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COURSE STRUCTURE GRADO EN ODONTOLOGÍA DEGREE: DENTISTRY YEAR 2016/2017 COURSE: ORTHODONTICS IV Course Title DENTAL THERAPEUTICS AND REHABILITATION ECTS Total Type Basic Period Obligatory 4 X er 1 C Calender 2ºC Weeks X 14 Pre-requisites NONE Course Language Castellano Valenciano Department DENTISTRY English X Specific Area of Kowledge DENTAL THERAPEUTICS AND REHABILITATION Course Coordinator and other Professors Name Paloma Valero Remohi Office / Faculty OFFICE Nº 309. DENTISTRY BUILDING. Email [email protected] Student appointment schedule Tuesdays and Wednesdays, 9-11h, previous appointment required Orthodontics IV / 2016-2017 1 Introduction to the Course. Orthodontics is the science of the diagnosis, prevention and treatment of the malocclusions and dento-facial deformities. The subject of Orthodontics III is within the DENTAL THERAPEUTICS AND REHABILITATION module, which comprehends all the action subjects with clinical performance. The Orthodontics teaching unit is divided into four subjects. In the subjects of Orthodontics I and II, the goal is for the student to acquire the knowledge and skills in DIAGNOSIS in orthodontics. The goal of the subjects of Orthodontics III and IV is that the student will learn and acquire skills in Orthodontic TREATMENT. More precisely, in the subject of Orthodontics III, the student will learn to plan and execute the orthodontic, surgical or orthopaedic rehabilitation treatment of dental malocclusion, dental eruption alteration, and TMJ and functional alterations in children. The program of the subject is made up of two parts: a first part where all the knowledge acquired in Orthodontics I and II on Growth and Craniofacial development, dental movement, tissue reaction to forces, biomechanics and etiopathology of malocclusions and dentofacial deformities, from a more clinical, treatment-oriented vision. This subject focuses on the treatment of skeletal dysplasias and/or functional alterations of the stomatognathic system, identifying the etiological factors of each type of deformity or functional alteration, and the impact these hace on groth and cranio-facial development, with the goal of stablishing patterns that allow the individualization in the prognosis of each patient. The proceedings in Orthodontics and Orthopaedics to design an individualized treatment plan (logical sequence of actions) are also studied. The second part of the subject starts with the study of clinical therapeutics in Orthodontics and Dentofacial Orthopaedics, which will be completed in Orthodontics IV. It starts with the action mechanism of devices, and is continued with the treatment of dental alterations in number, position and/or shape, eruption, function and TMJ in children. The student must bear in mind that Orthodontics is a unique subject, and he/she should integrate progressively the acquired knowledge in previous subjects, to make the most of the different teaching activities, both theoretical and practical. At the end of the subject the student will be capable of exploring the stomatognathic system function in patients of any age, specifically evaluate the functional occlusion and the TMJ; and take in consideration all this information when planning and orthodontics and/or dentofacial orthopedics treatment plan from a multidisciplinary perspective. Pre-Requisites Although no previous knowledge is required, it is advisable that the student has previous knowledge on craniofacial embryology and anatomy, skeletal structures, morphology, location and limiting structures. The student must correctly know the dental structures, phases and sequence of dental replacement, number of pieces in each phase; deciduos, mixed and permanent dentition. The student should have previous knowledge on physiopathology of the stomatognathic system physiopathology; craniofacial growth and development, be familiar with the etiopathogenesis of dental malocclusion, recognize and identify the elements in the different orthodontic devices. Orthodontics IV / 2016-2017 2 Course Objectives - - The student will be capable of writing custom-made orthodontic appliances prescriptions: more specifically, he will design removable appliances, functional appliances and orthopedic appliances. With the skill 36t, the student will be able to design, prescribe, place and control orthodontic fixed appliances. More specifically, he/she will be able to adjust clinically interceptive orthodontic devices, and appliances to move teeth and correct crossbites. General and Specific Skills offered by the Course Basic skills BS 1 Basic Skills 1 (RD 861) Students should be able to demonstrate their knowledge and understanding of the field. This knowledge should be built on general secondary level education, and, with the support of University-level textbooks, should include aspects derived from the forefront of the field of study. BS 2Basic Skills 2 (RD 861) Students should be able to apply their knowledge to their work or vocation in a professional manner. They should be able to demonstrate their skills by developing and debating opinions, and solving problems within their field of study. BS 3 Basic Skill 3 (RD 861) Students should have the ability to generate and interpret data relevant to their profession, to allow them to make reasoned decisions. This includes reflecting upon the relevant underlying social, scientific and ethical issues involved. Specific skills - 36. For the establishment of an adequate treatment, the dentist must be competent in: p. Preparation of the prescription for customized sanitary products “dental prosthesis” and “orthodontic and dentofacial orthopaedic appliances”. t. Plan and determine the specific characteristics of the design, records, prescription, clinical check, placement and clinical adjustment for the use of fixed and removable space maintainers, as well as interceptive orthodontic techniques, removable active elements destined to displace teeth or correct crossbites. Orthodontics IV / 2016-2017 3 Course Contents 1. 2. 3. 4. 5. 6. 7. 8. 9. Treatment of transversal malocclusions. Treatment of class I malocclusions. Treatment of class II 1st division malocclusions. Treatment of class II 2nd division malocclusions. Treatment of class III malocclusions. Treatment of mandibular asymmetries. Treatment of vertical malocclusions: deep bite. Treatment of vertical malocclusions: open bite. Treatment in deciduous dentition. Habits: abnormal deglutition, thumb sucking, oral respiration. Malocclusions: open bite, anterior crossbite, posterior crossbite. Space loss. Myofunctional therapy. 10. Treatment in mixed dentition: introduction. Diagnosis and treatment plan. Therapeutic strategies in mixed dentition. Clinical management. Course Structure and Design Educational activities are the means used to transmit the contents and promote the acquisition of the competences. They include: - Master class: Educational forming activity oriented preferably to the competence of acquisition of knowledge and representative of the most theoretical subjects. Priorizes the transmission of knowledge by the professor, demanding from the student previous preparation or posterior study. - Seminar: Educational forming activity that enhances participation of the alumni in the reasoned interpretation of knowledge and the sources of the area of study. It is oriented to the application of knowledge, together with the ability to gather, interpret and judge information and relevant data. It is representative of the subject or activities with a theoretical-practical outline. - Practice, Laboratory Practice: Educational forming activity oriented preferably to ability to gather, interpret and judge information and relevant data and the competence of acquisition of learning abilities. It is representative of the end of subject project. Orthodontics IV / 2016-2017 4 ESTIMATION OS STUDENT WORK VOLUME SUBJECT: ORTHODONTICS III CREDITS: 4 ECTS Breakdown of student work hours: 120 Formative activity Contact hours (A) Independent Study (B) Total work hours (C) C=A+B TAUGHT CLASSES Introduction to the material Theory classes 20 10 30 12 10 22 Debates Feedback and assignments review of Other PRACTICAL CLASSES Problem solving Debates Feedback and assignments review of Simulation Laboratory 24 Practical classes informatics room 24 in Outing Work presentation Other SEMINARS Problem solving Debates Feedback and assignments review of review of 5.2 5 10.2 4.8 5 9.8 18 18 WORKSHOP Feedback and assignments Oral presentations COURSEWORK PROJECT Personal hours Project EXAMINATIONS TESTS work AND Exam preparation Examinations 6 6 Other… TOTAL 72 48 RELATIONSHIP BETWEEN WORK HOURS / ECTS (the result of the relation working hours/ECTS will have to be equal to 30 hours, that is the hours that conform 1 ECTS in the CEU-UCH) Orthodontics IV / 2016-2017 120 120/4 5 Assessment Criteria The acquisition of skills by the student is confirmed through the evaluation. This system is completely associated to the skills the student should demonstrate and is coherent with the contents of such skills. Orthodontics IV is a project subject, reason why both the practicals and the seminars from this subject are mandatory in the second and posterior enrolments. The student will not be able to pass the subject only by passing the exam including the 100% of the subject. - Each part must be passed separately. Each activity is independently evaluated. - Only one justified absence is admitted for the seminars/practicals. - If during the course a grade of 7 or more is acquired in any of the parts, the grade can be kept under written petition of the student. The assessment criteria will be based on the following forming activities, in accordance to https://www.uchceu.es/estudios/grado/documentos/memoria/odontologia.pdf : - FA1. Master Class (Theoretical knowledge): 50% FA2: Seminars 20% FA4: Practicals 30% The final grade will be given in a range from 0 to 10 number scale, with the expression of one decimal point, to which the qualitative qualification may be added: 0-4,9: Suspenso (SS). 5,0-6,9: Aprobado (AP). 7,0-8,9: Notable (NT). 9,0-10: Sobresaliente (SB). http://www.boe.es/boe/dias/2003/09/18/pdfs/A34355-34356.pdf Ordinary call. Final grade composition: - AF4. PP: will represent 30% of the final grade. Assistance to practical classes is mandatory, and in case of no assistance, absence should be justified and made up for as soon as possible. Each practice will be evaluated by the professor. An arithmetic average of the grades will be calculated. - AF2. Seminars: 20% of the final grade. They are mandatory, and in the case of no assistance, absence should be justified and made up for as soon as possible. The student must present a written project for each seminar. An arithmetic average of the written proejcts will be calculated. - AF1. Theoretical knowledge: - Will represent 50% of the final grade. This examination will take place during the examination period and its contents will include all the course program. - The exam will consist of short questions and/or multiple choice questions. Extra-ordinary call. Final grade composition: Practice&Theory exam 1. Resolution of a clinical case, evaluated between 0-3 points. 2. Theory exam. The exam will consist of short questions and/or multiple choice questions. Evaluation between 0-7 points. Orthodontics IV / 2016-2017 6 Assessment Criteria The grades obtained in each part will be added up, and a final grade between 0-10 points will be obtained. Course Program 1. 2. 3. 4. 5. 6. 7. 8. 9. Treatment of transversal malocclusions. Treatment of class I malocclusions. Treatment of class II 1st division malocclusions. Treatment of class II 2nd division malocclusions. Treatment of class III malocclusions. Treatment of mandibular asymmetries. Treatment of vertical malocclusions: deep bite. Treatment of vertical malocclusions: open bite. Therapeutic principles and differential characteristics of treatments in relation of the patient’s age. 10. Retention and relapse. Detailed course program 1. Treatment of transversal malocclusions. Etiology and epidemiology. Differential diagnosis: dentoalveolar malocclusion, functional and skeletal. Etiology and epidemiology. Therapeutic principles and types of devices: orthodontics, orthopaedics, differential control of eruption, mandibular reposition, functional rehabilitation, occlusal adjustment and selective grinding, surgically assisted palatal expansion, orthognathic surgery. Indications and contraindications. Treatment protocols and retention depending on age and type of malocclusion: treatment of dentoalveolar crossbite. Treatment of functional crossbite. Treatment of skeletal crossbite. 2. Treatment of class I malocclusions. Concept. Primary, secondary and tertiary crowding. Dentoalveolar protrusion. Etiology and epidemiology. Differencial diagnosis. Therapeutic principles and types of devices: orthodontics, space control, arch length recovery, therapeutic extractions. Indications and contraindications. Treatment protocols and retention depending on age and type of malocclusion. 3. Treatment of class II 1st division malocclusions. Etiology and epidemiology. Differential diagnosis: class II division 1st dentoalveolar and skeletal. Prediction of mandibular growth and face patterns. Prognosis. Therapeutic principles and types of devices: orthodontics, differential control of eruption, mandibular repositioning, functional rehabilitation, orthopaedics, therapeutic extractions, skeletal distraction, orthognathic surgery. Indications and contraindications. Treatment protocols and retention depending on age and type of malocclusion: treatment of dentoalveolar class II 1st division, treatment of skeletal class II 1st division. 4. Treatment of class II 2nd division malocclusions. Etiology and epidemiology. Etiopathogenic theories: types of class II – 2nd. Differential diagnosis. Face pattern. Therapeutic principles and types of devices: orthodontics, differential control of eruption, mandibular unblocking, functional rehabilitation, orthopaedics, bimaxillary devices, therapeutic extractions, skeletal distraction, orthognathic surgery. Indications and contraindications. Treatment protocols and retention depending on age and type of Orthodontics IV / 2016-2017 7 Detailed course program malocclusion: treatment of dentoalveolar class II 2nd division, treatment of skeletal class II 1st division. 5. Treatment of class III malocclusions. Etiology and epidemiology. Differential diagnosis: dentoalveolar, functional and skeletal class III. Therapeutic principles and types of devices: orthodontics, differential control of eruption, mandibular repositioning, functional rehabilitation, orthopaedics, therapeutic extractions, orthognathic surgery. Indications and contraindications. Treatment protocols and retention depending on age and type of malocclusion. Treatment of class III malocclusion. Treatment of functional class III. Treatment of skeletal class III. 6. Treatment of mandibular asymmetries. Etiology and epidemiology. Differential diagnosis:hypo-growth: condylar hypoplasia, hemifacial microsomia, others. Hypergrowth: mandibular elongation, condylar hypertrophy, hemimandibular hyperplasia, tumors. Therapeutic principles and types of devices: orthodontics, differential control of eruption, mandibular distraction, high condylectomy, orthognathic surgery. Indications and contraindications. Treatment protocols and retention depending on age and type of progression of the asymmetry: treatment of the progressive mandibular asymmetry. Treatment of non-progressive mandibular asymmetry. 7. Treatment of vertical malocclusions: deep bite. Etiology and epidemiology. Etiopathogeny. Differential diagnosis: dentoalveolar and skeletal overbite, maxillary or mandibular. Mandibular rotation and face pattern. Smile line. Prognosis. Therapeutic principles and types of devices. Orthodontics, pure and relative intrusion, differential control of eruption, sagittal correction. Orthopaedics, maxillary and mandibular rotation control, orthognathic surgery. Indications and contraindications. Treatment protocols and retention depending on age and type of malocclusion. Interceptive treatment. Corrective treatment. 8. Treatment of vertical malocclusions: open bite. Etiology and epidemiology. Etiopathogeny. Differential diagnosis: dentoalveolar and skeletal overbite, maxillary or mandibular. Mandibular rotation and face pattern. Anterior and posterior smile line. Prognosis. Therapeutic principles and types of devices: Orthodontics, differential control of eruption, mandibular repositioning, functional rehabilitation, orthopaedics, therapeutic extractions, orthopaedics, control of maxillary and mandibular rotation, orthognathic surgery. Indications and contraindications. Treatment protocols and retention depending on age and type of malocclusion. Interceptive treatment. Corrective treatment. 9. Therapeutic principles and differential characteristics of treatments in relation of the patient’s age. Treatments in temporary dentition. Treatments in mixed dentition. Treatments in permanent dentition. Treatments in the adult patient. Differential therapeutic principles depending on age. Most effective types of devices and action mechanisms depending on patient’s age. Scientific evidence. Malocclusion interception, dento-facial deformities prevention and interception programs during infancy, adolescence and in the adult: differential characteristics. 10. Retention and relapse. Concept of retention and relapse. Retention need. Dominant factor in retention. Basic principles in retention. Beginning of retention. Duration of retention. Etiology of relapse. Types of retainers. Surgical aids in retention. Basic Bibliography Orthodontics IV / 2016-2017 8 Basic Bibliography 1. 2. 3. 4. 5. 6. COBOURNE TM. Handbook of Orthodontics. China. Elsevier. 2010 CANUT, J. A. Ortodoncia clínica y terapéutica. Barcelona Masson. 2000. BRAVO, L. A. Manual de Ortodoncia. Madrid. Síntesis. 2003. MOYERS, R. E. Orthodontics. Chicago. Med. Publish. 1988. PROFITT, W. J. B. Contemporary orthodontics. St. Louis. Mosby. 1999. GRABER LW. Current principles and Techniques. 5th Edtion. Elsevier Health Sciences. 2011 Additional Bibliography 1. 2. 3. 4. 5. 6. 7. 8. 9. HOUSTON, W. J. B. Manual de ortodoncia. Mexico. El manual moderno. 1988. MAYORAL, J. Ortodoncia. Principios fundamentales y Práctica. Barcelona .Labor. 1977. ENLOW, D.H.; HANS, M.G. Essential of Facial Growth. Philadelphia. Saunders Co. 1996. RICKETTS, R.M. Orthodotics Diagnosis and Planning. Denver, Rocky Mountain Co. 1982 CARLOS, E. Z. Compendio de cefalometría. Análisis clínico y práctico. Venezuela. Amolca. 2004. BARCHACH, J. Atlas de cirugía craniofacial y de hendiduras. Venezuela Amolca. 2004. LINDEN, W. D. Conceptos y estrategias en ortodoncia. Quintessence. 2006. JULIA, F. Tratamiento ortodóncico en adultos. Panamericana. 2006 GREGORET J. Ortodoncia y cirugía ortognática, diagnóstico y planificación. Barcelona. Espaxs. 1997. 10. VARELA M, LLAMAS JM. Ortodoncia una visión de futuro. Madrid. Ergon SA. 1999. 11. ENLOW, D. H. Essentials of Craniofacial Growth. Philadelphia. Saunders. 1996 Other Resources 1. Spanish journals: o Ortodoncia española. o Revista Española de Ortodoncia 2. European journals: o Angle Orthodontics o European J. Orthodontics 3. American Journals: o American J. Orthodontic o Dentofacial Orthopedic Recommendations to Students Taking This Course - - It is advisable that students have passed Orthodontics I and Orthodontics II to access this subject. Students should read the proceedings of each the practice from the practice booklet before each practice to ensure a better performance. Basic reference books should be consulted regularly when studying the subject. It is advisable that the students read the topic before it is explained in class. The student must make sure he/she understands the concepts and ideas, so that any doubts that arise in the reading can be solved in class. The student must follow the directions for Communal living in the Classroom approved by the Health Sciences Faculty. Orthodontics IV / 2016-2017 9 Links to Ongoing Research The Orthodontics and Dentofacial Orthopaedic Department at the UCH-CEU is presently developing 6 research lines directly related to the learning process of this subject: - Skeletal anchorage with miniscrews. - Rapid maxillary expansion. - Behaviour and factors related to adhesion. - Functional appliances. - Obstructive Sleep Apnea and Hypoapnea. - Eruption physiopathology. It is advisable that students get involved in the following of the scientific protocols that are being carried out in each research line, contributing in this way to feed the scientific development of the University, and at the same time discover new parallel research lines. Links to the Dental Profession The knowledge of the treatment protocols is an essential part of the therapeutics of the Orthodontic and Dentofacial Orthopaedics specialty. It is the ability to update these protocols, with the new light shed on them by the published evidence, what enables the achievement of clinical excellence. The Evidence-based Medicine teaching system provides the student with an autonomous learning system, which will help him/her to integrate new knowledge and face the complexity of developing judgements, whilst thinking over the social and ethical responsibilities linked to the application of these. Orthodontics IV / 2016-2017 10