Artificial intelligence (AI) is increasingly influencing how orthodontic care is delivered across the globe.Systems capable of identifying cephalometric landmarks, predicting growth patterns, assisting with aligner staging, and simulating treatment outcomes are becoming part of everyday clinical workflows. 1,2ese developments promise greater efficiency and analytical consistency.At the same time, their growing presence in clinical decision-making introduces new ethical considerations that the profession must address thoughtfully.e implications of AI in orthodontics extend beyond technical performance and raise broader questions about responsibility, transparency, data stewardship, fairness, and the preservation of patient-centered care and patient trust. 3e central challenge facing orthodontists is therefore not whether these technologies should be used, but how they can be incorporated into practice in a responsible and ethically grounded manner. ACCOUNTABILITY IN THE AGE OF ALGORITHMIC SUPPORTConventionally, orthodontic practice has operated within a clear framework of professional responsibility: Diagnostic interpretation and treatment decisions ultimately belong to the clinician.AI-supported tools introduce a different dynamic.Machine-learning models may generate recommendations based on patterns identified within large datasets, yet the reasoning behind these outputs is not always visible to the user.In some cases, such systems operate as "black-box" models, where the internal decision processes remain difficult for clinicians to interpret. 4en such systems influence treatment planning, important questions arise regarding responsibility.If an AI-generated recommendation contributes to an unfavorable outcome, determining where accountability lies becomes complex.Should responsibility rest with the clinician who applied the recommendation, the developer who designed the system, or the organization that implemented it?Current medicolegal structures in many healthcare settings were developed for human decision-making and are still adapting to the challenges posed by AIassisted care. 5til regulatory frameworks evolve further, one principle remains fundamental: e orthodontist retains ultimate responsibility for patient care.AI outputs should therefore be treated as advisory inputs rather than definitive clinical instructions. 4Careful evaluation of algorithmic suggestions, appropriate documentation of clinical reasoning, and open communication with patients remain essential safeguards as digital technologies become more deeply integrated into orthodontic practice.
Singh et al. (Tue,) studied this question.