Orthodontic lecture notes for undergraduate dental students (UDMY, UDMM, Myanmar)

1. University of Dental Medicine
Yangon, Mandalay
Myanmar
Department of Orthodontics
Undergraduate Orthodontic Course
(4th year BDS & 5th year BDS)
Lecture Notes
Compiled by Nay Aung, BDS, PhD

2. DEPARTMENT OF ORTHODONTICS
Definition and scope.
Orthodontics is one of the clinical dentistry, which studies the normal craniofacial growth and
development, the function of craniofacial complex and the biomechanical tissue response. Based
on these knowledge, orthodontic intervention and prevention of malocclusion, diagnosis and
treatment of morphologic disharmony derived from the abnormality of the craniofacial complex
are main area of study.
Departmental objectives.
Knowledge.
The student should acquire the knowledge of
-normal craniofacial growth and development, development of occlusion and
concepts of ideal occlusion, normal occlusion and malocclusion.
-biomechanical tissue response to functional and orthodontic / orthopedic forces.
-the development of malocclusion and dentofacial deformity.
-the analysis of malocclusion and set-up proper diagnosis and treatment plan.
Skill.
-The student should be able to fabricate Hawley type removable orthodontic appliance,
removable type expansion appliance, and space maintainers.
Attitude.
-The student should aware of the role of orthodontics in maintaining and
improving the function, esthetic and psychosocial conditions of and individual.
Orthodontics
Fourth Year B.D.S.
1. Programme Objectives
At the end of the course of instruction, the student should –
1.1 be able to acquire the knowledge of -
1.1.1 the concepts of ideal occlusion, normal occlusion, and malocclusion.
1.1.2 craniofacial growth and development and the functions of craniofacial
complex.
1.1.3 the development of occlusion and transition from primary to permanent
occlusion.
1.1.4 the design, construction and uses of removable orthodontic appliances.
1.2 be able to develop skill in -
1.2.1 wire bending and removable appliance construction.
1.3 have acquired the attitude of -
1.3.1 the importance of orthodontics in maintaining and improving the function,
esthetic and psychosocial condition of an individual.

3. 1.3.2 the importance of basic orthodontics for the understanding of diagnosis and
treatment planning of orthodontic patient.
Lesson Plan for Fourth Year B.D.S. Course.
Title 1. Introduction to Orthodontics and Dentofacial Orthopaedics.
Sr.No Objectives. (S.L.O) Content Method Media Time
1. At the end of the
session the student
should-
-be able to define
orthodontics and
dentofacial
orthopaedics.
-understand the
scope of
orthodontics and
dentofacial
orthopaedics.
-understand the
technical terms
frequently used in
orthodontics.
-be aware of the
prevalence of
malocclusion and
dentofacial
deformity within the
community and
realize its impact
upon the physical
and psychosocial
health of and
individual.
Definition and scope of
orthodontics and
dentofacial orthopaedics.
Terminology.
Occlusion- line of
occlusion, centric
occlusion, centric relation,
overbite, overjet, open bite,
deep bite, cross bite.
Alignment- angulation,
inclination, procline,
retrocline, protrusion,
retrusion.
Dentitional- rotation,
ectopic eruption, ankylosis,
peg shaped teeth,
supernumerary teeth,
delayed eruption,
macrodontia, microdontia.
Spaced anomaly- crowding,
spacing, tooth size jaw size
discrepancy.
Definition of malocclusion
and dentofacial deformity.
Prevalence of malocclusion
and dentofacial deformity
in the community.
Need and demand for
orthodontic treatment.
Effects of malocclusion and
dentofacial deformity on
the physical and
Lecture White
board
Slide
projector
OHP.
2 hr

4. psychosocial health of an
individual.
Title 2. Classification of Occlusion, Malocclusion and Craniofacial Skeletal Structures.
Sr.No Objectives. (S.L.O) Content Method Media Time
2. At the end of the
session the student
should-
-be able to write the
definition of ideal
occlusion, normal
occlusion,
malocclusion.
-understand the
concepts of ideal
occlusion, normal
occlusion and
malocclusion.
-be able to classify
the occlusion
according to Angle's
classification.
-be able to classify
the craniofacial
skeletal structures.
Definition and concept of
ideal occlusion.
Definition and concept of
normal occlusion.
Definition and concept of
malocclusion.
Angle's classification of
occlusion.
Classification of
craniofacial skeletal
structures into skeletal
pattern I, II and III.
Lecture
Tutorial
White
board
Slide
projector
OHP
Models
2 hr
2hr
Title 3. Etiology of Malocclusion and Dentofacial Deformity.
Sr.No Objectives. (S.L.O) Content Method Media Time
3. At the end of the
lesson the student
should-
-be able to list the
three main causes of
Factors contributing to the
development of
malocclusion and
dentofacial deformity.
-hereditary causes
Lecture White
board
OHP
4 hr

5. malocclusion and
dentofacial
deformity.
-understand how the
hereditary factor
could contribute to
the development of
malocclusion and
dentofacial
deformity.
-be able to list the
environmental
causes affecting the
position of teeth.
-be able to explain
the effects of thumb
sucking and tongue
position on the
dentoalveolar
structure.
-be able to list the
specific causes of
malocclusion and
dentofacial
deformity.
-be able to explain
the effects of
supernumerary teeth
on eruption and
position of teeth.
-be able to
understand the
sequeale of early loss
of deciduous teeth on
permanent dentition.
-environmental causes
-specific causes.
Hereditary causes.
-positional malrelation of
maxilla, mandible and
cranial base.
-size disharmony between
maxilla and mandible.
-teeth size jaw size
discrepancy.
Environmental causes.
-Equilibrium effects on
the dentition and jaw size
and shape.
-Masticatory function.
-Sucking and other habits.
-Tongue
position/thrusting.
-Mouth breathing.
Specific causes.
-Disturbances in
embryologic
development.
-Skeletal growth
disturbances.
-fetal moulding and birth
injury.
-childhood fracture of
the
jaw.
-Muscle dysfunction.
-Disturbances in the
dental development.
-congenital missing
teeth.
-malformed and
supernumerary teeth.
-interference with
eruption.
-ectopic eruption.
Slide
projector

6. -be able to
understand the
consequences of
missing permanent
teeth, ectopically
erupting teeth,
ankylosed
primary/permanent
teeth, malformed
teeth on the
developing
permanent dentition.
-be able to explain
the effects of dental
trauma to the
development of
malocclusion.
-Improper guidance of
eruption.
-early loss of primary
teeth.
-functional shift of
mandible.
-Trauma to teeth.
Title 4. Growth and Development of Craniofacial Complex.
Sr.No Objectives. (S.L.O) Content Method Media Time
4. At the end of the
lesson the student
should-
- be able to explain
bone remodeling,
sutural growth,
synchondrosis,
cartilaginous bone
growth.
-know the sites and
types of growth in
the cranial vault,
cranial base,
nasomaxillary
complex and
mandible.
-be able to explain
the growth of the
nasomaxillary
complex and
Functional components
of craniofacial skeletal
structures.
Sites and types of growth
in the cranial vault,
cranial base,
nasomaxillary complex,
and mandible.
Growth of the
nasomaxillary maxillary
complex and mandible.
Lecture White
board
OHP
Slide
projector
4 hrs

7. mandible according
to functional matrix
theory.
-know the various
methods used to
predict the pubertal
growth spurt.
-be aware of the
importance of
predicting growth
spurt in the growth
modification
orthodontic
treatment.
Pubertal growth spurt
and its relationship to
jaw growth.
-Prediction of pubertal
growth spurt.
-Clinical application.
Title 5. Development of Occlusion.
Sr.No Objectives. (S.L.O) Content Method Media Time
5. At the end of the
session the student
should-
-be able to
understand different
stages of permanent
tooth eruption.
-know the eruption
sequence of
permanent teeth
-know the timing of
eruption of teeth at
various dental ages.
-be able to list the
characteristic
features of primary
dentition.
-be able to explain
the space
relationships during
transition from
The eruption of
permanent teeth.
-preemergent eruption.
-postemergent eruption.
-postemergent spurt.
-juvenile occlusal
equilibrium.
-adult occlusal
equilibrium.
The eruption sequence
and timing.
Features of primary
dentition before
transition.
Space relationships in
the replacement of
incisors.
Space relationships in
replacement of canines
and primary molars.
Lecture White
board
OHP
Slide
projector.
3 hrs

8. primary to
permanent incisors.
-be able to explain
the space
relationships during
transition and the
development of
Angle's class I, II
and III molar
relation.
Title 6. Removable Orthodontic Appliances.
Sr.No Objectives. (S.L.O) Content Method Media Time
6. At the end of the
session the student
should-
-be able to define
orthodontic
appliance.
-be able to list the
various removable
orthodontic
appliances
-be able to define
various components
of Hawley type
removable
orthodontic
appliance and the
function of each
component.
-be able to apply this
knowledge in the
construction of
removable
orthodontic
appliances.
Definition of
orthodontic appliance.
Definition of removable
orthodontic appliance.
Components of
removable orthodontic
appliance.
-base plate.
-action unit.
-anchorage and
retention unit.
Functions of each
component.
Lecture White
board.
OHP
1 hr
Title 7. Orthodontic Technique Course.
Sr.No Objectives. (S.L.O) Content Method Media Time
7. At the end of the
course the student
should-
Wire bending
techniques.
-adam clasp
-labial bow
Practical Stainless steel
wire.
Wire bending
pliers,cutters.
45 hr

9. -have developed
skills in bending
wires.
-finger spring, "z"
spring, buccal canine
spring
Models.
Title 8. Introduction to Clinic.
Sr.No Objectives. (S.L.O) Content Method Media Time
8. At the end of the
session the student
should-
-have developed the
communication and
interpersonal skills
for taking proper
history.
Clinical observation.
History taking.
Chairside
teaching
Patient 3 hr
2.1 Total Teaching hours
Hours
Lecture/Revision/Tests 16
Tutorial/Practical/Discussion 50
Total 66
3. Assessment
3.1 Formative assessment
3.1.1 Class tests
3.1.2 Mid-term test
3.1.3 Practical
Product assessment on wire bending and
appliance construction.
3.2 Summative assessment
3.2.1 Theory
One three hour theory paper (Combined with
Children's Dentistry)
3.2.2 Practical
One hour practical assessment.
3.2.3 Viva Voce is not compulsory
3.3 Marks allocation
Formative assessment 30%
Summative assessment 70%
Theory 50%
Practical 20%

10. 1. Reference Book
Proffit, W.R. and Fields, H.W. (Jr.) . Latest edition.
Contemporary orthodontics 2nd
ed.
Mosby-Year-Book, Inc.
Graber, T.M.,
Principles and practice of orthodontics. Latest edition.
Moyers, R.E,
Handbook of orthodontics. Latest edition.
Year-Book Medical Publishers, Chicago.
Houston, W.J.B. 1982.
Orthodontic diagnosis Latest edition.
John Wright and Sons Ltd. Bristol, London and Boston.
Donald D. Enlow,
Hand book of facial growth Latest edition.
Tulley, W.J. and Campbell, AC (1976)
A manual of practical orthodontics Latest edition.
John Wright and sons Ltd. Bristol.
Gordon c. Diokson. Albert. E. Whealthy 19788.
An atlas of removable orthodontic appliances Latest edition.
Joan L. Blazucki, RG, BS, 1990.
Bench – Top orthodontics, Latest edition.
Quintessence Publishing Co, Inc.
Foster, T.D. (1982).
A textbook of orthodontics Latest edition.
Blackwell Scientific Publications, Oxford.
Mills, J.R.E (1982)
Principles and practice of orthodontics. Latest edition.
Churchill Livingston Edinburgh, London, Melborne and New York.
C.D. Stephens, K.G Isaacson 1990.
Prqctical orthodontic assessment, Latest edition.
Heinemann Medical Book.
K.G. Isaason J.K williams 1984.
An introduction to fixed appliances. Latest edition. Wright Bristol.

11. DEPARTMENT OF ORTHODONTICS
FINAL YEAR B.D.S.
1. Programme objectives
At the end of the course of instruction, the student should have –
acquired the knowledge of –
1.1.1 underlying principles required for the treatment planning of an orthodontic
patient.
1.1.2 various treatment modalities for various dentofacial anomalies of
cranofacial complex.
1.1.3 differentiating those orthodontic problems requiring referral to the
specialist.
1.2 acquired skill in –
1.2.1 conducting proper history taking, clinical examination, and diagnosis of an
orthodontic patient. Vc
1.2.2 formulating the correct treatment planning, design, and construction of
orthodontic appliances.
1.3 develop the attitude of –
1.3.1 importance of orthodontics in maintaining and improving the function ,
esthetic and psychosocial condition of an individual.
1.3.2 importance of orthodontic treatment as an adjunct to other phases of dental
practice.
1.3.3 importance of referral to the specialist for the sake of achieving the optima
oral health.

12. Lesson Plan for Final Year B.D.S. Course.
Title 1. Orthodontic Diagnosis.
Sr.No Objectives. (S.L.O) Content Method Media Time
1. At the end of the
session the student
should-
-be able to to
conduct proper
history taking for
orthodontic patients.
-be able to perform
clinical examination
of orthodontic
patient so as to
develop adequate
database for
diagnosis.
-be able to analyse
data from history,
clinical examination
and analysis of
diagnosis records
for the development
of problem list or
diagnosis.
Process of orthodontic
diagnosis.
History taking.
-methods.
-chief complaint.
-evaluation of physical
growth status.
-social and behavioral
history.
Clinical examination.
Extraoral examination of
face
-profile view
-front view
-soft tissue
Intraoral examination.
-general examination of
teeth, periodontium and oral
mucosa.
-specific orthodontic
examination.
-counting the teeth.
-intraarch anomalies.
-alignment anomalies.
-spaced anomalies.
-dentitional anomalies.
-dentoskeletal relation
-interarch anomalies.
-molar, canine and incisor
relation. (anteroposterior)
-overbite. (verical)
-crossbite.(lateral)
-soft tissue examination.
Analysis of diagnostic
records.
Study model.
Lecture
Tutorial
Chairside
teaching.
White
board
OHP
Slide
projector.
Study
model
X-rays
12 hrs
5 hrs

13. -model analysis.
-space analysis.
-diagnostic setup
Radiographs.
Photographs.
Writing clinical summary
and diagnosis.
Title 2. Treatment Planning.
Sr.No Objectives. (S.L.O) Content Method Media Time
2. At the end of the
lesson the student
should-
-be able to
formulate treatment
plan in conformity
with the best
possible esthetic,
function and
stability.
Formulation of treatment
plan.
-extraction / nonextraction
-orthodontic / orthopaedic
-choice of teeth for
extraction.
-timing and sequencing of
treatment.
-choice of appliance and
mechanical treatment plan.
Lecture White
board
OHP
Slide
projector
6 hrs
Title 3. Treatment in Mixed Dentition.
Sr.No Objectives. (S.L.O) Content Method Media Time
3. At the end of the
lesson the student
should-
-be able to write the
treatment protocol
for treatment of
crowding in mixed
dentition.
-be able to
diagnose space
management
problems and
recognize the need
for treatment.
-be able to select
and design various
types of space
regaining and
maintaining
appliance.
Treatment of crowding .
-diagnosis.
-treatment protocol
-space management.
-space regaining.
-space maintaining.
-expansion.
-appliance used for space
regaining, maintaining and
expansion.
Diagnosis and treatment of
spacing.
Diagnosis and treatment of
local crossbite.
Growth modification
treatment.
Lecture
Tutorial
Chairside
teaching
White
board
OHP
Slide
projector.
4 hrs

14. -be able to
diagnose and
planning treatment
for spacing and
crossbite.
-be able to
recognize condition
requiring growth
modification
treatment and the
need for referral.
Title 4. Treatment in Permanent Dentition.
Sr.No Objectives.
(S.L.O)
Content Method Media Time
4. At the end of the
session the student
should-
-be able to
diagnose and treat
simple crowding
using removable
appliance.
-be able to
diagnose and treat
spacing,
supernumerary
teeth, median
diastema using
removable
appliance.
-be able to
diagnose and treat
thumb sucking,
tongue thrusting.
-be able to treat
rotated and
malaligned teeth.
-be able to
recognize
Treatment of crowding.
-treatment protocol.
-clinical presentation of
crowding.
-treatment methods-
extraction, non-extraction.
-removable expansion
appliance.
Treatment of spacing.
Treatment of orthodontic
problems associated with
supernumerary teeth, ,high
fraenum.
Treatment of proclined
incisors.
-diagnosis and treatment
of thumb sucking.
-diagnosis and treatment
of tongue thrusting.
Treatment of rotation and
malaligned teeth.
Conditions requiring
referral.
Lecture
Chairside
teaching
White
board
OHP
Slide
projector
17 hrs

15. conditions
requiring referral.
Title 5. Biologic Tooth Movement and Biological Tissue Response.
Sr.No Objectives. (S.L.O) Content Method Media Time
5. At the end of the
lesson the student
should-
-be able to write the
sequence of
biologic response
to orthodontic and
orthopaedic forces.
-be able to state the
different types of
orthodontic tooth
movement.
-be able to apply
this knowledge in
application of force
and appliance
design.
Histologic structure of
periodontal ligament and
alveolar bone.
Response of tissues to
orthodontic and orthopaedic
forces.
Types of orthodontic tooth
movement.
Lecture White
board
OHP
Slide
projector.
8 hrs
Title 6. Role of Orthodontics in Cleft Lip and Palate.
Sr.No Objectives. (S.L.O) Content Method Media Time
6. At the end of the
lesson the student
should-
-be able to list the
effects of cleft lip and
palate in the teeth and
dentofacial structures.
-know the timing of
orthodontic treatment
in cleft patient.
Effects of cleft lip and
palate in the position and
alignment of teeth and
dentofacial structures
Timing of orthodontic
interventions in cleft
patients.
Lecture White
board
OHP
Slide
projector
4 hrs
Title 7. Removable Orthodontic Appliance.
Sr.No Objectives. (S.L.O) Content Method Media Time
7. At the end of the session
the student should-
-be able to list the
various orthodontic
appliances
-be able to select correct
choice of appliance.
Review of removable
orthodontic appliance.
-types of appliance
-choice of appliance
-care of appliance
-patient instruction
Lecture
Tutorial
:
White
board
OHP
Slide
projector
8 hrs
5 hrs

16. -be able to write
instructions to patient for
the care of appliance.
Title 8. Materials Used in Orthodontics.
Sr.No Objectives. (S.L.O) Content Method Media Time
8. At the end of the lesson
the student should-
-be able to know the
physical properties of
stainless steel wires and
base plate material.
Stainless steel wires
Base plate material
Expansion screws
Materials used in fixed
appliance treatment.
Lecture White
board
3 hrs
Title 9. Retention.
Sr.No Objectives. (S.L.O) Content Method Media Time
9. At the end of the lesson
the student should-
-be able to write the
reasons for the need of
retention appliance.
-be able to list various
types of retention
appliance.
-be able to select suitable
retention appliance.
The objectives of
orthodontic treatment.
Importance of the
stable orthodontic
treatment result.
The need for retention
and retention
appliances.
Lecture
Tutorial
White board
Retention
appliances
4 hrs
1 hr
Title 10. Laboratory Exercises.
Sr.No Objectives. (S.L.O) Content Method Media Time
10. At the end of the
session the student
should-
-be able to construct
Hawley type
removable appliance
and retainers.
-be able to construct
removable arch
expansion appliance.
-be able to list the
various types of
functional appliances.
Wire bending
Soldering
Removable appliance
construction
Functional appliance.
Arch expansion
appliance
Retainers
Tutorial
Practical
Models
Pliers/Wire
s
White
board
Appliances.
9 hrs
50
hrs

17. Title 11. Clinical Training.
Sr.No Objectives. (S.L.O) Content Method Media Time
11. At the end of the
clinical training the
student should-
-be able to take proper
orthodontic history
taking and perform
patient examination.
-be able to take
orthodontic impression.
-develop
communication skill in
explaining treatment
plan and giving patient
instruction.
-be able to make
appliance adjustments
and appliance delivery.
Chair side.
-history taking
-patient examination
and diagnosis.
-orthodontic
impression taking
-explanation of
treatment plan
-appliance adjustment,
delivery and patient
instruction.
Chairside
teaching.
Practical
Demonst:
Patient 10
Hours
2.1 TOTAL TEACHING HOURS
Hours
Lecture/Revision/Tests 66
Tutorial/Practical/Discussion 80
Total 146
3.1 Assessment

18. 3.1.1 Formative assessment
Theory
- Class test
- Mid - term test
- Practical
- Product assessment on wire bending and appliance construction.
3.1.2 Summative assessment
Theory
- One three hour theory paper, combined with Paedodontics
- Practical
- One hour practical assessment
- Viva voce is not compulsory
3.1.3 Marks allocation
formative assessment 30%
Summative assessment 70%
Theory 50%
Practical 20%
REFERENCE BOOK
Proffit, W.R. and Fields, H.W. (Jr.) Latest Edition
Contemporary Orthodontics 2nd
ed.
Mosby - Year - Book, Inc.
Graber, T.M
Principles and practice of orthodontics. Latest edition.

19. W.B. Saunders, London.
Moyers, R.E,
Handbook of Orthodontics. Latest edition.
Year - Book Medical Publishers, Chicago.
Houston, W.J.B. 1982.
Orthodontic diagnosis Latest edition
John Wright and Sons Ltd. Bristol, London and Boston.
Donald D. Enlow,
Hand book of facial growth, Latest edition.
Tulley, W.J. and Campbell, AC (1976)
A manual of practical orthodontics, Latest edition.
John Wright and Sons Ltd. Bristol.
Gordon C. Dickson. Albert. E. Whealthy 1978
An atlas of removable orthodontic appliances, Latest edition.
Joan L. Blazucki, RG. BS, 1990.
Bench- Top orthodontics, Latest edition, Quintessence Publishing Co, Inc.
Foster, T.D. (1982), A textbook of orthodontics, Latest edition.
Blackwell Scientific Publications, Oxford.
Mills, J.R.E (1982)
Principles and practice of orthodontics, Latest edition.
Churchill Livingstone Edinburgh, London, Melborne and New York.
C.D. Stephens, K.G Isaacson 1990.
Practical orthodontic assessment, Latest edition.
Heinemann Medical Book.
K.G Isaason J.K williams 1984.
An introduction to fixed appliances, Latest edition.
Wright Bristol