with communication, documentation, and informed consent playing a central role in the legal evaluation of malpractice claims. https://doi.org/10.17605/OSF.IO/FUHS7 (accessed on September 14, 2025)
Varvara et al. (Mon,) studied this question.