ORTHOdontics PGI

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CLINICAL EXAMINATION: (1) ITS STUDY: STATIC AND FUNCTIONAL

(2) ITS VALUE FOR DIAGNOSIS AND TREATMENT
PLANNING

INCLUDES LAB EXERCISES ON:

PHOTOGRAPHS
STUDY MODELS
X-RAYS
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FACULTY: Hani Hasbini, DDS.

Goals: This series of lectures and the following laboratory exercises should enable the resident to:
1. Know the key questions to ask the patient in the first interview.
2. Perform an extra-oral, intra-oral and functional examination of the patient.
3. Understand the function of complementary examinations, what to ask for and when.
4. Diagnose the case in all aspects.
5. Identify the objectives of the treatment.
6. Plan the treatment.
7. Come up with a prognosis.

Objectives: At these lectures, the resident should know:

1. How to open a file for an orthodontic patient (the chief complaint of the patient and/or his family, his social, behavioral,
medical and dental history.)
2. How to perform the following examinations:
a. Face and profile.
b. Dental arch.
c. Functions.
3. How to make use of the complementary exams, and choose the most useful exam for the particular case, study the dental
models, radiographic examinations, cephalometric examination.
4. How to reach the esthetic, functional, dento-alveolar and skeletal diagnosis.
5. Evaluate the major, minor and ideal objectives of the treatment.
6. Establish a treatment plan: what, when and how to treat.
7. The prognosis of the case with or without treatment.
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COURSE DURATION: This course is scheduled between October and May for the first year residents. It is given every Tuesday at a 1.5-hour session between
11:30 a.m. and 1:00 p.m. It includes fundamental knowledge on the procedures that should be followed in order to establish both, functional and clinical
examination of a patient.

EXAMINATIONS: Biannual examinations (progress and final) are given for this course. During it any number of progress tests or assignments may be given.
Their cumulative weight in proportion to the final grade may not exceed 50%.
CLINICAL EXAMINATION:
(1) ITS STUDY: STATIC AND FUNCTIONAL
(2) ITS VALUE FOR DIAGNOSIS AND TREATMENT PLANNING
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SUMMARY OUTLINE - INTRODUCTION
- INTERVIEW
- EXTRA-ORAL EXAMINATION
- INTRA-ORAL EXAMINATION
- FUNCTIONAL EXAMINATION
- COMPLEMENTARY EXAMS
- DIAGNOSIS
- TREATMENT OBJECTIVES
- TREATMENT PLANNING
- PROGNOSIS
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COURSE OUTLINE

1. INTRODUCTION

2. INTERVIEW
A. Chief complaint
B. Social and behavioral history
C. Medical history
D. Dental history

3. EXTRA-ORAL EXAMINATION
A. Face examination
B. Profile examination
C. Smile
D. TMJ

4. INTRA-ORAL EXAMINATION
A. General condition of the mouth
B. Each arch alone
 a. Hard tissue
b. Soft tissue
C. Arches in occlusion
a. Sagittal
b. Vertical
c. Transversal

5. FUNCTIONAL EXAMINATION
A. Smile
B. TMJ
C. Centric relation
D. Occlusal examination
E. Muscle examination
F. Functional examination
a. Speech
b. Swallowing
c. Breathing
G. Para functions

6. COMPLEMENTARY EXAMS
A. Study models
a. Arch Length Discrepancy
b. Bolton analysis
c. Diagnostic set-up
d. Articulator study if needed & axiography
e. Digital (Sursmile, Ortho-Cad …)
B. Radiographic examination
a. Panoramic x-ray
b. Periapical (long cone)
c. Bite-wing
d. Occlusal
e. Cephalometric
e.1. Lateral
e.2. Postero-Anterior (PA)
e.3. Axial (Submentovertex)
e.4. Hand wrist
e.5. Tomography (Impacted teeth,TMJ)
e.6. Transcranial
e.7. 3 D (C T Scan, I-Cat …)
 e.8. RMI (TMJ)
C. Cephalometric examination
a. Structural analysis
b. Cephalometric analysis

7. DIAGNOSIS
A. Esthetic
B. Functional
C. Dentoalveolar
D. Skeletal

8. TREATMENT OBJECTIVES
A. Major objectives
B. Minor objectives
C. Search for ideal objectives

9. TREATMENT PLANNING
A. Generalities
B. What to treat?
C. When to treat?
D. How to treat?

10. PROGNOSIS
A. Without treatment
B. With treatment

REFERENCES

1. Bassigny Francis: Manuel d’orthopedie dento-faciale: Masson.

a. Chapter 3: Orthodontic evaluation: 31-65.
b. Chapter 5: Treatment of orthodontic malocclusions: 117-170.
2. Chateau Michel: ORTHOPEDIE DENTO- FACIALE: Clinique
(Diagnostic et Traitement) Julien Prélat.
a. Chapter 1: Comment doit être conduit l’examen: 30-72.
b. Chapter 5: Bilan fonctionnel et général: 165-171.
c. Chapter 7: Elements de pronostic: 182-185.
3. Chung JU, Hwang JY, Cha Jae JHY. Late–faming supernumerary teeth. JCO 2004; 38(12): 656-660.
4. Graber MT, Swain F. Orthodontics-Current Principles and Techniques. C.V. Mosby company:
a. Chapter 1: Diagnosis and treatment planning in orthodontics: 3-100.
5. Gottlieb EL. Stability of orthodontic treatment. Part 1. JCO 2006; XL(1):27-38.
6. Gottlieb EL. Stability of orthodontic treatment. Part 2. JCO 2006; XL(1):83-93.
7. Gottlieb EL The editor’s corner: Some thoughts about symmetry. JCO 2001; 35(7): 409-410.
8. Proffit WR. Contemporary Orthodontics. Third edition. Section III: Diagnosis and treatment planning: 145-293.
9. Redmond WR. Digital Models: A new diagnostic tool. JCO 2001; 35(6):386-7.
10. Recommendations de l’A.N.A.E.S. (Agence Nationale d’Acreditation et d’Evaluation en Sante) : Indications de l’orthopedie dento-faciale et dento –maxillo-
faciale chez l’enfant et l’adolescent –juin 2002.
11. Sabri R. The Eight components of a balanced smile. JCO 2005; 39(3): 155-68.
12. Van der Linden B. Diagnosis and treatment planning in Dentofacial orthopedics: Quintessence books.
a. Chapter 3: Examination of the Patient: 69-90.
b. Chapter 4: Diagnostic Aids: 91-116.
c. Chapter 5: Examination of Gathered Material: 117-158.
d. Chapter 6: Diagnosis and Classification: 159-164.
e. Chapter 7: Indications and Contraindications for Treatment: 165 –184.
f. Chapter 8: Starting points in treatment planning: 185-218.
13. Houston WJB, Stephens CD, Tulley WJ. A textbook of orthodontics. Second edition.
a. Chapter 5: Examination of the patient: 54-79.
b. Chapter 8: Treatment planning: 141-165.