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School of Dentistry

Orthodontics 3311/3312
3rd Year

2013

Unit Guidebook
Coordinators: Samuel Bennett
Mithran Goonewardene

Orthodontics

Contact details
Unit coordinator:

Sam Bennett
Mithran Goonewardene

e-mail:

Samuel.bennett@uwa.edu.au

Phone:

Mithran.goonewardene@uwa.edu.au
9346 7671

Fax :

9346 7666

Clinical Tutors:

Mike Razza
Carl Sim
Consuelo Loza
Graeme Bond
Andrew Savundra
Frank Furfaro

All material reproduced herein has been copied in accordance with and pursuant to a statutory licence administered by
Copyright Agency Limited (CAL), granted to the University of Western Australia pursuant to Part VB of the Copyright Act
1968 (Cth).
Copying of this material by students, except for fair dealing purposes under the Copyright Act, is prohibited. For the purposes
of this fair dealing exception, students should be aware that the rule allowing copying, for fair dealing purposes, of 10% of
the work, or one chapter/article, applies to the original work from which the excerpt in this course material was taken, and not
to the course material itself.
The University of Western Australia 2001

Version 2: Dentistry 1709

3rd YEAR ORTHODONTICS

Table of Contents

I.

List of Educational Materials

II.

How You Do It

III.

When You Do It: the Schedule

IV.

Doing It: Instructions

V.

Supplementary Materials:
Laboratory Exercise 1- Basic Wire bending
Laboratory Exercise 2-Wire Components for URA
Laboratory Exercise 3- Wire Components for URA (contd)
Laboratory Exercise 4- Acrylic finishing/repair
Laboratory Exercise 5- Diagnostic Model Preparation
Laboratory Exercise 6- Facial Form Analysis
Cephalometric and Space Analysis
Cephalometric illustrative tracings
Cephalometrics glossary
Laboratory Exercise 7- Case records
Laboratory Exercise 8,9- Typodont/Lingual Arch

Ethical Scholarship, Academic Literacy and Academic Misconduct


Clinical Sessions and Clinical Policy
Board of Examiners
UWA Student Guild

I. LIST OF EDUCATIONAL MATERIALS


UNC Level 2 -Unit 1
Malocclusion: Definition and Prevalence
Known Causes of Malocclusion
Equilibrium Theory and the Etiology of Malocclusion

UNC Level 2 -Unit 2


Facial Form Analysis
Cephalometric Tracing Techniques
Cephalometric Superimposition
Space Analysis and Its Interpretation
Ackerman-Proffit Classification: Systematic Description of Malocclusion
UNC Level 3 -Unit 1
Essentials of Orthodontic Diagnosis
Concepts of orthodontic Treatment Planning
Biology of Orthodontic Treatment
Mechanical Principles in Controlling Orthodontic Force
Orthodontic Anchorage and Controlled Tooth Movement
UNC Level 3 -Unit 2
Space Management in Preadolescent Children
Crossbites and Vertical Problems in Children
Concepts of Adjunctive Orthodontic Treatment
Adjunctive Orthodontic Treatment Procedures

II. HOW YOU DO IT


A. The Course
This course builds on the knowledge you have acquired about human
growth and development to :
1) give you a perspective on orthodontic problems, with special reference to
their definition, prevalence and etiology;
2) teach you diagnostic procedures for developmental problems, so that you
can distinguish skeletal from dental components of these conditions and will
be prepared to sort patients by the difficulty and severity of their problems;
3) provide an introduction to clinical treatment of children. This includes
learning the procedures in treating a child in the orthodontic clinic, the
actual diagnostic work-up of your first child patient, and participation in
appointments in which treatment is planned.
4) enable you to fabricate, and adjust several commonly used removable and
fixed orthodontic appliances that are described in this syllabus.
5) understand and explain the biomechanical principles involved in
orthodontic tooth movement.
6) recognize the clinical situations for which these appliances are indicated,
and be aware of their limitations.
7) understand and explain the effects that these appliances can produce (both
desirable and undesirable).
At the commencement of this unit, It is assumed that the student has a working
knowledge of the 2nd year growth and development unit. Students should be able
to:

Outline the graphs for average somatic growth changes from birth to
adulthood, describing the impact of early and late development, gender
effects and factors which may affect the growth patterns, timing and rates.

Describe the impact of theses somatic growth changes on growth and


development of the jaws and dentition.

Differentiate children with normal and abnormal somatic growth

Identify normal and abnormal patterns of jaw growth

Explain the theories of craniofacial growth and outline and explanation for
the aetiology of facial growth problems

Explain the role of endocrine function in the development of normal and


abnormal jaw growth

Describe the dentofacial changes associated with adolescence

List the timings of tooth eruption and identify the dental age of a patient

List the six significant stages of tooth development.

Describe clinical problems associated with disruption to the lifecycle of


the tooth

Describe the four major theories of tooth eruption and provide and
explanation for clinical problems associated with tooth eruption

Describe the normal dental arch dimensional changes between the


deciduous to the permanent dentition

Discuss in general terms, the importance of growth and development of


the dentofacial region in the therapeutic procedures used to address
developmental problems.

Describe the maturational changes which occur in the growing dentition


from childhood through to late adulthood

PLEASE ENSURE THAT YOU HAVE REVIEWED THIS MATERIAL AS


YOU WILL NEED A WORKING KNOWLEDGE TO SUCCEED IN YOUR
CLINICAL SESSIONS

The seven goals above correspond to the four instructional units of the course but in
no means aims to prepare you for comprehensive management of orthodontic
problems. On occasion, young children will present to the clinic with problems
which lie outside the scope of this course. For interest, students will be encouraged
to research issues associated with these problems but this will not be included in the
examination process.
Like Growth and Development(Level 1), this course is largely selfinstructional. In addition to types of self-instructional material you have seen
previously, this course has laboratory exercises in which diagnostic techniques are
employed and laboratory and clinical simulation techniques are performed. You
will have personal contact with faculty in seminars and clinic to discuss material
you have learned from computer teaching programs and reading assignments, and
also in the clinical component of the course in which you work up a child patient
and develop a treatment plan in the orthodontic clinic. Simple procedures may be

undertaken in the clinic by the dental student or referred on to the specialist clinics
for more extensive treatment An amount of lecture time equivalent to what you
would have spent in lectures to cover the self-instructional materials once has been
set aside, but of course you can view the self-instructional materials at any time
during their unit.
The course is in four didactic units in two levels. The first two units in level
2, in which the self-instructional material is concentrated, span over the first two
months. Superimposed in this time are the laboratory sessions which two
formative on-line tests on the UWA MOODLE system. The material from Level
2 will constitute the Semester 1 Examination.
The third and fourth units in level 3 may be reviewed at any time, but will be
formally reviewed in semester 2. The material from Level 2 and 3 will be reviewed
in the Semester 2 Examination.
JFS McGIBBON AWARD - 2013
The Australian Society of Orthodontists (WA Branch), on behalf of the dental
profession, has established a fund to endow an award in memory of the late JFS
McGibbon, who was an eminent orthodontist in Perth and part-time teacher of
orthodontics for many years. The fund will be administered in accordance with
the following regulations.
The Award will be made by the School of Dentistry, on the recommendation of
two examiners appointed by the School of Dentistry on the recommendation of
the Australian Society of Orthodontists (WA Branch) to the student enrolled for
the degree of Bachelor of Dental Science, who, in the opinion of the examiners,
has submitted the best essay on a topic directly or indirectly related to
orthodontics.
Essays must be in typescript and must not exceed the length prescribed by
examiners at the time the topic is determined. Tables, diagrams and illustrations
should be used where appropriate.

The title of the topic for 2013:


Discuss how the orthodontist can assist the restorative dentist in achieving
optimal outcomes in interdisciplinary treatment
The following requirements should be observed and these are generally in
accordance with the publication notes in the Australian Dental Journal:
The essay, which should not exceed 3000 words, should be typewritten on one
side of A4 paper with double spacing and margins of at least 40mm. An abstract
of not more than 150 words should be presented at the beginning of the paper.

The assignments will be due on Friday 27th September by 5:00pm.


A separate sheet should preface the essay, bearing its title and the name of the
author.
References should be numbered and placed alphabetically according to the
author's name, typed in a separate list at the end of the essay. They should
conform to the following style: Name of author; title of article; name of
periodical (acceptable abbreviation); volume; number pages and year. Example:
Beckett, L.S. Full dentures with fewer tears. Austral. D.J., 4: 5, 287-298, 1959.
Where a reference is made to a book, the form should follow: Goldman, H.M.
"Periodontia". St. Louis, the CV Mosby Co., 3rd Ed., 1953, p.378.

It is your job to:


1) read the instructions
2) view the videos and/or computer teaching programs (all with self-tests),
and read the assigned texts
3) use feedback from the video/computer self-tests and further review to be
sure you have learned the material
4) complete the laboratory exercises and online formative quizzes according
to the deadlines outlined in the schedule
5) attend the seminar at the end of each unit.
6) Hand an assignment for the McGibbon Award in by the due date
7) Attend clinics as scheduled.

Learning Strategies
Study materials for this course consist of
1) computer teaching programs
LOCATION OF MATERIALS: Access to modules and self tests is
the same as you used for Level I, so you may not need to do the
following.

and click on Register for access.

Fill out the registration form, using uncortho as the registration


code.
Once you submit your registration, an automated email will be
sent to the email address you entered into the form: NOTE:
Your account will not be active until you click on the
verification link in this email.
After your account has been verified, you can then log into the
site using your username and password.

2) reading materials from your orthodontic text, Contemporary Orthodontics


(4th edition)
3) computer tests are available in the computer labs in the library, and through
use of your personal laptop computer at any of the various connections in
the school. Level II and III material all have self-tests for you to use to
determine how well you understand a given topic.
There will be some lectures in which you will need to take notes, just as in
other courses and a clinical session in which you will obtain diagnostic
information about a child patient. Deliberately, the same ideas are presented
in more than one format. You need to go through all the assigned material,
because the coverage and content are different in each. Then you can
review and study it in the format you prefer.
Student Group
For individual feedback and the seminars, the class is broken into several groups of
students:
Group 1

Group 2

Group 3

Group 4

Group 5

Group 6

Abdel-Messih

DePiazzi

Kierath

Loh

Rasmussen

Tan, V

Al Kadhi

Di Francesco

Koh

Mark

Rijks

Tan, Y

Ang

Doucas

Kong

Natalwala

Rogers

Tay

Baskar

Esselle

Neoh

Saeedi

Chang

Fernando

KorhonenBannister
Koshal

Ong

Shelton

Chao

Gandhi

Kwoh

Oversby

Sivapatham

Chen

Goh

Lemut

Pham

Staer

Chong

Han

Leow

Pothukuchi

Sutedja

Choy

Hwang

Leung

Pritchard

Tai

Crane

Joppich

Lo

Qiu

Tan, C

Tedja
Teh
Verma
Voola
Walker
Yang
Zhang

It is important to review the learning objectives for each Unit prior to the
review session and formulate your responses individually to gain maximum
value form the experience. Although faculty will present a summary of these

focus points, it is not the intention to provide students with another lecture to
learn verbatim. This is an opportunity to discuss the learning objectives.
The course has been revised each year, almost exclusively based on student
feedback. We have added material as an outcome of student suggestions and
deleted/revised material as an outcome of student concerns. Please continue to let
me know of any comments or concerns that you think would improve the course.

Evaluation

Level 2-Unit I Examination (1 hr-SA)

Formative

Level 2-Unit 2 Examination (1 hr-SA)

15%

On-line Cephalometric Quiz

Formative

On-Line Space Analysis Quiz

Formative

Practical (Wire bending/Typodont)

10%

Semester 1 Exam

20%

(2 hours-MCQ)

Review Test ( 1 hr MCQ)

15%

McGibbon Essay

Formative

Clinical Grade

10%

Final Examination (2 hrs-MCQ)

30%
100%

Professionalism

Pass/Fail

Professionalism In the assessment process professionalism will be based on the


Professionalism Policy for Dental Students and will be assessed as Pass/Fail
component.

Supplementary Examinations and Assessment


If a student does not pass this unit, then a Supplementary Examination may be
granted but this will depend on the students overall academic performance to date
in the BDSc course.
Decisions regarding Supplementary Exams and additional assessments are made
by the Board of Examiners at its meeting in early December. A Supplementary
Examination can take any form and will not necessarily be a written examination
paper. The Course Co-ordinator and/or the Board of Examiners may recommend
an alternative form of assessment if the students work has been deficient in one
particular part of the course in this case a student may be required to undertake
extra work and assessment in that part of the course only (e.g. if the diagnosis
tests were failed, than an OSCE style exam or a written assignment may be
granted; if insufficient practical work was done then extra practical work may be
required, etc).
Preparing for Exams:
This course has multiple resources for you to utilize in your training: Textbook,
online modules, module self-tests, lab manual, seminar presentations, and prior
coursework in orthodontics. Students in the past have complained about
expectations not being aligned regarding exams and how best to prepare.
Considering this, here is a synopsis of the resources that should best prepare you
to excel in this course:

Textbook Mastery of assigned readings (textbook) correlate to the


highest level of preparedness for exams. Reading assigned pages should be
considered an absolute necessity for excellent performance in the course.

Online modules The modules approximate the


textbooks information with supplemental cases and pictures.
Online modules cover important concepts found in the book but do
not include everything. If you study only the modules, you will not
be fully prepared for the exams.

Module self-tests These are a good representation of the


difficulty level of questions represented in the course exams.

Lab material and outlines this part of the guidebook is


important to review for exams.

Seminar Presentations presentations delivered by


residents will help guide you in your studies, and are particularly
helpful to clarify any questions you may have.


Prior G&D Coursework Information from prior course
reading/modules may be on future G&D exams. Any questions
from prior coursework material will be very general concepts.

Dental Graduate Outcomes


The Orthodontics 306 Unit contributes to the Graduate Outcomes by providing students with different types of learning opportunities. Lectures are followed by Practical Laboratory
sessions, offering opportunity for discussion and feedback. Clinical sessions are undertaken, providing supervision of students in their application of the knowledge gained through the
lectures, and their application of the practical skills gained within the laboratory setting.
UONo

UNIT OUTCOMES :
At the end of this 8
week term, students
will:

THEME

Describe and explain


orthodontic problems
and the implications on
the patient's health status
and society

Integrated Science
of Medicine and
Dentistry

Integrated Science
of Medicine and
Dentistry
Dental Health in
the Community

Sno

STRAND

TEACHING and
LEARNING
EXPERIENCES

ASSESSMENT

YLO
No

YEAR OUTCOMES

Normal Structure
and Function

Lecture

Summative, Written
Examination, Short
Answer Questions

2.3.1

Abnormal Structure
and Function

Self directed learning

Formative, Written
Assignment, Short
Answer Questions

3.3.1

Demonstrate knowledge of
relevant normal human
structure and function
including aspects of
development, growth and
aging
Identify abnormal human
structure, function and
behaviour and their effects
on health
Discuss population
perspectives to health and
dental health care in
communities

10

Population
Perspective on
Health

10.3.1

Describe the range of


normal dental
development and
recognise developing
malocclusion and
methods for determining
treatment.

Demonstrate orthodontic
diagnostic procedures
for developmental
problems and outline
rudimentary treatment
plans

Integrated Science
of Medicine and
Dentistry

Normal Structure
and Function

Lecture

Summative, Written
Examination, Short
Answer Questions

2.3.1

Demonstrate knowledge of
relevant normal human
structure and function
including aspects of
development, growth and
aging

Integrated Science
of Medicine and
Dentistry

Abnormal Structure
and Function

Self directed learning

Formative, Written
Assignment, Short
Answer Questions

3.3.1

Clinical Dental
Practice

Pathological
Structure and
Function

Integrated Science
of Medicine and
Dentistry

Normal Structure
and Function

Lecture

Summative, Written
Examination, Short
Answer Questions

2.3.1

Integrated Science
of Medicine and
Dentistry

Abnormal Structure
and Function

Self directed learning

Formative, Written
Assignment, Short
Answer Questions

3.3.1

Clinical Dental
Practice

Pathological
Structure and
Function

Clinical skills

Summative,
Practical/Clinical,
Practical task

5.3.1

Clinical Dental
Practice

Patient Assessment
and Management

Identify abnormal human


structure, function and
behaviour and their effects
on health
Identify and discuss
pathological and clinical
features of disease in the
context of dental practice
Demonstrate knowledge of
relevant normal human
structure and function
including aspects of
development, growth and
aging
Identify abnormal human
structure, function and
behaviour and their effects
on health
Identify and discuss
pathological and clinical
features of disease in the
context of dental practice
Demonstrate appropriate
patient assessment and
management in clinical
settings under supervision

5.3.1

6.3.1

UONo

Perform simple
orthodontic therapy to
children at the general
practitioner level and
describe principles of
comprehensive
treatment.
Explain
the
biomechanical principles
involved in orthodontic
tooth movement in
children

Design, fabricate, and


activate/adjust a number
of removable and fixed
orthodontic appliances
in clinical situations

Clinical Dental
Practice

Patient Assessment
and Management

Clinical skills

Summative,
Practical/Clinical,
Practical task

6.3.1

Demonstrate appropriate
patient assessment and
management in clinical
settings under supervision

Integrated Science
of Medicine and
Dentistry

The Scientific and


Evidence Base of
Dentistry

Lecture

Summative, Written
Examination, Short
Answer Questions

1.3.1

Use critical thinking to


evaluate knowledge and
simple clinical problems

Self directed learning

Formative, Written
Assignment, Short
Answer Questions

Clinical skills

Summative,
Practical/Clinical,
Practical task
Summative,
Practical/Clinical,
Structured exam

4.3.1

Demonstrate some
advanced clinical
procedures correctly and
safely in simulated clinical
settings

4.3.2

Demonstrate simple
operative procedures
correctly and safely in
clinical settings

Clinical Dental
Practice

Skills and
Procedures

Clinical skills

Clinical Dental
Practice

Skills and
Procedures

Laboratories

UNIT OUTCOMES
: At the end of this 8
week term, students
will:

SUONo

Specific Unit Outcomes

Describe and explain


orthodontic problems
and the implications
on the patient's health
status and society

Explain the general and specific


causes of malocclusion and
dentofacial deformity

Describe the range of


normal dental
development and
recognise developing
malocclusion and
methods for
determining
treatment.

Demonstrate
orthodontic diagnostic
procedures for
developmental
problems and outline
rudimentary treatment
plans

Perform simple
orthodontic therapy to
children at the general
practitioner level and
describe principles of
comprehensive
treatment.

Describe the prevalence of


malocclusion types and the impact
on the patient's health status

Describe the range of normal


dental development and recognise
developing and presenting
malocclusion

Outline the methods for


determining the need for treatment
of various malocclusion types

Demonstrate orthodontic
diagnostic procedures for
developmental problems in the
clinical situation.

Develop a list of patients problems


to enable a list of treatment
objectives to be outlined

Outline a rudimentary treatment


plan so that patients may be sorted
by the difficulty and severity of
their problems

Perform clinical treatment to


children and participate in active
orthodontic treatment at the general
practitioner level

Describe the basic principles of


comprensive treatment delivered at
specialist level of various
malocclusion types

Explain
the
biomechanical
principles involved in
orthodontic
tooth
movement in children

Describe and apply the knowledge


of biomechanics to the construction
and management of removable
appliance therapy in a clinical
environment.

Design, fabricate, and


activate/adjust
a
number of removable
and fixed orthodontic
appliances in clinical
situations

Design, fabricate, and


activate/adjust a number of
removable and fixed orthodontic
appliances; including appliances
such as expansion plates,
removable appliances for
individual tooth movement, simple
functional appliances and fixed
lingual arches.
Recognize the clinical situations
for which such appliances are
indicated as well as the limitations;

Explain the effects that these


appliances can produce (both
desirable and undesirable).

UONo

UNIT OUTCOMES : At the end of this 8 week term, students will:

GENERIC
OUTCOMES

Describe and explain orthodontic problems and the implications on the patient's
health status and society

DisciplineSpecific
Knowledge
and Skills
Understanding
Health and

Society
2

Describe the range of normal dental development and recognise developing


malocclusion and methods for determining treatment.

Demonstrate orthodontic diagnostic procedures for developmental problems and


outline rudimentary treatment plans

Perform simple orthodontic therapy to children at the general practitioner level and
describe principles of comprehensive treatment.

DisciplineSpecific
Knowledge
and Skills

Critical
Thinking and
ProblemSolving Skills
Personal and
Professional
Skills
DisciplineSpecific
Knowledge
and Skills
Critical
Thinking and
ProblemSolving Skills
DisciplineSpecific
Knowledge
and Skills

DisciplineSpecific
Knowledge
and Skills

Explain the biomechanical principles involved in orthodontic tooth movement in


children

Design, fabricate, and activate/adjust a number of removable and fixed orthodontic


appliances in clinical situations

DisciplineSpecific
Knowledge
and Skills
DisciplineSpecific
Knowledge
and Skills
Critical
Thinking and
ProblemSolving Skills

III. WHEN YOU DO IT: THE SCHEDULE


12.30 pm Thursday January 31st
OHCWA Room 211

Course Introduction

Dr. Goonewardene

Commence Level 2- Unit 1 Self Instruction


Malocclusion: Definition and Prevalence
Known Causes of Malocclusion
Equilibrium Theory and the Etiology of Malocclusion
1.30 pm

Thursday January 31st


Laboratory 1

Wire bending exercises


Diagnostic Model Trimming-See powerpoint on Moodle

12.30 pm

Thursday February 7th


OHCWA Room 211

1.30 pm

Thursday February 7th


Laboratory 2 -

1.30 pm

Wire Components

Wire components of URA

Thursday February 14th


Laboratory 3-

Wire components of URA

12.30 pm Thursday February 21st


Group 1
Group 2
Group 3
Group 4
Group 5
Group 6
1.30 pm

Dr. Bennett

Small Group Reviews


Level 2- Unit 1 Self Instruction
Dr. Bi Le
Dr. Hui Lau
Dr. Natalia Lim
Dr. Chanida Supaporn
Dr. Consuelo Loza
Dr. Sam Bennett

Thursday February 21st


Laboratory 4-

Acrylic Processing and finishing


Acrylic Repair demonstration

OHCWA 211
OHCWA 202
OHCWA 215
OHCWA G04
OHCWA 205

Orthodontic Clinic

12.30 pm Thursday February 28th

1.30 pm

Level 2- Unit 1 Self Instruction TESTFormative OHCWA Room 211

Thursday February 28th


Laboratory 5-

Cephalometric Tracing
Model Analysis-Space Analysis
Facial Form Analysis

*NOTE-Wire exercises, URA and models to be submitted by Friday 13th April


Reduction of 5% per day for late submission

12.30 pm

1.30 pm

Thursday March 7th

Molar uprighting- Li arch


Dr. Bennett
OHCWA Room 211

Thursday March 7th


Laboratory 6-

Treatment Planning Cases

Commence Level 3- Unit 1 Self Instruction


Essentials of Orthodontic Diagnosis
Concepts of orthodontic Treatment Planning

1.30 pm

Thursday March 14th


Laboratory 7-

Lingual Arch
Molar Uprighting
Premolar Extrusion

Complete (Ideally before commencing Clinical Rosters) Formative tests on Moodle titled:
Facial Form and Cephalometrics Quiz-Formative
Space Analysis Quiz-Formative
1.30 pm

Thursday March 21st

Group 1
Group 2

Small Group Reviews


Level 2- Unit 2 Self Instruction

Dr. Sam Bennett


Dr. Bi Le

OHCWA 211
OHCWA 202

Group 3
Group 4
Group 5
Group 6

Dr. Hui Lau


Dr.Natalia Lim
Dr. Chanida Supaporn
Dr. Mithran Goonewardene

12.30 pm Thursday March 28th

1.30 pm

OHCWA 215
OHCWA G04
OHCWA 205

Ortho Clinic

Level 2- Unit 2 Self Instruction TEST


Summative OHCWA Room 211

Thursday March 28th


Laboratory 8Lingual Arch
Molar Uprighting
Premolar Extrusion

*NOTE- Wire exercises, URA and models to be submitted by Friday 12th April
Lingual Arch, Molar Uprighting and Premolar extrusion projects to be submitted by
Friday 20th September
Reduction of 5% per day for late submission

Commence Level 3- Unit 1 Self Instruction


Biology of Orthodontic Treatment
Mechanical Principles in Controlling Orthodontic Force
Orthodontic Anchorage and Controlled Tooth Movement

SEMESTER 1 EXAM in EXAM TIMETABLE on Level 2 Units 1 and 2

8.00 am

Thursday July 18th

Small Group Reviews


Level 3- Unit 1 Self Instruction

Group 1
Group 2
Group 3
Group 4
Group 5
Group 6

Dr. Consuelo Loza


Dr. Sam Bennett
Dr. Bi Le
Dr. Hui Lau
Dr.Natalia Lim
Dr. Chanida Supaporn

OHCWA 211
OHCWA 202
OHCWA 215
OHCWA G04
OHCWA 205
Ortho Clinic

Commence Level 3- Unit 2 Self Instruction


Space Management in Preadolescent Children
Crossbites and Vertical Problems in Children
Concepts of Adjunctive Orthodontic Treatment
Adjunctive Orthodontic Treatment Procedures

8.00 am

Thursday August 22nd

Group 1
Group 2
Group 3
Group 4
Group 5
Group 6

Small Group Reviews


Level 3- Unit 2 Self Instruction

Dr. Chanida Supaporn


Dr. Mithran Goonewardene

Dr. Sam Bennett


Dr. Bi Le
Dr.Hui Lau
Natalia Lim

OHCWA 211
OHCWA 202
OHCWA 215
OHCWA G04
OHCWA 205

Ortho Clinic

9.00 am

Wednesday September 4th

Invisalign Technique
Dr Razza OHCWA LT

9.00 am

Wednesday September 18th

REVIEW TEST FJ CLARK

*NOTE- Lingual Arch, Molar Uprighting and Premolar extrusion projects to be submitted by
Friday 20th September
Reduction of 5% per day for late submission
*Written McGibbon Essay Submission date Friday 27th September
Reduction of 5% per day for late submission

FINAL EXAMINATION IN EXAM TIMETABLE

IV. DOING IT
Level 2-UNIT I. THE NATURE OF ORTHODONTIC PROBLEMS
Directions:
1) Go through the instructional materials
Part 1. Malocclusion: what is it and why should we treat it?
(a) Read Contemporary Orthodontics Chapter 1, pp. 3-23.
(b) Malocclusion: Definition and Prevalence. Then take the self-test.
Part 2. The etiology of malocclusion
(a) Read Contemporary Orthodontics Chapter 5, pp. 130-161.
(b) Known Causes of Malocclusion, and do the computer self-test.
(c) Equilibrium Theory and the Etiology of Malocclusion, and the computer self-test.

2) Review the educational objectives below. They are an outline of what you are expected
to know when you have completed the unit. If you aren't sure you can meet the objective, look back
at the appropriate instructional material.
Part 1. Malocclusion: what is it and why should we treat it?

Describe ideal occlusion in terms of the relationship of the teeth to the line of occlusion.
Describe ideal occlusion in terms of the occlusal relationship of the teeth in all three planes of
space (transverse, antero-posterior and vertical).
List the dental characteristics on which the Angle classification is based.
Discuss the advantages of the Angle system for classification.
Describe the functional, health and psychosocial reasons for orthodontic treatment, and place
them in perspective in terms of their relative importance.
Describe realistic goals for orthodontic treatment, and indicate the way they have changed as
modern dentistry developed.
Discuss how need for orthodontic treatment compares with demand in the US at present and
how demand is likely to change in the near future.
Part 2. The etiology of malocclusion

Describe known causes of malocclusion in terms of major categories, and put the known
causes in perspective relative to the total number of patients with malocclusion.

Indicate the two types of malocclusion most likely to be due to inherited jaw proportions, and
describe the evidence to support your categorization.
Indicate the mechanism by which trauma to the mandible can affect its future growth.
Identify the magnitude of force needed to cause movement of a tooth, and relate this to the
observed threshold for tooth movement.
Identify the duration of force needed to cause movement of a tooth, and relate this to the
impact of habits like thumb sucking on the dentition.
Describe the maturation of oral function from infancy to adult life, with particular emphasis on
the pattern of swallow.
Discuss myofunctional therapy for tongue thrusting as a potential therapy for anterior open
bite in children, with emphasis on its underlying assumptions and their validity.
Describe the possible role of nasal obstruction in the etiology of malocclusion, and indicate
the probable mechanism by which it would have an effect.

Level 2-UNIT 2. DIAGNOSTIC PROCEDURES


Directions:
1) Go through the instructional materials
Dentofacial Proportions
(a) Read Contemporary Orthodontics Chapter 6, pp. 163-195
(b) Facial Form Analysis. This computer teaching program incorporates the
equivalent of the other computer self-tests, so there isn't a separate test. The exercise on this
material is described below in the Space Analysis exercise.

Principles of Cephalometric Analysis


(a) Read Contemporary Orthodontics Chapter 6, pp. 201-218.
(b) Cephalometric tracing techniques. For this program, the online cephalometric quiz
serves as the self-test.
(c) Cephalometric superimposition. For this program also, the online quiz serves as
the self-test.
(d) Complete Online Facial Form and Cephalometrics Quiz-Formative

Space Analysis
(a) Read Contemporary Orthodontics, Chapter 6, pp. 195-201
(b) Space Analysis and Its Interpretation, and take the computer self-test.
(c) Complete Online Space Analysis Quiz-Formative

Systematic Description of Malocclusion


(a) Read Contemporary Orthodontics, Chapter 6, pp. 218-229
(b) Ackerman-Proffit Classification: the Systematic Description of Malocclusion, and
take the computer self-test.

Dentofacial Proportions

Describe ideal dentofacial proportions from the full face aspect, indicating the role of
symmetry and the relationship of the width of upper to lower face characteristics.
Describe ideal dentofacial proportions from the lateral aspect, indicating the a-p and vertical
relationships of the upper, mid and lower face.
Describe the method and objectives of facial form analysis.
Discuss the limitations of facial form analysis.
Carry out a facial form analysis
Principles of Cephalometric Analysis

Discuss the background for the development of cephalometric radiography in orthodontics.


Identify the two major uses of cephalometric radiographs in orthodontics.
Given a cephalometric radiograph, identify and trace landmarks necessary to properly outline
and evaluate the position of (a) cranial base, (b) skeletal maxilla, (c) maxillary dentition, (d)
skeletal mandible and (e) mandibular dentition.
Given a cephalometric tracing, evaluate whether the incisor teeth are retrusive, positioned
properly or protrusive relative to their supporting bone.
Given a cephalometric tracing, evaluate the antero-posterior and vertical relationships of the
jaws to the cranial base and to each other.
Compare and contrast the measurement analysis and template analysis methods of evaluating
cephalometric radiographs.
Given an initial and progress or final cephalometric tracing, complete an overall
superimposition and maxillary and mandibular superimpositions, producing a composite
tracing.
Given a composite cephalometric tracing, describe the changes evident in the tracing and
relate them to growth or treatment.

Space Analysis

Identify the four major assumptions about growth and development on which space analysis is
based.
Discuss the rationale for expecting decreased accuracy of space analysis in children who do
not have a Class I jaw relationship.
Identify the diagnostic materials needed to perform a space analysis.
Carry out a space analysis, as described in Laboratory exercise 2.
Indicate how you would interpret a space analysis result in a child whose facial form or
cephalometric analysis indicated that the incisors were retrusive or protrusive.

Systematic Description of Malocclusion

Identify the five major characteristics of malocclusion on which systematic description is


based.
Discuss the rationale for considering incisor crowding and incisor protrusion as being two
aspects of the same thing.
Describe how a skeletal posterior crossbite can be differentiated from a dental crossbite.
Describe how a skeletal Class II or Class III malocclusion can be differentiated from a dental
Class II or Class III.
Describe the cephalometric characteristics of a skeletal open bite and a skeletal deep bite.
Indicate how you would distinguish a dental anterior open bite from a skeletal open bite.

Level 3-UNIT 1.
Orthodontic Diagnosis & Treatment Planning

Recognize and evaluate skeletal and dental relationships in all three planes of space.
Recognize and quantify the patient's arch length status.
Evaluate the skeletal and arch length considerations, interactions and appropriateness of
treatment or non-treatment.
Recommend treatment or referral of specific problems based upon case evaluation.

Removable Appliances Session Objectives:Lab

Biologic Response to Orthodontic Force

Describe the histologic/cellular/vascular response of the supporting structures to force


applied to teeth.
Discuss the role of biologic electricity in maintenance and turnover of alveolar bone.
Describe the relationship of orthodontic force levels to anchorage.

Mechanical Principles in Controlling Orthodontic Force

Define and apply the principles of anchorage in appliance design to control and minimize
unwanted tooth movement.
Describe and recognize different types of removable orthodontic appliances in the following
categories: (a) functional appliances; (b) Crozat; (3) Hawley type; and (4) Clear Aligner
Therapy.
Describe and make correct appliance designs of the active Hawley type with specific
recommendations for these components: (a) active; (b) retention; (c) connector; and (d)
reactive or anchorage.
Select the correct wire size for active and retentive elements of active Hawley type
appliances.
Define and explain the biomechanical principles that pertain to orthodontics, specifically the
meaning of terms such as "force", "moment", "fulcrum", "center of rotation", and
"anchorage" as applied to biomechanics.
2. Demonstrate the relationship between wire size, strength, stiffness and the force
produced for a given deflection.
3. Explain the difference between tipping and bodily tooth movement, and how an
applied force can produce either.

Orthodontic Anchorage and Controlled Tooth Movement

Describe the reaction of a tooth to a single force placed against the crown.
Describe the reaction of a tooth to a two-force system placed against the crown as a function
of the moment-to-force ratio.
Indicate the changes in orthodontic forces and
moments needed for successful movement of a tooth that has lost alveolar bone support (as
from previous periodontal disease).
Describe the adaptations in the contemporary edgewise appliance to reduce in-out (first
order) bends in arch wires.
Describe the adaptations in the contemporary edgewise appliance to reduce angulation
(second order) bends in arch wires.
Describe the adaptations in the contemporary edgewise appliance to reduce torque (third
order) bends in rectangular arch wires.

UNC Level 3 -Unit 2


Space Management in Preadolescent Children

Discuss the indications and contraindications for the selection of space maintaining
appliances.
Discuss the indications and contraindications for the selection of various space regaining
appliances.
Discuss the construction of different appliances.

Describe the timing and sequence of treatment.


Identify the possible causes of midline diastemas and spacing.
Discuss the relationship between spacing and protrusion
Potential Crowding & Space Maintenance
Describe diagnostic information necessary to make decisions concerning space maintenance
or management.
Identify and discuss alternative space analysis procedures.
Discuss the importance of determining the etiology of tooth loss.
Discuss the phenomenon of space loss.
List factors that weigh in the decision whether to maintain or regain space.
Discuss the relevancy of the above factors to space management.

Crossbites and Vertical Problems in Children

Identify skeletal contributions to anterior crossbites.


Identify dental contributions to anterior crossbites.
Identify the significance of functional shifts in anterior crossbites.
Evaluate space, tooth orientation and position, intermaxillary relationships, and eruption
timing and sequence regarding the teeth involved in the anterior crossbites as etiologic and
treatment factors.
State rationale for correcting anterior crossbites.
Recommend appropriate treatment for anterior crossbites including timing and appliance
design.
Explain the relevance of facial form to posterior crossbite diagnosis.
List the etiologic factors of posterior crossbite.
Describe the clinical findings consistent with a bilateral maxillary constriction, a bilateral
constriction accompanied by a mandibular shift, and a true unilateral maxillary constriction.
Describe the rationale for correcting posterior crossbites.
Describe the appropriate timing and appliance design for posterior crossbite treatment.

Vertical Problems / Habits


Define vertical problem and its classification, i.e., dental, skeletal, and possible etiologies.
Describe epidemiology relating to vertical problems and malocclusion.
Identify skeletal patterns predisposing patients to deep bite and open bite.
Explain oral-facial growth patterns and physiology as they relate to vertical problems.
Identify treatment and timing for vertical problems.

Adjunctive Orthodontic Treatment Procedures

Describe indications for repositioning anterior teeth in adults.


Discuss use of diagnostic set-ups in planning adjunctive incisor positioning.
Describe indications and methods for extrusion of fractured teeth.
Describe periodontal implications of orthodontic treatment in adults.

Explain the indications for molar uprighting in adjunctive orthodontic treatment as part of
general dental care.
Describe the technique used to upright a tipped molar.
Identify appropriate appliances for different clinical problems.
Explain types of appliances, in terms of active and reactive units.
Explain appliance placement, adjustments and timing.
Identify potential side effects or sequela of treatment.
Describe patient tolerance of the appliances.
Identify expected treatment time.
Describe retention procedures.

SUPPLEMENTAL
MATERIALS

LABORATORY EXERCISE 1
Basic Wire Bending
These simple exercises are to familiarize you to some simple wire bending tasks
1. Follow the lines and ensure that the bends are accurate and the wire remains in the
same plane. Use 0.7 mm wire

2. This is a small finger spring constructed out of 0.6 mm wire-ensure that the helices are
3mm in diameter and lie in the same plane.

3. This is meant to represent a type of expansion wire which is attached to two bands on
the upper molars. Bend this out of 0.9 mm wire and follow the lines accurately.
Ensure that it lies in one plane.

4. These two wire are formed out of 0.5mm wire and represent two possible fixed
appliance archforms with 3mm helices used to attach elastics-ensure that you follow
the lines and that the wire is as flat as possible when it lies on the bench top.

Diagnostic Model Preparation

SEE file in Moodle

LABORATORY EXERCISE 2 and 3


LAB Spring to Tip Incisor Facially

Use:

Correction of anterior crossbites of dental origin; more commonly for correction


of retroclined maxillary incisors if larger spring fro all incisors

Supplies:

Bird beak pliers, models and wire cutters

Construction and Evaluation Criteria

Use of 0.6mm stainless steel round wire to fabricate the spring

The free end of the wire is bent upon itself and turned toward the incisal edge of tooth to
protect the mucosa.

The free end contacts the distal surface of the incisor

The most anterior horizontal section of wire contacts the lingual of the distal marginal ridge of
the incisor

The helices is formed from 1.5 turns and is 2-3 mm in diameter. The first helix will open
when the tooth is moving in the appropriate direction and is wound away from the palate when
going from the free end to the tag end.

Neither helix extends laterally beyond the distal edge of the central incisor.

The horizontal sections converge with respect to each other but they do not overlap.

The second helix is wound palatally when going from the second horizontal section to the tag
end.

At no point is the lingual portion more than 1 mm from contact with the free gingival margin.

The tag end extends posteriorly 15 mm, parallel to the midpalatal-sagittal suture and within 1
mm of it. The tag end has at least one bend to aid retention in the acrylic and contacts the
palatal tissue 20-25 mm from the incisor at the midline.

Spring to Tip Incisors Facially

Labial Bow

Use:

Can be used to tip incisors lingually when they have been displace by a sucking
habit and there is adequate vertical clearance and space within the arch; can be
used to control position of the incisors . May also be used for retention and anchorage

Supplies:

Bird beak pliers, models, wire cutters, and wax spatula

Construction & Evaluation Criteria

Use 0.7mm stainless steel round wire.

The horizontal portion of the bow should contact the labial surface of the incisors at the center
of the clinical crown.

The vertical U loops should start at the mesial one-third of the canine.

The U loop should not contact the tooth or gingival tissue but should lie parallel and 1 mm
to the buccal.

The U loop should be about 6 mm in length the exact height and configuration of the loop
depends on the depth of the vestibule and the amount of intended tooth movement. The

greater the movement required, the larger must be the U loop. (Increasing the length of the
wire increases the range of activation and reduces the force per unit deflection.)

The distal leg of the U loop should be adapted to follow the buccal contour and pass
occlusal to the distal canine contact, where it must be closely adapted to avoid occlusal
interferences.

The wire should be closely adapted to the palatal interproximal area, yet avoiding contacting
the palatal surface of the teeth.

The ends of the wire should be turned down sharply towards the palate and cut off to maintain
a 0.5 mm space between the wire and the palate so the wire may be completely embedded in
acrylic.

The wire must lie PASSIVELY in place on the model.

Labial Bow
-------------------------------------------------------------------------------------------------------------------------Adams Clasp and Double Adams Clasp, Ball clasp

Use:

Used to retain appliance by engaging undercuts in crown form

Supplies:

Adams Plier, models, wire cutters, and wax spatula

Adams Clasp- Construction & Evaluation Criteria

Use 0.7mm stainless steel round wire.

Cut away mesial and distal gingival margin(1mm) to expose undercut for Adams clasp
retention

Clasp arrowheads must converge towards the undercut to ensure that they are retentive.

Pass Adams clasp over contact point between teeth so as to prevent disruption to occlusion,

Converge retentive portion towards palate

The wire should be closely adapted to the palatal interproximal area, yet avoiding contacting
the palatal surface of the teeth.

The ends of the wire should be turned down sharply towards the palate and cut off to maintain
a 0.5 mm space between the wire and the palate so the wire may be completely embedded in
acrylic.

The wire must lie PASSIVELY in place on the model.

Ball clasp again engages undercut interproximally

Pass ball clasp over contact point between teeth so as to prevent disruption to occlusion,

LABORATORY 4
Fabricating and Finishing Cold-cure Acrylic

Use:

Removable appliances are commonly used as functional appliances for growth


modification and tooth movement in children.

Supplies:

Models, mixing bowls, slow speed handpiece, large E-cutter, wax spatula, pliers,
scaler, and buffalo knife

Construction & Evaluation Criteria


Wax all wires to hold them in place, covering all helices and the portions of the wire that must
be able to move in order to function (see page 33). The tags anchoring the springs to the
acrylic should be positioned such that there is a little space between the model and the wire to
allow acrylic to flow under the tag.
Paint the model with separating medium where the acrylic will go, i.e. the whole palatal
surface and the lingual aspects of the teeth up to the incisal edges. Use only the provided
separating medium.
Wax labial bow and molar clasps into place as shown on the bottom figure on page 33. Also
flow a little wax into the spaces between the incisors to prevent the acrylic from flowing onto
the facial surfaces and make the retainer easier to remove.
Soak the model by placing it into a rubber mixing bowl so that only the base of the cast is
immersed. Do not immerse the whole model since the may lift off.
Orthodontic resin (powder or liquid) should be applied in a salt and pepper fashion and
extended around the cervical margin of all teeth covering the wires. The acrylic should be
extended distally to at least 2 mm beyond the most posteriorly positioned wire.
The acrylic should be uniformly 1-2 mm thick and have a smooth non-porous finish.
The acrylic should be fully cured before removing the appliance from cast, otherwise
distortion will occur.
To cure the acrylic, totally immerse the model in cold water.
The acrylic must then be trimmed for maximum retention and hygiene.
The posterior margin should be trimmed to the middle of the first molars in the midline, but
extended 2-3 mm distal to the wires further laterally (see figures on page 34). The posterior
margin must be smoothed and rounded to prevent gag reflex.
The appliance should be polished with wet pumice, then polishing compound.
The tissue surface should be inspected for sharp projections which should be removed, but the
tissue surface should never be polished.

Exercise 4
Finishing with Cold Cure Acrylic

Repair of a Broken Appliance (Demonstration)

Supplies:

Slow speed handpiece and E-cutter, models and cured appliance, mixing bowl, pliers
Wax spatula, scaler, and buffalo knife

Construction & Evaluation Criteria

The appliance must be inspected to make sure the wires have not become distorted. Replace
the broken appliance on the model. The two halves must fit passively. It may be necessary to
recontour certain wires.

The appliance should be removed from the model and a trough cut approximately 3 mm wide,
which incorporates dovetails for mechanical retention with the remaining acrylic. The trough
must be cut the total depth of the acrylic.

The stone model should be coated with separating medium in the area of the break.

The broken pieces of the appliance should be replaced on the model and if necessary
stabilized with wax on the labial surface of the teeth.

Cold-cure acrylic must be applied in a salt and pepper fashion to the area of the prepared
trough. The acrylic should be extended over the palatal surface of the appliance halves, but do
not thicken excessively.

The resin must polymerize completely prior to removing the appliance and polishing the
surface to a smooth non-porous finish, of similar thickness to the rest of the appliance.

Repair of a Broken Appliance

LABORATORY 5

Facial Form Analysis, Cephalometrics, Space Analysis


you must complete the computer teaching programs on cephalometric tracing and cephalometric
superimposition
The online cephalometrics quiz on Moodle will test your proficiency of the following topics and
is based on the self instructional material and reading material: (1) identification of landmarks on a
cephalometric radiograph; (2) analysis of dentofacial proportions based on construction of reference
planes and both linear and angular measurements; and (3) cranial base, maxillary and mandibular
superimpositions. A detailed protocol for these topics is also provided below. You are not required to
turn in an actual tracing.
The quiz counts for 3% of the course grade in cephalometrics and 2% for the space analysis

Objectives: You will:


(1)

Need to review people in your group

(2)

Verify that you have the Facial Profile Analysis and Space Analysis forms

(3)

Complete the Facial Profile Analysis form and the Space Analysis form

(4)

Turn in the completed space analysis and facial form analysis

Background for Space Analysis


Purpose:
To measure the size of the erupted permanent teeth and estimate the size of the
unerupted permanent teeth and compare this estimate to the space available between the first
permanent molars.
Assumptions:

1.
2.
3.
4.
5.

Analysis used:

There is a correlation between erupted mandibular incisors and the


remaining succedaneous teeth.
The prediction tables are valid for your patient.
Arch dimensions do not change appreciably during growth.
The mesial shift is predictable.
All succedaneous teeth are developing normally.

Tanaka-Johnson Analysis

Applicability:

These prediction tables were derived from a sample of Caucasians of Northern


European descent living in Iowa. You must decide if your patient is a member
of this same population group. These tables are not applicable to the different
racial groups. If your patient does not fit the population to which these tables
apply you can (1) complete the space analysis recognizing these limitations; or
(2) a more accurate alternative is to obtain long cone periapical radiographs of
all unerupted permanent teeth and measure their mesiodistal widths adjusting
for magnification. However, in view of the required radiation exposure, this is
not routine procedure and option (1) is preferred.

Materials needed:

Digital images of dental casts


Digital image of patients profile
Pencil
Space analysis form

When you are performing a space analysis using real dental casts, you should consider using a
modified Boley gauge to make the necessary measurements. The Boley gauge must be modified to
accurately measure the widths of teeth. Using your slow-speed handpiece and a heatless stone, grind
the square ends of the measurement tips to points as shown in the diagram (left).

Remove shaded areas


indicated by arrows

Procedure for the Facial Profile Analysis and Space Analysis Exercise using Digital Images
You will have to upload the following digital images for this patient:
- Right facial profile
- Maxillary occlusal
- Mandibular occlusal
- Right buccal occlusion
- Left buccal occlusion
a). Facial Profile Analysis
Using the right facial profile image for your patient complete the Facial Profile Analysis form. Carefully
follow the instructions on the form to draw the patients profile on the form in the correct location. After
drawing their profile answer the questions at the bottom of the form as they relate to this patients profile

b) Space Analysis
Using the preceding information complete the Space Analysis Form for your patient. The following
paragraph numbers refer to section numbers on the Space Analysis Form.
1.

Measurement of Available Mandibular Space.


Measure the four segments (a, b, c, d) on the mandibular cast. Each measurement is entered
on the appropriate line of the Space Analysis Form. The values for each segment are
summed and the sum represents the space available in the arch.

2.

Measurement of Mesio-distal Permanent Mandibular Incisor


On the digital image, measure the greatest width of each incisor and calculate the sum.

3.

Measurement of the Available Maxillary Space.


Maxillary space available is determined in the same manner as was done for the mandibular
arch. The measurements are repeated and recorded as outlined in section 1.

4.

Measurement of the Mesio-Distal Permanent Maxillary Incisor Width


On the digital image, measure the greatest mesio-distal width of each incisor and calculate
the sum.

5.

Mandibular Space Analysis.


This section will provide you with the space discrepancy (+) for the mandibular arch.
Transcribe the appropriate data to this section. Record the total mandibular incisor width
through use of the table at the bottom of the form to establish the size of the canines and two
premolars for one mandibular quadrant. Enter the figure for both right and left sides. Add
the three figures to calculate the total space required. Compare the total space required with
the total for space available.

6.

Maxillary Space Analysis.


This section is similar to #5 except that the mandibular incisor width is used to estimate the
size of the canines and two premolars for one maxillary quadrant. Enter the figures for both
right and left sides and complete the calculations.

7.

Skeletal Jaw Relationship.


Complete this section from the information on the facial Profile Analysis. It is necessary to
determine the skeletal status of the patient since this will enable us to project the mandibular
incisor stability found with each skeletal class and its space implications.

8.

Occlusion of the First Permanent Molars.


This is observed from the images of the casts in occlusion, each side individually, and
recorded.

9.

Molar Shift

This mesial shift is measured for patients with a Class I skeletal pattern and end-to-end
molars. The right and left sides are totaled. The sum will need to be subtracted from the
space discrepancy figures for section #5 to obtain a realistic analysis.
10.

Lip Support
This information is also taken from the Facial Profile analysis. If lips are over-supported or
under-supported, this may indicate that the incisor teeth are protrusive or regressive
respectively. A correction for this effect will be necessary in interpreting space analysis
results. Arch expansion is contraindicated when incisors are protrusive.

Interpretation
This is the most important section. The numerical results obtained in sections 5 and 6 need to be
adjusted and interpreted in light of the skeletal relationships, molar occlusion, molar shift, and lip support.
If more information is necessary or you need to review this material, please see the slide tape The
Space Analysis and Its Interpretation.
FACIAL PROFILE ANALYSIS FORM AND SPACE ANALYSIS FORM ARE ON THE NEXT
TWO PAGES.

UNIT 3. CLINICAL INTRODUCTION TO THE CHILD PATIENT


Directions:
1) Attend the introductory lectures and clinical sessions, go through the instructional materials,
and work up your patient for presentation at the TP/CP seminar
(a) Read the sections in the Pediatric Dentistry Clinical Syllabus that are assigned in the
introductory lecture.
(b) Read Contemporary Orthodontics Chapter 7, pp. 238-249
(c) Attend the information gathering clinic with the patient assigned to your sub-group of four
students.
(d) Carry out facial form analysis, space analysis and (if indicated) cephalometric analysis for
that child.
Optional Reference: Read Pediatric Dentistry: Infancy Through Adolescence 4th ed. Pinkerham
JR. Casamassimo PS, Fields HW, Nowak AJ, McTigue DJ, 2005.

V. Supplemental Materials
THE FOLLOWING TRACING PROCEDURES ARE PROVIDED AS A REFERENCE AND STUDY AID
Part 1. Techniques for cephalometric tracing and landmark identification
Place the acetate paper, rough side up, exactly over the film, with the film oriented so the face is to the
right. Tape them together, making sure the top and right side of the film and the tracing paper coincide.
Trace the outline of sella turcica (S). (For this and all remaining steps, follow the illustration in the
syllabus. The procedure is exactly the one outlined in detail Cephalometric Tracing.) Determine the
midpoint and place a dot at point S.
Part 2. Protocol for Cephalometric analysis
(1) Reference lines
Begin the analysis by drawing the five important horizontal planes:
-S-N plane (extend the S-N line posteriorly beyond S)
-true horizontal plane (perpendicular to true vertical, through Or)

-palatal plane (extend the ANS-PNS line posteriorly beyond PNS)


-occlusal plane (extend a line along the occlusal surface of the molars and
molars both posteriorly and anteriorly)
-mandibular plane (extend the Go-Gn line posteriorly)

premolars

or

primary

Drop a true vertical line (parallel to the chain) from nasion. Draw a segment of a true vertical line, as a
dashed line, though points A and B.
Draw the long axis of the maxillary and mandibular incisors.
(2) Analysis
Observe the orientation of the horizontal reference lines, and the position of points A and B relative to
the true vertical line from nasion.
Measure the following angles and record the values on the analysis sheet:
-ANB
-SN-GoGn
-maxillary incisor to palatal plane
-mandibular incisor to mandibular plane
-interincisal angle
Measure the following linear distances and record them on the analysis sheet:
-max incisor facial surface to true vertical line through NA
-mand incisor facial surface to true vertical line through NB
-pogonion to true vertical line through NB
From your observation of jaw positions relative to the reference lines and the measurements, you can
summarize the patient's dentofacial relationships by evaluating:
-Vertical skeletal relationships
-Anteroposterior skeletal relationships
-Maxillary tooth-jaw relationships
-anteroposterior
-vertical
-Mandibular tooth-jaw relationships
-anteroposterior
-vertical

Part 3. Superimposition of Cephalometric Radiographs


For superimposition of a basic tracing see detailed protocol below,
1. Cranial base superimposition. Superimpose your tracing on the red tracing, on the S-N line at S,
and tape the two tracings together. Place a blank sheet of tracing paper over the superimposed tracings. Make

a composite superimposition tracing, first reproducing the red tracing in solid lines, then using dashed lines to
show differences between this and your tracing.
2. Maxillary superimposition. Superimpose the two tracings on the lingual contour of the maxillary
anterior alveolar process and the palatal plane. Make a composite tracing of the maxillary area only, showing
the changes in the position of the maxillary teeth.
3. Mandibular superimposition. Superimpose the two tracings on the lingual contour of the
mandibular symphysis, the outline of the inferior alveolar canal and the crypt of the unerupted lower third
molar. Make a composite tracing of the mandibular area only, showing the changes in the position of the
mandibular teeth and the external contours of the mandible.

LANDMARK IDENTIFICATION FOR STANDARD UNC CEPH ANALYSIS

Co
Po

ANS
A

Co

B
Pg
Gn
Me

PLACEMENT OF ANALYSIS MEASUREMENTS


(Mean Values)
SN
U1-SN
FH

PP

IAN
MP

OP

L1-MP

CEPHALOMETRIC ANALYSIS SHEET

SNA
SNB
ANB
SN-GoGn
Maxillary incisor to SN plane
Mandibular incisor to Mandibular plane
Interincisal angle
Maxillary incisor to NA
Mandibular incisor to NB
Pg to N-Perpendicular

Normal
White

Black

81
78.2
2.8
32
103.8
97.3

84.7
79.2
5.5
38.2
108.9
100

126.8
3.mm
23.2
5.4mm
27.3
-4 to -2mm

113.8
7.4mm
24.1
11.4mm
36.7

56

Initial

Final

C. GLOSSARY OF CEPHALOMETRIC TERMS

Nasion (N)

The anterior end of the fronto-nasal suture, or junction of frontal and


nasal bones. This is seen in profile as an irregular notch. The nasal
bone less dense roentgeno-graphically than the frontal bone, making it
relatively easy to follow the suture even when the notch is not apparent.

Sella turcica (S)

Literally the "Turkish Saddle." The center of the bony crypt occupied
by the hypophysis cerebri (pituitary gland). Roentgenographically a
very constant profile outline seen in its lateral aspect.

Porion (P)

This is a machine registration of the most superior point of the external


auditory meatus, not necessarily corresponding to the anthropometric
landmarks in the skull proper, but nevertheless constant.

Orbitale (Or)

The lowest point on the inferior bony margin of the orbit (average of
two sides if two images seen).

Gnathion (Gn)

The most outward and everted point on the profile curvature of the
symphysis of the mandible. It is located by bisecting the angle formed
by the mandibular plane and the facial plane.

Pogonion (Pg)

The most anterior point on the symphysis of the mandible.

Menton (M)

The most inferior point on the cross section of the symphysis of the
mandible.

Gonion (Go)

The most outward and everted point on the angle formed by the
junction of ramus and body of the mandible on its posterior inferior
aspect (average of two sides if two images seen).

Anterior nasal
spine
(ANS)

The spinous process of the maxilla forming the most


anterior projection of the floor of the nasal cavity
.

Occlusal plane
(OP)

Frankfort plane
(FH)

The general plane of the molars and premolars (use left side if two
images apparent).
Established on lateral headfilms by connecting the lowest point on the
shadow of the
left bony orbit with the uppermost part of the ear-rod.

Mandibular plane
(MP)

The Go-Gn line

(SN)

Sella to nasion line.

"Y" (growth) axis

Line connecting sella with gnathion, representing approximate path of


downward and forward growth of the face from beneath the cranium.

Palatal plane
(PP)

ANS to PNS

Inferior alveolar
nerve
(IAN)

The shadow cast by the bony canal in the mandibular ramus. A stable
landmark for mandibular superimposition.

U1-SN

L1-MP

Angle formed by maxillary incisor to sella nasion line indicates


inclination of incisors to cranial base.
Angle formed by mandibular incisor to the mandibular plane (Go-Gn)

LABORATORY 6

Case records- models, photos and radiographs will be provided for the group to
outline a problem list and establish treatment objectives

LABORATORY 7 and 8
MOLAR UPRIGHTING- PREMOLAR EXTRUSION-LINGUAL ARCH
Components of a Fixed Appliance Part I (A and B)

Preparation:

Review all self study material and readings on Molar Uprighting

Use:

A canine to canine stabilizing lingual arch is used to group the anterior teeth
together to act as anchorage for creating movement in posterior teeth. It can
also be used for retention.

Supplies:

Cotton Pliers, Scaler, Hemostat (straight if available), Handpiece, E-cutter,


Bird Beak Pliers, Wax Spatula, wire cutters

Construction & Evaluation Criteria


(A)

Canine to Canine Stabilizing Lingual Arch

Use 0.030 stainless steel round wire.

The wire must be adapted so that it contacts the lingual surface of the mandibular incisor
in a smooth curve (see drawing).

The ends of the wire are extended to the disto-lingual line angle of the canines and contact
a broad surface of the lingual surface with a hook-shaped bend.

The wire lies passively in contact with canines and incisors.

(B)

Bondable Molar Tube

Select a double molar tube bondable bracket

The occlusal surface of the bracket should be parallel with the occlusal surface of the
tooth and located gingival to the marginal ridges.

The bracket base should fit into the developmental groove on the buccal surface of the
right mandibular molar.

Center the bracket on the buccal surface and mark guidelines with a lead pencil.

Mix the composite (referring to the Appendix section titled Bonding Orthodontic
Attachments;

- Components of a Fixed Appliance Part I


(A)

Canine to Canine Stabilizing Lingual Arch

(B)

Bondable Molar Tube

Components of a Fixed Appliance Part II (C and D)

Preparation:

Read Syllabus: Illustrations on pp. 34, pp.; Contemporary Orthodontics 4 th


Edition, pp. 635-644

Use:

A segmental stabilizing arch wire is used group the premolars and anterior
teeth (using the canine to canine stabilizing lingual arch wire) together as
anchorage in order to produce movement in the molar teeth.

Reference:

Contemporary Orthodontics Fourth Edition: pp. 635-644 (For Final)

Supplies:

Cotton pliers, Scaler, Hemostats, Slow-speed Handpiece, E-cutter, Bird Beak


Pliers, Wire Ligature Cutter

Construction & Evaluation Criteria


(C)

Direct Bond Brackets

Brackets are bonded to the facial surface of the premolars and canine in the quadrant
where the molar is to be uprighted. (In the clinic, an acid-etch composite bonding system
is used.)

Bracket placement depends on the intended tooth movement. Each bracket is designed to
fit on the central portion of the facial surface of the tooth. Ideal placement is with the arch
wire slot of each bracket perpendicular to the long axis of the tooth, parallel to the

occlusal surface, and in the center of the mesio-distal tooth surface. However, quite often
in adult adjunctive orthodontic treatment, it is neither necessary nor desirable to move
malposed teeth in the anchorage segment. If this is the case, ignore the long axis
placement rule and position the brackets for maximum convenience so that a straight
length of edgewise wire may be placed with minimum adjustment. In either case, the
brackets must be placed free of occlusal interferences.

(D)

Segmental Stabilizing Arch Wire

Use 0.018 x 0.025 stainless steel arch wire extending from the distal aspect of the
premolar to the mesial of the canine.

Bend the wire to lie passively in the premolar and canine brackets.

The mesial end of the wire must be turned gingivally and towards the tooth at a point 1
mm beyond the mesial of the canine bracket. This will prevent soft tissue irritation.

A continuous figure-eight ligature tie should be placed from premolar and canine bracket
to consolidate this section of the dental arch prior to seating the braided archwire.

The arch wire must be ligated into each bracket using a dead soft 0.010 stainless steel
ligature wire.

Each twisted ligature wire should be cut at approximately 2 mm length and the pig-tails
tucked gingivally and under the wire to avoid soft tissue irritation.

Components of a Fixed Appliance Part II

(C)

Direct Bond Brackets

(D)

Segmental Stabilizing Arch Wire

Adjunctive Treatment with Limited Fixed Appliances


Preparation:

Read Syllabus

Use:

A segmental arch wire and compressed coil spring is used to upright the
mesially tipped molar by tipping it distally.

Reference:

Contemporary Orthodontics Fourth Edition: pp. 639-644

Supplies:

Cotton pliers, Scaler, Hemostats, Slow-speed handpiece, E-cutter, Bird Beak


pliers, wire cutters

Construction & Evaluation Criteria


(A)

Ideal Premolar-Canine Bracket Alignment (see p. 40, illustration A)

Use 0.018 x 0.025 braided arch wire extending from the distal aspect of the molar tube
to the mesial of the canine.

The wire should be contoured to the shape of the arch (when looking from the occlusal)

The mesial end of the wire must be turned gingivally and towards the tooth at a point 1
mm beyond the mesial of the canine bracket. This will prevent soft tissue irritation.

The braided wire should be placed in the occlusal of the two upper molar tubes, extending
approximately 1 mm distal from the tube. The arch wire must be ligated into each bracket
using a dead soft 0.010 stainless steel ligature wire.

Each twisted ligature wire should be cut at approximately 2 mm length and the pig-tails
tucked gingivally and under the wire to avoid soft tissue irritation.

The distal end of the wire should project no more than 1 mm beyond the distal of the
molar tube.

(B)

Segmental Archwire and Compressed Coil Spring to Upright Molar (See p 34, Illustration
band p. S27)

Use 0.017 x 0.025 stainless steel rectangular wire extending from the distal aspect of the
molar tube to the mesial of the canine.

The wire should be contoured to the shape of the arch

A continuous figure-eight ligature tie should be placed from premolar and canine bracket
to consolidate this section of the dental arch prior to seating the archwire.

The mesial end of the wire should be bent 90 degrees gingivally to minimize gingival
irritation.

A 0.0009 x 0.036 coil spring 2 mm longer than the distance from the mesial of the
molar tube to the distal of the terminal premolar bracket should be placed over the 0.017
x 0.025 arch wire and compressed between the molar tube and premolar bracket.

The archwire must be securely tied at each premolar and canine bracket with individual
stainless steel ligature ties which should be carefully cut and tucked gingival to the
brackets.

Place model in hot water to soften wax and observe movement of the molar.
Adjunctive Treatment with Limited Fixed Appliances

(A)

Ideal Premolar-Canine Bracket Alignment

(B)
85)

Segmental Archwire and Compressed Coil Spring to Upright Molar (See also pages 80 -

Lower Lingual Holding Arch


Preparation:

Read Contemporary Orthodontics 4th Edition, pp. 474-476. See Figure 12-71
on page 477

Use:

A lower lingual holding arch is used to bilaterally maintain space.

Reference:

Contemporary Orthodontics Fourth Edition: pp. 474-476 & Figure 12-71 on


477

Supplies:

E-cutter, Buffalo knife (large lab knife), wire bending pliers, wire cutters

Construction and Evaluation Criteria


IN this exercise, we will only bend the wire to adapt to the model but for completeness, the
attachments to bands is included

The performed band should be well adapted to the contour of the tooth and the superior
margin of the band should be approximately 1 mm below the mesial and distal marginal
ridges

You will spot weld the sheath to the molar band. When you weld the sheath to the
band, the horizontal sheath should be positioned on the lower band so that the locking
attachment (the area designated with triangle) is located distally. (See Syllabus, page
S22). The sheath is located in the occlusal one-third of the band and its mesial most
extension is in the middle of the mesio-lingual cusp.

The sheath should be angulated so that the mesial aspect is angled superiorly to allow a
clear path of removal of the lingual arch over the incisal edges of the lower incisors

START HERE

The lingual arch portion is fabricated from a .036 preformed lingual arch. The anterior
component of the wire should rest on the cingulae of the central and lateral incisors above
the soft tissue. The anterior arch should be bent in an ideal arch so that it will not
maintain existing arch irregularity.

At the distal of the lateral incisors, the wire is stepped approximately 1 mm lingual to the
surface of the canine and existing primary teeth to allow eruption.

The vertical adjustment loops are contoured so that they will not impinge on the gingiva.

The lingual arch must be passive in the transverse, anteroposterior and vertical planes of
space when either end of an arch is removed from the lingual sheath.

Lower Lingual Holding Arch

T-Loop To Extrude Premolar

Preparation:

(Schematics only loop will be placed


between the premolars and height of legs may be unequal)

Use:

This T-Loop setup is used to extrude a tooth into ideal position.

Reference:

Contemporary Orthodontics Fourth Edition: pp. 644-647

Supplies:

Cotton Pliers, Scaler, Hemostats, Slow-speed Handpiece, E-cutter, Bird Beak


Pliers, Wire Cutters

Construction and Evaluation Criteria

Use 0.017 x 0.025 stainless steel rectangular wire.

The wire must project 1 mm beyond the distal of the molar tube.

The T-Loop must be formed at the mid-point between the premolar brackets.

The T-loop should follow the buccal contour of the premolar teeth and should not contact
any tooth material, soft tissue, nor project unnecessarily into the buccal vestibule.

The two vertical legs of the T should be 1-2 mm apart.

The posterior part of the wire should engage the molar and second premolar passively.

The anterior part of the wire should lie about 2 mm occlusal to the bracket on the first
premolar.

The mesial 2 mm of the wire must be bent gingivally and toward the tooth just anterior to
the mesial wing of the first premolar bracket.

The cut ends of the wire must be smoothed and rounded to prevent tissue irritation.

The arch wire must be securely ligated into each bracket and the individual ligature ties
cut carefully and tucked gingivally.

T-Loop to Extrude a Premolar

Ethical Scholarship, Academic Literacy and Academic Misconduct


[Ethical scholarship is the pursuit of scholarly enquiry marked by honesty and
integrity.
Academic Literacy is the capacity to undertake study and research, and to
communicate findings and knowledge, in a manner appropriate to the particular
disciplinary conventions and scholarly standards expected at university level.
Academic misconduct is any activity or practice engaged in by a student that
breaches explicit guidelines relating to the production of work for assessment, in a
manner that compromises or defeats the purpose of that assessment. Students
must not engage in academic misconduct. Any such activity undermines an
ethos of ethical scholarship. Academic misconduct includes, but is not limited to
cheating, or attempting to cheat, through:
Collusion
Inappropriate collaboration
Plagiarism
Misrepresenting or fabricating data or results or other assessable work
Inappropriate electronic data sourcing/collection
Breaching rules specified for the conduct of examinations in a way that
may compromise or defeat the purposes of assessment.
Penalties for academic misconduct vary according to seriousness of the case, and
may include the requirement to do further work or repeat work; deduction of
marks; the award of zero marks for the assessment; failure of one or more units;
suspension from a course of study; exclusion from the University, non-conferral
of a degree, diploma or other award to which the student would otherwise have
been entitled.
Refer to the Ethical Scholarship, Academic Literacy and Academic Misconduct
and individual Faculty policies.

Appeals against academic assessment


If students feel they have been unfairly assessed, they have the right to appeal
their mark by submitting an Appeal Against Academic Assessment form to the
Head of School and Faculty Office. The form must be submitted within twelve
working days of the formal despatch of your unit assessment. It is recommended
that students contact the Guild Education Officers to aid them in the appeals
process. They can be contacted on +61 8 6488 2295 or
education@guild.uwa.edu.au. Full regulations governing appeals procedures are
available in the University Handbook, available online at Appeals Against
Academic Assessment.

Clinical Sessions
Students are rostered to Clinic weekly (Monday and Wednesday mornings). If a
student requires a change of the roster, this must be requested in writing to Dr
Razza.
Clinical sessions will consist of one hour for administration, case presentation,
records keeping and three hours of clinical time.

Orthodontics

You will demonstrate on assigned child and adult patients the ability to
provide competent dental service including a range of preventive and
orthodontic treatment.

You will demonstrate the diagnostic acumen necessary to develop a


comprehensive treatment plan considerate of the patients needs, using the
basic diagnostic data from charting, oral exam, radiographic
interpretations and orthodontic assessment.

You will perform those preventive procedures, which are indicated for the
patient. The services will include prophylaxis, topic fluoride application,
home care instruction and dietary counselling.

You will demonstrate the ability to refer when necessary, for consultative
evaluations from Orthodontics, Oral Surgery, Endodontics, Periodontics
and the Paediatric Specialist.

You will demonstrate the ability to influence and control the childs
behaviour, motivate and gain the patients co-operation.

Commencing in February 2012 through Semester 2, each student will be expected


to be in attendance in the Undergraduate Clinic in accordance with their
individual roster schedule. If there are any conflicting assignments, please see Dr
Tien or Dr Razza.

Children are referred through Dental Therapy Centres throughout Western


Australia for orthodontic treatment.

General Instructions: Undergraduate Clinic

A.

Keep your Orthodontic Lecture Handouts and Guidebook at your clinic


desk and read over the appropriate materials BEFORE your appointment
period. Short, preparatory reading eliminates wasting everyones time in
clinic the instructor, the student and the patient.

B.

You are responsible for the clinical correlation of lecture and reading
materials and should be prepared to discuss any anticipated treatment
procedures with an instructor, including general dental needs.

C.

Be in the clinic at 8:00AM review all clinical records and determine all
procedures expected to be completed on the day. Be ready to seat the
patient by 8:30am. Do not keep a patient waiting until 8:45am for an
8:30am appointment.

D.

Be well organised and know where your instruments are materials are
located. All instruments and materials should be readily accessible before
you bring the patient into the clinic. As soon as the patient is seated you
should be ready to begin treatment. Careful planning will help you to
anticipate your needs.

Clinic Policy

A.

Do a complete evaluation of the patients current status. This is important


because frequently the treatment plan or treatment sequence may require
modification. Call an instructor before starting any procedure.

B.

For clinical procedures the instructor will be called for the following
steps:
- Always before beginning procedures and any time for questions
- Following appliance adjustments
- Following impressions and a wax bite
- Before functional appliance wax bites
- Prior to dismissing the patient

C.

If the patient arrives more than 15 minutes late, there may not be
sufficient time to complete the planned treatment and the patient will be
so informed. This may result in the patient being dismissed at the
discretion of the instructor.

D.

Have a clean mirror and probe from the pre-set tray ready for the
instructor to use.

E.

If you are waiting for a check by an instructor, do something such as


write up your progress notes or discuss oral hygiene with the child.

F.

For any patients who require general dental assessments or treatment, the
student will complete an appropriate referral letter. The referral letter is
to be submitted to the instructor and modifications completed prior to
posting.

Procedures: Undergraduate Clinic

1.

Review medical history and progress notes of patient. Be sure a medical


history form is completed and in the patient card.

2.

Some patients are just beginning treatment with us, while some are in the
middle of a treatment plan formulated last year. Each patient should be
re-examined and have an up-to-date treatment plan.

3.

Treatment Plan Sequence:


(a) Most patients will need an extra-oral and intra-oral exam, charting
(b) Radiographs are to be taken after the Faculty member signs orders.
Radiographs are taken in Radiology or referred to a private
Radiology clinic.
(c) Appliance designs or appropriate referral letter.

4.

At the end of the appointment, provide appropriate home care instructions


(HCI) in written and oral form.

5.

Record all data in the patients chart (Titanium) and have the chart signed
or authorised by the faculty member. The receptionists at the front desk
can make appointments, but you must indicate the timing of the next
appointment in Titanium or you may schedule the patients next

appointment. No patient should leave OHCWA without an appointment


or a recall appointment.

6.

You must ensure that you make an appointment note in Titanium to advise
the reception team of your patients next appointment requirements and
advise the patient to make their appointment before they leave OHCWA.
If a patient does not need a next appointment, you should set the patients
RECALL date with the appointment code *UORTHO in Titanium on the
Recalls tab in the patient file. All students should know how to do this as it
is included in your Titanium training at the beginning of the year.

7.

Complete the necessary Computer generated grading, one for each


patient seen on the day.

8.

Parents should be instructed to remain outside in the waiting room unless


called into the clinic for instructions or clinical advice.

Attendance and Leave

Attendance - Attendance at ALL lectures, laboratory and rostered clinical


sessions is COMPULSORY for all students, as specified in the Faculty Rules.
Failure to attend lectures, laboratory sessions or clinics may result in the need
for remedial work, written or other assignments being prescribed, exclusion
from the clinic, exclusion from the written examinations or a combination of
these.

Sick Leave - Any student who is unable to attend a lecture, laboratory or


clinical session due to illness MUST telephone the School of Dentistry office
and speak to either Sharon Baker (9346 7636) or Jessie White (9346 7676)
BEFORE their first lecture or other session of the day starts..
If none of the above staff are available to take your call, then you MUST leave
a message on the voicemail system. You should also telephone AGAIN later
in the morning to make sure that the message was received. If you have
patients booked in for that morning session and you are unable to speak to the
above staff, then you should also telephone the clinic and advise the staff there
so your patients are not kept waiting unnecessarily.
A valid Doctors Certificate, not signed by a family member, must be
presented to the School of Dentistry office (i.e. to Sharon Baker or Jessie
White) within 24 hours of your return to work at the School.

Compassionate Leave - Students should follow the same process of


telephoning the School office, as outlined above for Sick Leave, in order to
notify staff of their absence and the reason why the Compassionate Leave is
required. Where possible (e.g. to attend a funeral), advanced notice should be
given so patients can be cancelled prior to the day of Leave in order to reduce
the inconvenience to your patients.

Other Leave - The procedure for students in the School of Dentistry to apply
for Leave for reasons other than illness or compassionate reasons is as
follows:
A copy of the School of Dentistrys student Leave Form is supplied
as an Appendix in the Course Guide Book for Years 1-4 of the
BDSc course. All students will be supplied a copy of this Course
Guide Book.
The student should firstly seek in principle approval for the
Leave from the Head of School. An explanation of the reasons for
the Leave will be required and, where applicable, supporting
documents should be supplied. Students should note that this is not
a guarantee of final approval for the Leave; instead it is only to
ensure that there is a valid reason for the Leave.
If approved in principle by the Head of School, then the student
must meet with each Unit Co-ordinator for any Units where
lectures, laboratory clinical, other teaching or assessment sessions
will be missed or otherwise affected. The student should discuss the
possible arrangements for catching up all missed
work/assessments with each Unit Co-ordinator. The Unit Coordinator will then sign the Leave Form and outline the work to be
done, or otherwise make comments if they are unable to make
alternate arrangements for the missed work.
Students should note that it is not always possible to arrange catch
up sessions or examinations due to logistical reasons. Students
should also understand that, any such extra work may be
inconvenient, may not feasible, or may otherwise affect the staff
members work requirements. Students should be considerate of
the possible effects that their Leave may have on patients, staff and
other students.
Final approval is then to be obtained from the Head of School once
all affected Unit Co-ordinators have provided their signed
comments. If any Unit Co-ordinator is unable to make alternate
arrangements for the student to catch up on all work, then the
Leave may not be granted. Such situations will be considered by
the Head of School in consultation with staff and students involved
or affected.

Approved leave forms will then be forwarded to the Faculty office.


Any applications for Leave for more than one week must also be
approved by the Dean.
If a student is not happy with the outcome of their application for
Leave, then they should contact the Head of School in the first
instance.

Board of Examiners
Should a student perform poorly in an examination or other assessment, to enable
them to achieve a pass they may be required to undertake additional assessments
(ie viva, remediation, practical work etc). Further assessments can be
scheduled anytime prior to the BoE meeting which is held in December.
All Students MUST ensure that they can be contacted by the School and that they
are available to attend any further examination at short notice during the
University's examination period which extends to the day the Board of Examiners
in Dentistry meets.
Therefore it is the students responsibility to make sure that they are readily
available should they be required to sit any further assessments during this time.

Academic dishonesty
All forms of cheating, plagiarism and copying are condemned by the University as
unacceptable behaviour. The Facultys policy is to ensure that no student profits
from such behaviour. Generally a failure will be recorded for the subject in which
the cheating has occurred. Serious cases shall be referred to the Universitys
Board of Discipline. All students should note that cases of copying are
automatically reported to the Sub-Dean and documentary evidence along with
associated correspondence is placed on the students permanent record.

UWA Student Guild


Students can contact the Guild as follows
The University of Western Australia Student Guild
Phone: (+61 8) 9380 2295
Facsimile: (+61 7) 9380 1041
E-mail: enquiries@guild.uwa.edu.au
Website: http://www.guild.uwa.edu.au
Charter of Student Rights
The following URL details your rights as a student of this University:
http://www.guild.uwa.edu.au/info/student_help/student_rights/charter.shtml
If students feel they have been unfairly assessed, they have the right to appeal
their mark by submitting an Appeal Against Academic Assessment form to the
Head of School and Faculty Office. The form must be submitted within 12
working days of the formal dispatch of your unit assessment. It is recommended
that students contact the Guild Education Officers to aid them in the appeals
process.

Dental Graduate Outcomes


The Orthodontics 3311/3312 Unit contributes to the Graduate Outcomes by providing
students with different types of learning opportunities. Lectures are followed by
Practical Laboratory sessions, offering opportunity for discussion and feedback.
Clinical sessions are undertaken, providing supervision of students in their application
of the knowledge gained through the lectures, and their application of the practical
skills gained within the laboratory setting.

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