COLLEGE OF DENTISTRY
PRE CLINICAL ORTHODONTICS [433 PDS]
DEPARTMENT OF PREVENTIVE DENTAL SCIENCES
STUDY GUIDE
1
Message from the Dean
Assalamualaikum wa rahamatullahi wa barakatahu
It is my pleasure to welcome you to the College of dentistry - Zulfi at Majmaa’h
University, Kingdom of Saudi Arabia. College of Dentistry aims to improve the dental
health of the people in Kingdom of Saudi Arabia through providing the students with
excellent clinical training, supporting research and learning environment. Towards this
goal the Department of Preventive Dental sciences has prepared a study guide in
Preclinical Orthodontics for the benefit of the students.
I have read this study guide and would like to assure you that this is an excellent
job in addressing all the questions a student will have at the start of the course. This
study guide also contains all the schedule of lectures and practical exercises. I would
like to congratulate the team for coming up with this study guide.
I am proud to serve as a Dean of the College of Dentistry and I am sure that the
assurance from the dedication of our energetic and benevolent faculty and staff prompts
you to be skilled and knowledgeable in attaining high standard of education.
Best wishes
Dr. Abdul Rahman Al Atram
2
Message from the members of the committee
Dear Students,
We are delighted to welcome you to the course of Preclinical
Orthodontics. This is a basic course which you will be studying in
your fourth year; this study guide will inform and update you about
the various topics to be covered in both the first and second
semester.
The topics covered in this module are highly relevant and have
clinical implications which will be of great help in your professional
life. This subject is one of the very important foundation courses in
dentistry and based on these fundamental principles you will
progress on to become a good dental surgeon. Hence we the
committee suggest you to use this handbook to prepare yourself
during the course and gain maximum benefit.
Best wishes & Good luck
3
APPROVAL FOR THE COURSE
This course has been reviewed, revised and approved by:

The Department of Preventive Dental Sciences.

College Curriculum Committee.

College Council.
4
S.No.
TABLE OF CONTENTS
Page No.
1
Message from the Dean
2
2
Message from the members of the committee
3
3
Approval of the course
4
4
General course information
6
5
Course description
7
6
General course objectives
8
7
Course contents
9
8
Detailed objectives of lectures
16
9
Detailed objectives of practical
22
10
11
12
13
14
Student expected study hours and student support
Teaching and learning resources
Facilities required
Students Assessment
Course Evaluation & Improvement process
25
26
26
27
28
5
GENERAL COURSE INFORMATION
Course Title Preclinical Orthodontics
Course Code 433 PDS
Course
Theory
components
First
1
& Credit
semester
hours
Second
1
semester
Practical
Total
1
2
1
2
Prerequisites None
CoNone
requisites
Year / Level
4th year continuous course in 1st and 2nd semester
Course
coordinator
Course
committee
Tutors
Name
Rank Email
Office hours
6
COURSE DESCRIPTION
Preclinical Orthodontics is a one year course, given as lecture and
one practical session in the fourth year.
It is the introductory course for fourth year dental students. The primary
objective of this course is providing knowledge of basic principles and
diagnostic procedures in orthodontics.
This course is designed to provide basic concepts of growth and
development of craniofacial structures, etiology diagnosis and management
of different types of malocclusion and dentofacial discrepancies by general
dental practitioners.
The laboratory section includes the development of psychomotor and
cognitive skills. Laboratory sessions are designed to provide students with
the required knowledge and skills to perform basic analysis and diagnosis
of malocclusion and basis for referral of a patient to an orthodontist. In this
section students will learn the skills in laboratory on models required during
the management of orthodontic patients. The dental students will learn the
fabrication of various removable appliances and their management
required for the treatment of orthodontic patients.
7
GENERAL COURSE OBJECTIVES
1. Demonstrate knowledge of general principles and concepts of growth and
development.
2. Differentiate between normal and abnormal growth and development of dento-facial
complex.
3. Demonstrate knowledge of standard orthodontic classification of malocclusion and
should be able to differentiate skeletal and dental malocclusions.
4. Students should be able to perform basic orthodontic diagnostic procedures like
lateral cephalometric tracing and model analysis.
5. Identify functional and esthetic deficiencies requiring intervention and management
and know when to make a referral to an orthodontic specialist.
6. Identify predisposing conditions and appropriate intervention and /or active treatment
recommendation to prevent malocclusion.
7. Demonstrate the knowledge of adverse effects of orthodontic therapy.
8. Demonstrate the knowledge and skills to manage the orthodontic emergencies.
9. Demonstrate the knowledge and skills in management of removable orthodontic
appliances.
8
COURSE CONTENTS:
A - Lectures: 1st semester (14 lectures)
Theme I – Introduction and growth and development (4 lectures)
Lecture List of topic
1
2
3
4
Detailed content
Introduction
to
orthodontics
History of orthodontics
Branches of orthodontics
Aims and scope of orthodontic
treatment
Prenatal
growth and
development
Prenatal growth of cranial base
Chondro-cranial ossification
Prenatal embryology of maxilla,
palate and mandible
Post natal
growth and
development
Growth of cranial base
Cortical drift, remodelling and
synchondrosis
Post natal growth of naso
maxillary complex and mandible
Development
of normal
occlusion
Prenatal and postnatal
development of dentition
Deciduous, mixed and permanent
dentition stage.
No of
weeks
Contact
hours
1
1
1
1
1
1
1
1
Theme II: Occlusion concepts and malocclusion (3 lectures)
5
Occlusion in
orthodontics
Concepts of occlusion
Classifications of occlusion
Centric relation in orthodontics
Andrews six keys to normal
occlusion
1
1
9
6
7
Classification
of
malocclusion
Etiology of
malocclusion
Define malocclusion
Intra arch and interarch
malocclusion
Skeletal and dental malocclusion
Describe Incisor and canine
classification.
Classification
Moyer’s classification
Graber’s classification
1
1
1
1
1
1
1
1
1
1
Theme III: Diagnosis (3 lectures)
8
9
10
Examination
and diagnosis
Essential and supplemental
diagnostic aids
Case history
Clinical examination
Cephalometric
land marks
and analysis
Anatomic structures
Cephalometric Landmarks
Cephalometric tracing
Model
analysis
Arch perimeter analysis
Bolton’s analysis
Ashley Howe’s analysis
Theme IV: Biomechanics (2lectures)
11
Biomechanics
Physiologic tooth movement
Histology of tooth movement
Optimum orthodontic force
Phases of tooth movement
Center of Resistance and Center of
Rotation
Types of tooth movement
10
12
Anchorage
Definition
Types of anchorage
Temporary anchorage devices
1
1
1
1
1
1
Theme V: Preventive and Interceptive orthodontics (2 lectures)
13
14
Preventive
orthodontics
Interceptive
orthodontics
Preventive orthodontics
Space maintenance Space
maintainers
Types of space maintainers
Interceptive procedures
Serial extraction
Interception of Class II and class III
malocclusion
11
B. Semester 2 (14 lectures)
Theme VI – Orthodontic Appliances (7 lectures)
Lect
List of topic
ure
1
Materials and
Instruments in
orthodontics
2
3-4
5-6
7
No of
weeks
Contact
hours
Different types of materials
Instruments used in orthodontics
1
1
Removable
appliances
Advantages and disadvantages
Components
Management
1
1
Fixed appliances
Banding and Bonding
Brackets
Elastics
Stages of treatment
Definition
Types of functional appliances
Removable and fixed functional
appliances
2
2
2
2
1
1
Functional
appliances
Orthopedic
appliances
Detailed content
Basis for orthopedic appliances
Head gear
Face mask
Theme VII: Management of malocclusion (5 lectures)
8
Orthodontic
treatment
strategies and
timing
Early treatment
Occlusal relationship problems
Eruption problems
Ectopic eruption and space-related
problems
1
1
9
Class I
malocclusion
Management of diastema, spacing,
crowding and rotations
1
1
10
Class II
malocclusion
1
1
11
Class III
malocclusion
Management of class II division 1
and division 2malocclusion
Management of skeletal class II
malocclusion
Features of class III malocclusion
Interception during growth
1
1
12
12
Deep bite, open
bite and cross
bite
Treatment of pseudo class III
Anterior open bite
Posterior open bite
Dental deep bite skeletal deep bite
Anterior and posterior cross bite
1
1
Theme VIII: Adverse effects (1 lecture)
13
Adverse
effects of
orthodontic
treatment
Local effects
Systemic effects
Cross infection
1
1
1
1
THEME IX: Retention and relapse (1 lecture)
14
Retention
and relapse
Causes of relapse
Theories of retention
Raleigh Williams- key to eliminate
lower retention
Types of retention
13
C – Practical
Semester 1
Session
No
1-2
Exercise
Detailed content
Impression and
study models
Trimming and
Upper arch
Lower arch
Models
trimming of study models
finishing of study
finishing of study models
models
base of study models
5-8
Model analysis
9- 11
cephalometric
3-4
analysis
12-14
Malocclusion
No of
weeks
2
Credit
hours
6
2
6
arch perimeter analysis
perform Bolton’s analysis
Ashley Howe’s analysis
Pont’s analysis
4
12
Identify cephalometric landmarks
Perform cephalometric analysis
3
9
Models of different types of
malocclusion
3
9
Semester 2
Session Exercise
No
1
Materials used in
orthodontics
2-4
Fabrication of clasp
Detailed content
Bands, brackets, wires, elastics
C clasp
Adam’s clasp
Triangular clasp
No of
weeks
Credit
hours
1
3
3
9
14
5-6
7-8
9
10-11
12-13
14
Fabrication of labial
bow
Short labial bow
Long labial bow
Fabrication of springs
T spring
Finger spring
Z spring
Fabrication of
Hawley’s appliance
Fabrication of
removable appliance
with Z spring
appliance
Case analysis
Typhodont
exercise
Retentive component
Labial bow
Acrylization
Retentive component
Active component
Acrylization
Diagnosis and treatment
planning Fabrication of
removable appliance
Wax up and simulation of
mechanics
2
6
2
6
1
3
2
6
2
6
1
3
15
DETAILED OBJECTIVES OF THE CONTENTS:
LECTURES
Semester 1
1. Introduction to orthodontics
At the end of the lecture student should be able to –
 To understand and explain the importance of the course
 Enumerate Branches of orthodontics
 Describe aims and scope of orthodontic treatment
 Understand the History of orthodontics
2. Prenatal growth and development
At the end of the lecture student should be able to –
• Describe Prenatal growth of cranial base
•
Demonstrate knowledge on Chondro-cranial ossification
•
Explain Prenatal embryology of maxilla, palate and mandible
3. Post natal growth and development
At the end of the lecture student should be able to –
 Understand the growth of cranial base

Describe cortical drift, remodelling and synchondrosis

Explain post natal growth of naso maxillary complex and mandible
4. Development of normal occlusion
At the end of the lecture student should be able to –
 Explain development of dentition and occlusion
 Understand prenatal and postnatal development of dentition
 Describe deciduous, mixed and permanent dentition stage.
5. Occlusion in orthodontics
At the end of the lecture student should be able to –
 Describe Concepts of occlusion
 Enumerate Classifications of occlusion
 Understand Importance of centric relation in orthodontics
16

Describe Compensatory curvatures and Andrews six keys to normal occlusion
6. Classification of malocclusion
At the end of the lecture student should be able to –
• Define malocclusion
•
Enumerate Intra arch malocclusion and interarch malocclusion
•
Differentiate between skeletal and dental malocclusion
7. Etiology of malocclusion
At the end of the lecture student should be able to –
• Classify etiology of malocclusion
• Describe Moyer’s classification of malocclusion
• Explain Graber’s classification of malocclusion
8. Examination and diagnosis
At the end of the lecture student should be able to –
 Describe essential and nonessential or supplemental diagnostic aids
 Record the case history
 Perform clinical and functional examination
9. Cephalometric land marks and analysis
At the end of the lecture student should be able to –
 Enumerate uses of cephalometry
 Identify anatomic structures in the cephalogram
 Perform the cephalometric tracing
10. Model Analysis
At the end of the lecture student should be able to –



11.
Perform Arch perimeter analysis
Demonstrate Bolton’s analysis
Perform Ashley Howe’s analysis
Biomechanics
At the end of the lecture student should be able to –
 Understand Physiologic tooth movement
 Understand Phases of tooth movement
 Define Force , Couple , moment, Center of Resistance and Center of Rotation
17

Enumerate Types of tooth movement
12. Anchorage
At the end of the lecture student should be able to –
 Define anchorage
 Understand the concepts of anchorage
 Enlist Types of anchorage
 Describe temporary anchorage devices
13. Preventive orthodontics
At the end of the lecture student should be able to –
 Define preventive orthodontics
 Understand preventive measures undertaken
 Describe Space maintenance and space maintainers
 Enumerate different types of space maintainers
14. Interceptive orthodontics
At the end of the lecture student should be able to –
 Describe various interceptive procedures
 Explain Serial extraction and guidance of eruption
 Enderstand the Interception of developing skeletal malocclusions
 Explain methods for Interception of Class II and class III malocclusion
18
Semester 2
1: Materials in orthodontics
At the end of the lecture student should be able to –
 Identify different types of materials used in orthodontics
 Enumerate use of materials in orthodontics
 Enlist uses of elastics in orthodontics
2. Removable appliances
At the end of the lecture student should be able to –
 Enlist advantages and disadvantages
 Describe components of removable appliance
 Explain management of removable appliances
3-4. Fixed orthodontic appliances
At the end of the lecture student should be able to –




Demonstrate knowledge of banding and bonding
Describe types and characteristics of orthodontic brackets
Enumerate types of elastics used during orthodontic treatment
Enumerate stages of treatment by using fixed appliances
Enumerate other materials used in fixed mechanotherapy
5-6. Functional appliance
At the end of the lecture student should be able to –
 Define myofunctional l functional appliances
 Enlist different types of myofunctional appliances
 Describe removable and fixed functional appliances
7. Orthopedic appliances
At the end of the lecture student should be able to –

Explain basis for orthopedic appliances
19

Describe orthopedic appliances i.e. head gear and face mask
8. Orthodontic treatment strategies and timing
At the end of the lecture student should be able to –




Understand special considerations in early treatment
Describe occlusal relationship problems and their management
Enlist eruption problems and their management
Describe ectopic eruption and space-related problems
9. Management of class I malocclusion
At the end of the lecture student should be able to –




10.
Describe diagnosis and management of diastema, spacing, crowding and
rotations
Management of spacing, crowding and rotations
Management of crowding
Management of rotations
Management of class II malocclusion
At the end of the lecture student should be able to –



11.
Describe management of class II division 1 malocclusion
Describe Management of class division 2malocclusion
Understand Management of skeletal class II malocclusion
Management of class III malocclusion
At the end of the lecture student should be able to –



Describe Features of class III malocclusion
Understand Interception during growth
Treatment of true classII and pseudo class III
12. Management of deep bite, open bite and cross bite malocclusion
At the end of the lecture student should be able to –



Describe management of anterior open and posterior open bite
Describe management of dental deep bite skeletal deep bite
Describe management of anterior and posterior cross bite
20
13. Adverse effects of orthodontic treatment
At the end of the lecture student should be able to –




Enumerate adverse effects of orthodontic treatment
Enlist local effects of orthodontic treatment
Enumerate Systemic effects
Describe Cross infection
14. Retention and relapse
At the end of the lecture student should be able to –




Enumerate causes of relapse
Enlist theories of retention
Understand Raleigh Williams- key to eliminate lower retention
Explain Types of retention
21
Detailed Objectives of PRACTICALS
Semester 1
Theme I – Impression and study models
Session 1-2: Upper and lower arch impression
At the end of the practical session the student should be able to

Make the impression of upperarch

Make the impression of lower arch

Make a cast by pouring impression
Session 3-4: Trimming and finishing of study models
At the end of the practical session the student should be able to

Demonstrate trimming of study models

Demonstrate finishing of study models

Make the base of study models
Theme II: Analysis of diagnostic records
Session 5-8: Model analysis
At the end of the practical session the student should be able to

Perform arch perimeter analysis

Perform Bolton’s analysis

Ashley Howe’s analysis
Session 9-11: cephalometric analysis
At the end of the practical session the student should be able to

Identify cephalometric landmarks
22

Perform cephalometric analysis
Session 12-14: Malocclusion
At the end of the practical session the student should be able to
Identify the models of different types of malocclusion

Describe characteristic features of different types of malocclusion
Semester 2
Theme I: Materials and instruments
Session 1: Materials and instruments used in orthodontics
At the end of the practical session the student should be able to

Identify materials used in orthodontics

Identify and describe used of materials used in orthodontics
Theme II: Fabrication of clasp
Session 2-4: Fabrication of clasp
At the end of the practical session the student should be able to

Fabricate C clasp

Fabricate Adam’s clasp

Fabricate Triangular clasp
Theme III: Labial bow
Session 5-6: fabrication of long and short labial bow
At the end of the practical session the student should be able to

Fabricate Short labial bow
23

Fabricate Long labial bow
Theme IV: Springs
Session 7-8: Fabrication of springs
At the end of the practical session the student should be able to

Fabricate T spring

Fabricate Finger spring

Fabricate Z spring
Theme V: Removable appliances
Session 9: Fabrication of Hawley’s appliance
At the end of the practical session the student should be able to

Fabricate componenets of hawleys appliance

Acrylize the appliance
Session 10 - 11:Fabrication of removable appliance with Z spring
At the end of the practical session the student should be able to

Fabricate componenets of removable appliance including Z spring

Acrylize the appliance
Theme VI: Case analysis
Session 12-13:Case analysis
At the end of the practical session the student should be able to

Demonstrate knoweledge and perform diagnosis , treatment planning and
fabricate removable appliance for the case.
Theme VII: Typhodont exercise
Session 14:Typhodont exercise ( demonstration)
24
At the end of the practical session the student should be able to

Simulate fixed orthodontic mechanotherapy on typhodont model
Student additional private study hours per week & student support:
In Additional to the credit hours in the college hours the student is expected to put in 6
hours of private study/learning hours per week. (This is an average for the semester not
a specific requirement in each week).
The students are encouraged to interact with the tutors of the course for any additional
help required during the course. The staff members are instructed to inform the students
regarding the office hours when they can approach the faculty for their help
After each class the faculty member allocates a few minutes to clear the doubts of the
students if needed
The power point presentation of each class is uploaded on the faculty member’s
website from where the students can easily retrieve it and come prepared for the
lecture.
Group of three students are allotted to one faculty member, who is their mentor, the
students can even approach their respective mentors if they have any additional
problems with the subject.
25
Teaching and learning resources:
Students will be shown power point presentations, quiz, and essay competition. During
the practical’s students will be shown models and casts to give them in depth
knowledge and understanding of the subject. Live demonstration will be given to
students for various wire bending exercises.
Use of more teaching aids during classes with special emphasis on the applied aspects
of the structures, questions asked during the class would also aid in developing
cognitive skills. In addition we would design quizzes and assignments in such a way
that the students would have to correlate the various topics and information given to
them.
The students will be asked oral questions, debates, group discussions group tasks will
be designed so that the students learn to interact with their batchmates. In addition
project work will be assigned to small groups so that they learn to take up the
responsibility and complete it.
Recommended text books:
Required Textbook
Contemporary orthodontics: 4th edition. William R. Proffit
Textbook
Orthodontics: the art and science: 4th edition. S.I. Bhalaji
References

American journal of Orthodontics and Dentofacial Orthopedics

The Angle Orthodontist – an international journal of
Orthodontics and Dentofacial Orthopedics
Website
www.angle.org
Facilities Required:
Theory:
26
1. A class room with a seating capacity of 30 students, equipped with a projector
and smart board.
Practical:
1. A well-equipped laboratory with a trimmer and plaster /dental ctone
dispenser.
2. Stainless steel wires and pliers for wire bending exercises.
3. Lateral cephalogram of patients, view box, pencil, divider, scale and tracing
sheet for cephalometric tracing.
Student Assessment:
Evaluation & assessment of students:
By Oral and Written examination, periodic assessment through assignments, evaluation
of the projects and group tasks.
Assessment of student communication skills will be through the seminars and term
papers.
Distribution of marks for Preclinical Orthodontics
The following percentages (%) of the total grade will be assigned
Preclinical orthodontics (2 credit hours, 1 theory, 1 lab)
Theoretical part ……………………………….……..50 %
Practical part …………………………………………50%
Assessment Tools
1st and 2nd Semester
In- Course
Assessments
60 %
Final written exam
30 %
Final exam practical
10%
Total
100 %
Midterm exam
Midterm exam
Practical
Practical
assessments
Behavior
Research
Homework
Presentation
Quiz
Written
Practical
exercises
Practical
exercises
General
Activity
Written
Oral
Written
20%
10%
15%
5%
3%
2%
2%
3%
Practical
exercises
27
The final marks obtained for the course will be decided by taking 50% marks from
first semester and 50% from second semester.
SEMINARS
A. Guidelines for seminar sessions:
1. One seminar per student is scheduled during the semester.
2. Duration of each seminar will be of 5 minutes.
3. The students will be given the topics for seminar at least two weeks in
advance. The topics will be selected randomly by the students by a picking a
slip (lottery method).
4. The student is expected to prepare a PowerPoint presentation for the
seminar. They can take the help of a staff member in preparing themselves
for the presentation.
5. After each session group discussion will be allowed.
6. The tutor (faculty member in charge) will give his comments and feedback
about the presentation.
7. All the students are expected to be present during the seminars and also
prepare themselves by reading about the topic of presentation so as to have
8. An active and productive group discussion.
Course Evaluation and Improvement Process:
The students will be given a feedback form, which can be submitted to the course
director or to the dean which will help in improvement of the subject teaching.
28
The head of the department or the Dean has informal meetings with groups of students
to discuss the contents of the course, method of teaching to evaluate the course and
the instructor.
Meetings will be conducted every week in the department to update the status of each
student and the difficulties felt by the colleague will be resolved accordingly. The dean
randomly attends lectures to assess the instructor. The power point presentation of
each lecture is distributed to all the staff members of the department for evaluation and
suggestions for improvement.
Teachers will be subjected to go for up gradation of knowledge by attending the relevant
conferences and will be encouraged to carry on a self-improvement.
Other staff members are invited to attend the seminar presentation of students to verify
the standards of student learning and their work.
29