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TABLE OF CONTENT

A. SEMESTER LEARNING ACTIVITY PLAN 4 A.1 COURSE IDENTITY 4 A.2 COURSE TOPIC 6 A.3 COURSE PROGRAM 7 A.4 MAPPING OF LEARNING OUTCOMES – COURSE OUTCOMES 11 A.4.1 The expected Learning Outcomes of Dental Medicine Program graduates 11 A.4.2 The expected Course Outcomes 11 A.4.3 Mapping of Learning Outcomes – Course Outcomes 11 B. COURSE ASSESSMENT 11 B.1 ASSESMENT RUBRIC 11 B.2 ASSESMENT SYSTEM 13 C. COURSE DEVELOPMENT 14 C.1 ACADEMIC YEAR 2016/2017 RESULT 14 C.2 PROBLEM ANALYSIS 14 C.3 SOLUTIVE STRATEGY 14 D. APPENDICES 15 D.1 DOCUMENT OF COURSE ACTIVITY 15 D.1.1. Sample of students’ attendance form 15 D.1.2. Sampe of statement of examination official report 16 D.2 SAMPLE OF STUDENT WORK 17 D.2.1. Sample of test paper 17 D.2.2. Sample of student work 20 D.2.3. Sample of student assignment 21 D.3. RECAPITULATION OF ASSESMENT 22 D.3.1. Item Analysis 22 D.3.2. Sample of evaluation method 23 D.3.3. Academic Year 2017/2018 result 25 D.3.4. Problem / Solution analysis 26

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A.SEMESTER LEARNING ACTIVITY PLAN

1. Course identity

Module Name & Code module

Clinical Orthodontics KGO 501

Module Level Profession program Abbreviation, if applicable - Semester/term 8, 9, 10 / Fourth and Fifth year Module coordinator(s) Dr. Irwadi Djaharu’din, drg., M.Kes., Sp.Ort(K) Lecturer(s)

1. Prof. Thalca Hamid,drg.,MHPEd., Sp.Ort.(K)., PhD

2. Jusuf Sjamsudin, drg., Sp.Ort.(K) 3. Dr. Ida Bagus Narmada, drg., Sp.Ort.(K) 4. Dr. Ari Triwardhani, drg., MSc., Sp.Ort.(K) 5. Dr. I Gusti Aju Wahju Ardani, drg., M.Kes.,

Sp.Ort (K) 6. Alida, drg.,M.Kes.,Sp.Ort. 7. Dr. Irwadi Djaharu’din, drg., M.Kes. SpOrt (K)

Language Bahasa Indonesia Classification within the curriculum

a. Compulsory course b. Specific Scientific Skill c. Clinical dental science

Learning Models Profession Program: Clinical Skills, Discussion.

Teaching format/class hours per week during the semester

Clinical Skills 340 minutes clinical case treatment management and discussion

Workload 90,6 hours/3 Semester Credit Points 3 (~4.53 ECTS) Requirements 3 patients with removable orthodontics

appliance treatment, starting with: 1. Make an impression 2. Model study analysis 3. Midline in model study 4. Treatment case analysis 5. Planning a removable orthodontics

appliance design 6. Insertion of removable orthodontics

appliance design 7. Activation of removable orthodontics

appliance design 8. Control 9. Reparation of removable orthodontics

appliance design Learning goal/competencies 1. Able to make patient selection

2. Able to do anamnesis 3. Able to perform clinical examinations:

intra-and extra-oral; functional analysis 4. Able to provide explanations before

patients or parents sign the Informed concerned

5. Able to do supporting data collection 6. Able to fill in orthodontic medical records

and case analysis

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7. Able to diagnose both dental and skeletal malocclusions (Class I, II, and III)

8. Able to prepare a malocclusion treatment plan

9. Able to do a referral system before and during orthodontic treatment

10. Able to make orthodontic removable appliance designs

11. Able to activate various active components 12. Able to explain the care that has been done

and explain the next treatment to be carried out according to the initial treatment plan

Content • Examination and treatment of the patient of: 1. Dental malocclusion according to Angle

Class I with a variety of malocclusions, such as: anterior crushing with or without deep bite; protrusion with or without anterior open bites; labioversi anterior teeth; anterior cross bite; anterior cross bite of one or several teeth.

2. Dental malocclusion according to the Angle Class II division or Class II division 2 with a variety of malocclusions, such as: anterior crunching.

3. Dental malocclusion according to Angle Class III or pseudo Class III or Class I with anterior crossing. with variations in malocclusion such as: anterior crushing.

• In the Orthodontics clinical learning profession students must be able to fill in orthodontic status in order to establish a diagnosis of malocclusion; determine the etiology of malocclusion; and develop a plan of care and care for malocclusion patients.

• Fill in orthodontic status including: doing anamnesa; facial profile analysis (extra oral); intra oral analysis; study model analysis; cephalometric and panoramic photo analysis; and functional analysis.

• In the Orthodontics professional clinical learning students must be prepared to carry out treatment for malocclusion treatment, prognosis; and the progress of treatment results under the guidance of the instructor.

Study/exam achievements ASSESSMENT: 1. Individual clinical activities 2. MINI CEX (Control/Activation) 3. DOPS (Treatment Case Analysis) 4. SOCA (Orthodontics Profession Exam) 5. Case progress 6. Soft skills

Individual Score:

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Individual Score 1 : Presence Criteria:

1. 1. On time : 100 2. 15 minutes late : 75 3. Not Present : 0

Individual Score 2 : Activity Criteria:

1. Active, creative in accordance with competence: 85

2. Less active: 65 3. Passive: 25

Individual Score 3 : Communication/ Attitude Criteria :

1. Really appreciate others and can interact in the group: 75 - 100

2. Appreciate the opinions of others but are not able to interact in a group: 55 – 74

3. No respect the opinions of others, but can interact in a group: 55 - 74

4. No respect to the opinions of others and do not interfere in a group: 0 – 54

Individual Score 4 : Relevance Criteria : 1. Strong relevance to the tasks assigned : 75 2. Has to do with assigned tasks: 55 3. Discussion outside a task assigned : 45 Individual Score 5: Knowledge Criteria : 1. Adequate : 75 2. not complete : 60 3. Not knowing : 40 Individual Scores (Clinical Orthodontics) = Scores (Presence + Activity+ Attitude+ Relevance+ Knowledge) / 5 FINAL ASSESSMENT: Requirements to pass a minimum B score by completing: Denture reparation :10% DOPS :10% Discussion : 5% Complete denture, Removable partial denture, Fixed-fixed bridge : 50% Mini-CEX : 10% SOCA : 15% Final index for profession program defined as follow: A : 100 ≥ FI > 86 AB : 86 > FI ≥ 78 B : 78 > FI ≥ 70 BC : 70 > FI ≥ 62 C : 62 > FI ≥ 54

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D : 54 > FI ≥ 40 E : 40 < FI

Forms of media Multimedia (Laptop & LCD)/ Books, Journal Literature 1. Buku Petunjuk Klinik Profesi Ortodonti.

2019. 2. Ortodonti II. 2017 . Airlangga University

Press . Surabaya Universitas Airlangga 3. Mitchell L. An Introduction to Orthodontics.

4th ed. United Kingdom. Oxfort University Press. 2013.

4. Bahreman A. Early-age Orthodontic Treatment.Quintessence Publinsing Co Chicago London.2013.

5. Profitt WR, Fields HW, Sarver DM. Contemporary Orthodontic. 4th ed. Mosby Elsevier. 2007.

6. Jacobson A, Jacobson RL. Radiographic Cephalometry: From basic to 3D Imaging. 2nd ed. Chicago.Tokyo. London. Quintessence Publising Co. Inc. 2006.

7. Graber TM, Vanarsdall RL, Vig KWL. Orthodontics : Current Principles Technigues. 4th ed. Elsevier Mosby. St Louis. 2005.

8. Issacson KG, Muir JD, Reed RT. Removable Orthodontic Appliances, Oxford, Wright. 2002.

9. Rakosi T, Jonas I, Graber TM. Color Atlas of Dental Medicine : Orthodontic Diagnosis. Georg Thieme Verlag, Suttgart. New York. 1993.

10. Houston WJB, Issacson KG. Orthodontic Treatment With Removable Appliances, 2nd ed., Bristol, John Wright and Sons Ltd. 1990.

11. Graber TM, Neuman B. Removable Orthodontic Appliance. WB Saunders Co.Philadelphia /London/Toronto. 1984.

2. COURSE TOPIC

Orthodontic clinical course topics are include general analysis, local analysis, photo, functional, model analysis and diagnosing malocclusion, identifying etiology of malocclusion, treatment planning for orthodontic treatment and designing removable orthodontic appliances.

3. MAPPING LEARNING OUTCOMES – COURSE OUTCOMES

The graduates of Dental Medicine Program UNAIR are expected to have the following competencies:

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LO 1 : Able to understand the basic principles and applied basic medical science and basic social science to support dentistry

LO 2 : Able to apply basic medical science, clinical medicine, basic dental science, and clinical dental science to solve problems on dental cases

LO 3 :

Able to demonstrate general physical examination and stomatognathic system examination, establishing diagnosis, and formulating treatment plans in order to achieve excellent oral and dental health through promotive actions, preventive actions, curative actions,and rehabilitative actions towards mannequin or simulation patient

LO 4 : Able to perform dental research as the application of scientific methods and disseminate the results according to the rules of science

LO 5 : Able to perform general physical examination and stomatognathic system examination, establishing diagnosis, and formulating treatment plans in order to achieve excellent oral and dental health through promotive actions, preventive actions, curative actions, and rehabilitative actions towards patient

LO 6 : Able to perform procedures and series of steps to restore the function of stomatognathic system in dental hospital

LO 7 : Able to demonstrate procedural knowledge and step series to restore the functions of stomatognathic system in environmental community

LO 8 : Able to perform dental practices based on relevant areas of expertise, accountability principles, partnership, ethics, and law mata

Achievement of course learning Course Outcome (CO)

1. Have an ability to make a patient selection 2. Have an ability to do an anamnesis for medical history 3. Have an ability to carry out clinical examinations: intra-and extra-oral; functional analysis; photo analysis, model analysis 4. Have an ability to provide explanations before patients or parents sign: Informed consent 5. Have an ability to collect secondary data. 6. Have an ability to fill in orthodontic medical records and case analysis 7. Have an ability to diagnose both dental and skeletal malocclusions (Class I, II, and III) 8. Have an ability to establish an orthodontic treatment plan for malocclusion 9. Have an to do a referral system before and during orthodontic treatment 10. Have an ability to design orthodontic removable appliances 11. Have an ability to activate various active components of removable orthodontic appliances 12. Have an ability to explain the treatment that has been done and explain the next treatment to be carried out according to the initial treatment plan

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LO 1 LO 2 LO 3 LO 4 LO 5 LO 6 LO 7 LO 8 CO 1 * CO 2 * CO 3 * * * * CO 4 * CO 5 * CO 6 * * * * CO 7 * CO 8 * CO 9 *

CO 10 * CO 11 * * * * CO 12 * * * *

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4. COURSE PROGRAM

Week Learning outcome

Learning Material

Learning Method

Media Time Student’s Learning

experience

Score Criteria and indicator

(hard dan soft skills)

Value

reference

1 2 3 4 5 5 6 7 8

1-2

Have an ability to make a patient selection

Students select patients who have indications of orthodontic treatment with removable or remofix appliance

Practice and discussion

Patient

4x3x50

Penyuluhan tentang kesehatan gigi pada pasien dengan melakukan perawatan maloklusi

Detailed and smooth communication

0.5% 1,2

3-6

Have an ability to do an anamnesis for medical history, clinical examination: intra and extra oral examination, functional analysis

− Seeking for causes of malocclusion

− Molar and canine clinical relation

− Look for presence of tooth and face asymmetry

− Mandibular movement from resting position to centric occlusion


Patient 4x3x50

Melakukan praktek pada pasien


0.5% 1,2,3,5, 6, 7

7-8 Have an ability to provide explanations before patients or parents sign: Informed consent

Able to explain to patients and parents wht will be done before, during, and after orthodontic treatment


Patient 4x3x50


Detailed and smooth

communication

0.5% 2,6,7

9-10 Have an ability to collect secondary data.

− Making a study model

− Making intra-and extra-oral photos

− Making cephalometric and panoramic radiograph photos

− Making a bite registration


Patient 4x3x50


Detailed and smooth

communication

0.5% 9,10

11-12 Have an ability to fill a medical history and case analysis

− Face profile analysis

− Study model analysis

− Cephalometry analysis

− Panoramic photo analysis


Patient 4x3x50

Model analysis, profile photo and radiography

Detailed analysis and smooth communication

0.5% 4,5,7

10


Learning Material

Learning Method


experience



Value

reference

1 2 3 4 5 5 6 7 8

13-14 Have an ability to diagnose dental and skeletal malocclusion.

− Classification of dental malocclusion according to Angle based on model analysis and cephalometry analysis

− Classification Skeletal malocclusion based on models and cephalometry analysis


Patient 4x3x50



0.5% 4,5,11

15-16 Have an ability to establish orthodontic treatment plan

− The right order of the treatment

− Identification of etiology of malocclusion

− Make design of removable orthodontic devices according to malocclusion


Patient 4x3x50



0.5% 2,3,9

17 Have an ability to write a reference letter before and during orthodontic treatment

− Write a reference letter before and during orthodontic treatment


Patient 4x3x50

Reference system

(reference letter)


0.5% 1

18-19 Have an ability to make design of orthodontic removable appliance

− Removable orthodontic appliance with anterior transversal expansion

− Removable orthodontic appliance with expansion of the anterior to frontal

− Removable orthodontic appliance to enforce the permanent first molar

− Removable orthodontic appliance for correction of anterior crossing

− Orthodontic removable appliance for anterior crowded

− Removable orthodontic appliance for correction of 2 mm median line shift


Patient and

study model

4x3x50

Practical experience

to the patient and study model

Detailed and right

identification

0.5% 2,8

21. Have an ability to do an removable

− Design of removable orthodontic appliance

Practice and

Patient 4x3x50

Practical experience

Skills right analysis and

0.5% 2,8,10

11


Learning Material

Learning Method


experience



Value

reference

1 2 3 4 5 5 6 7 8

orthodontic appliance insertion

− Make a spring − Scavenging of

the appliance − Adam’s clasps

adjustment − Spring

position

discussion

to the patient

smooth communication

22 Have an ability to activate, active component in malocclusion case

− Adam’s clasps adjustment

− Activated an, active component of removable orthodontic appliance


Patient 4x3x50

Practical experience to the patient

Skills right analysis and smooth communication

0.5% 2,8,10

23 Have an ability to select second patient

Students select patients who have indications of orthodontic treatment with removable or remofix appliance


Patient 4x3x50

Dental health education about treatment in malocclusion

Skills right analysis and


0.5% 1,2,3,5





Patient 4x3x50


Detailed , right analysis and smooth communication

0.5% 2 ,8, 10

25 Have an ability to do an anamnesis for medical history, clinical examination: intra and extra oral examination, functional analysis

− Seeking for causes of malocclusion





Patient 4x3x50


Skills in anamnesis, and clinical identification (Mini C-Ex)

0.5% 1,2,3,5, 6, 7





Patient 4x3x50


Activated an, active component of removable orthodontic appliance (DOPS)

0.5% 2 ,8, 10

27 - Have an ability to provide explanations before patients or parents sign:




Patient 4x3x50



0.5% 2,6,7

12


Learning Material

Learning Method


experience



Value

reference

1 2 3 4 5 5 6 7 8

Informed consent


− Able to explain to patients and parents what will be done before, during, and after orthodontic treatment

28 Have an ability

to explain the treatment that has been done and explain the next treatment to be carried out according to the initial treatment plan

- The summary of the case

- Treatment plan

- Design of removable orthodontic appliance

- Past treatment

- Next treatment plan that will be carried out


Patient 4x3x50


Skills, right analysis and


0.5% 2,8,10

Have an ability to activate, active component in malocclusion case




Patient 4x3x50



0.5% 2 ,8, 10

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Have an ability to collect secondary data.

− Making a study model

− Making intra-and extra-oral photos

− Making cephalometric and panoramic radiograph photos

− Making a bite registration


Patient 4x3x50


Detailed and smooth

communication

0.5% 9,10





Patient 4x3x50



0.5% 2 ,8, 10

31 Have an ability to fill a medical history and case analysis

− Face profile analysis

− Study model analysis

− Cephalometry analysis

chair-side teaching and discussion

Patient 4x3x50

Fill a medical history and case analysis

Skills to fill an orthodontic medical history (Mini C-Ex)

0.5% 1,2,3,5, 6, 7

13


Learning Material

Learning Method


experience



Value

reference

1 2 3 4 5 5 6 7 8

− Panoramic photo analysis

− Classification of dental and skeletal malocclusion





Patient 4x3x50



0.5% 2 ,8, 10

33 Have an ability to establish orthodontic treatment plan

− The right order of the treatment

− Identification of etiology of malocclusion

− Make design of removable orthodontic devices according to malocclusion

− Write a reference letter before and during orthodontic treatment


Patient 4x3x50

Model analysis, profile photo and radiography and reference system


0.5% 1,2,3,9

34 Have an ability to explain the treatment that has been done and explain the next treatment to be carried out according to the initial treatment plan


- Treatment plan


- Past treatment



Patient 4x3x50


Skills, right analysis and


0.5% 2,8,10





Patient 4x3x50



0.5% 2 ,8, 10

35 Have an ability to make design of orthodontic removable appliance

− Removable orthodontic appliance with anterior transversal expansion

− Removable orthodontic appliance with expansion of the anterior to frontal


Patient and

study model

4x3x50

Fill a orthodontic

medical history and designing

removable orthodontic

design


0.5% 2,8

14


Learning Material

Learning Method


experience



Value

reference

1 2 3 4 5 5 6 7 8

− Removable orthodontic appliance to enforce the permanent first molar

− Removable orthodontic appliance for correction of anterior crossing

− Orthodontic removable appliance for anterior crowded

− Removable orthodontic appliance for correction of 2 mm median line shift





Patient 4x3x50



0.5% 2 ,8, 10

37 Have an ability to do an removable orthodontic appliance insertion

− Design of removable orthodontic appliance

− Make a spring − Scavenging of

the appliance − Adam’s clasps

adjustment − Spring

position


Patient 4x3x50



0.5% 2,8,10





Patient 4x3x50



0.5% 2 ,8, 10

39 Have an ability to activate, active component in malocclusion case of second patient




Patient 4x3x50



0.5% 2 ,8, 10



- Treatment plan


- Past treatment



Patient 4x3x50


Communication skills that show an understanding of the management of the cases of malocclusion (SOCA)

0.5% 2,8,10

15


Learning Material

Learning Method


experience



Value

reference

1 2 3 4 5 5 6 7 8





Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10



- Treatment plan


- Past treatment



Patient 4x3x50



0.5% 2,8,10

Have an ability to activate, active component in malocclusion case of second patient




Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10

46 Have an ability to explain the treatment that has been done and explain the next treatment to be carried out according to


- Treatment plan



Patient 4x3x50


Communication skills that show an understanding of the management of the cases of

0.5% 2,8,10

16


Learning Material

Learning Method


experience



Value

reference

1 2 3 4 5 5 6 7 8

the initial treatment plan

- Past treatment


malocclusion (SOCA)





Patient 4x3x50



0.5% 2 ,8, 10

47 Have an ability to activate, active component in malocclusion case of the second patient




Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10



- Treatment plan


- Past treatment



Patient 4x3x50



0.5% 2,8,10





Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10

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Learning Material

Learning Method


experience



Value

reference

1 2 3 4 5 5 6 7 8



- Treatment plan


- Past treatment



Patient 4x3x50



0.5% 2,8,10





Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10



- Treatment plan


- Past treatment



Patient 4x3x50



0.5% 2,8,10





Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10

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Learning Material

Learning Method


experience



Value

reference

1 2 3 4 5 5 6 7 8





Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10





Patient 4x3x50



0.5% 2 ,8, 10

60 Have an ability to show a progress of removable orthodontic appliance

− Procedure of model impression

− Making of model trim

− Determination of mid line

Practice Patient 4x3x50

Practical dental impression for progress report

Detailed, right analysis and smooth communication

10% 1,2

61-63 Have an ability to show a progress of removable orthodontic appliance

− Procedure of model impression

− Making of model trim

− Determination of mid line

Practice Patient 4x3x50

Practical dental impression for progress report

Detailed, right analysis and smooth communication

10% 1,2

64-66 Have an ability to analyze, communicate and skilled in removable orthodontic treatment

Able to explain the analysis of cases of the patients who have been treated

Interview and discussion

1x3x50 Interview examination

Detailed, right analysis and


10% 1-8

5. Learning Process : In professional learning at the orthodontic department has a load of 3 credits (4.53 ECTS) taken in 8,160 minutes (6 x 66 x 170 minutes) where students are required to complete a number of 24 clinical assessment according to requirements, 3 discussions, 7 controls and 1 mini Cx and 1 time DOPS. and ends with a professional examination (interview examination ) (SOCA)

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Students in carrying out their clinical work are guided by orthodontic clinical module books (Appendix) Mini Cx is performed on the second patient for 1 time DOPS is carried out when students doing a treatment to the patient (the list of jobs done by DOPS is listed in the grades book) Students who do not work at the dental unit or treat patients are required to have discussions with the instructor Students may take professional examinations if they have completed 100% of the types of requirement that have been set. Professional examinations to determine the achievement of cognitive competencies in analyzing, planning, predicting the results of treatment of a case and based on progress assessment Students are declared competent if they have completed all requirement with a value of B and passed the professional examination with a value of ≥B Plans for learning time are arranged in the semester learning plan table The number of students working in dental conservation clinics per day is 30 students and the number of dental units 20, so that per dental unit is used by 1-2 students alternately In doing their work, students are guided by instructors. Each instructor guides 6 students per day

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B. COURSE ASSESSMENT

1. ASSESMENT RUBRIC

CLINICAL WORK THAT MUST BE COMPLETED BY STUDENTS No Name of Courses Requirement 1 CLinical Ortodonti 1 4 skill 1 theory

(1 patient) 2 Clinical Ortodonti 2 10 skill 4 theory

(2 patient) 3 Clinical Ortodonti 3 10 skill 4 theory

(2 patient) 4 Professional examination , discussion, Mini-CX, DOPS

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RECAPITULATION OF ASSESSMENT : Patient I / II

ASSESSMENT ORTHODONTICS Student Name :....……………………………………………………………………Working day …………………………………………………. Student Number : …………………………………… Orthodontic I / II / III / Date of first day in Orthodontic clinic………………….………………………… Patient name and address: ..………………………..…………………………………………………………………………………………………………………… Diagnose of malocclusion :.……………………………………………………………………………………………………………………………………………………………………… Instructor Name : ……………………………………………………………………..……………………………………………………………………………………

A. SKILL ASSESSMENT Assessment

1. IMPRESSION IMPRESSION

DATE SIGN VALUE DATE SIGN VALUE

2. I N S E R T I O N

MAXILLA / MANDIBLE MAXILLA / MANDIBLE

1.DATE SIGN VALUE 1.DATE SIGN VALUE

3. R E P A R A T I O N





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4. ACTIVATION




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RECAPITULATION OF ASSESSMENT : Patient I / II

ASSESSMENT ORTHODONTICS Student Name :....……………………………………………………………………Working day ……………………………………………… Student Number : …………………………………… Orthodontic I / II / III / Date of first day in Orthodontic clinic………………….…….. Patient name and address : ..………………………..…………………………………………………………………………………………………………… Diagnose of malocclusion :.……………………………………………………………………………………………………………………………………… Instructor Name : ……………………………………………………………………..…………………………………………………………………

NOTES:

1. A sheet of pink color (ortho 1), white (ortho II), yellow (ortho III), green (extension). 2. The selected application is DIRECTED. 3. Students Obtain SIGNATURE and VALUE, if they have shown proof of the payment 4. New insertion of appliance: Rp. 25,000, - each jaw; Insertion Incline bite plane: Rp. 25,000, - each jaw; 5. Impression: Rp. 25,000, - Control and activation: @Rp. 10,000, - every visit

B. T H E O R Y

1. CASE ANALYSIS

1.DATE SIGN VALUE

2. CONTROL OF THE CASE



C. PROGRESS

D. TOTAL : EVALUATION

PATIENT’S PHOTO

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CLINICAL DISCUSSION : ASSESSMENT INCLUDES Soft skill :

1. Dress in accordance with the clinical order 2. Being polite in expressing opinions 3. Be polite to instructors and friends in groups 4. 4. Use good language

Cognitive: 1. Ability to express opinions. 2. Ability to provide arguments. 3. Ability to ask questions. 4. Ability to solve problems / answer questions

DATES TOPIC SCORE TOTAL SCORE

VALUE LECTURER SIGN SOFT

SKILL KOGNITIF

TOTAL VALUE

NOTES: Soft skills and cognitive:

Score 4: meets 4 criteria Score 3: meets 3 criteria Score 2: meets 2 criteria Score 1: fulfills 1 criterion a. Conversion of total score to value

TOTAL SCORE : VALUE: 8 90 7 80 6 70 5 60 4 50 3 40 2 30

b. Value of Clinical Discussion (Total Value/6) = ............

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MINI-CLINICAL EVALUATION EXERCISE (MINI-CEX)

Student name: Student number:

Dates: Instructor:

No Stages Criteria Scoring Criteria Date Score Value Intructor’s sign

1. General analysis

1. Anamnesis - Greetings, introduce yourself and smile - Asking the identity of the patient and the patient's parents - Asking the main complaint - Inquire history of teeth - Asking about race, the presence or absence of endocrine disorders, surgery, childhood illness, allergic presence or absence - Ask about family characteristics related to malocclusion 2. Measure weight 3. Measure height 4. Evaluate breathing habits 5. Do tonsil examinations 6. Examine skeletal shape

Score 4: when asking all items in full Score 3: when asking for 5 items Score 2: when asking 3-4 items Score 1: when asking 1-2 items Score 0: didn’t do all the items

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2. Local Analysis

1. Extra oral examination Profile type Lip face type Talk function Head shape Bad habits 2. Perform intra-oral examination Oral mucous tissue Tongue Palate Frequency of caries Oral hygiene Tooth phase 3. Check the condition of the teeth 4. Do panoramic photo analysis 5. Conduct a cephalometric photo

analysis

− Score 4: if able to do all items − Score 3: if able to do 4 items − Score 2: if able to do 3 items − Score 1: if you are able to do 1-2 items − Score 0: if didn’t able to do all items

3. Functional Analysisl

1. Perform free way space examination 2. Evaluate the path of closure 3. Evaluate the temporomandibular joint 4. Evaluate the presence or absence of mandibular displacement

− Score 4: if able to do all items − Score 3: if able to do 3 items − Score 2: if able to do 2 items − Score 1: if you are able to do 1 items − Score 0: if didn’t able to do all items

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4. Study model analysis

1. Able to determine the shape of the arch of the tooth

2. Calculating the mesiodistal width of the 4 maxillary incisors

3. Determine the discrepancy in the model

4. Determine the curve of spee 5. Determine the presence or absence

of diastema 6. Determine the symmetry of the

maxillary and mandibular teeth 7. Determine the teeth that are located

wrong 8. Determine the magnitude of the

median curve of the dental arch to the median face

9. Determine tooth group abnormalities 10. Determine the relation of the

posterior teeth of the sagital, transverse, and vertical maxilla to the mandible

11. Determine the relation of the anterior teeth to the sagital and vertical maxilla to the mandible

12. Determine possible etiology of malocclusion

− Score 4: if able to do 11-12 items − Score 3: if able to do 7-10 items − Score 2: if able to do 4-6 items − Score 1: if able to do 1-3 items − Score 0: if didn’t able to do all items

5. Diagnosis and

1. 1. Determine the classification of class I Angle malocclusions

− Score 4: if able to do all items − Score 3: if able to do 3 items

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Malocclusion analysis

2. 2. Determine the classification of I / 1 class I malocclusions according to Angle

3. 3. Determine the classification of class I I / 2 malocclusions according to Angle

4. Determine the classification of class III malocclusions according to Angle

− Score 2: if able to do 2 items − Score 1: if you are able to do 1 items − Score 0: if didn’t able to do all items


6. Type of tretament

1. Determine the type of treatment 2. Make a treatment plan according to

the case of malocclusion

− Score 4: if able to do all items − Score 3: if able to do all items but not

detailed − Score 2: if able to do all items with

correction − Score 1 :if able to do 1 items − Score 0: if didn’t able to do all items

7. Appliance design

1. Determine the types of retentive components

2. Determine the types of active components

3. Determine the design of the acrylic plate

4. Determine anchorage


TOTAL SCORE : Instrutor’s notes to the student:

29

Value of mini-CEX (Total Score/7): Student’s Sign Instructor sign

30

DIRECT OBSERVATIONAL PROCEDURE SKILL (DOPS) I


Dates: Instructor:

INSERTION


1 Preparation 1. Place the patient correctly 2. Pair the patient's chest cover 3. Installing a table mat 4. Provide a glass and mouthwash 5. Prepare tools in sterile conditions:

glass mouth, sonde, tweezers, Adams pliers, universal pliers, 3 finger pliers, cut pliers

6. Wear a handscone and mask

− Score 4: if able to do all items − Score 3: if able to do 4-5 items − Score 2: if able to do 2-3 items − Score 1: if you are able to do 1 items − Score 0: if didn’t able to do all items

2 Insertion of the appliance

1. Able to place an appliance with retentive and stable in mouth

2. Able to insert an appliance with 3. Evaluate the location of active and

retentive components 4. Adjust the active component and

retentive in the correct position 5. Evaluate the contact between the

acrylic plate and the tooth surface 6. Evaluating stability

− Score 4: able to insert removable orthodontic appliance in the mouth, lies in the correct position, retentive and stable position. Shows to instructor 2 times maximum.

− Score 3: able to insert removable orthodontic appliance in the mouth, lies in the correct, retentive and stable position. Show to instructor> 2x.

− Score 2: unable to insert removable orthodontic appliance in the mouth (recommended for repair).

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− Score 1: unable to insert removable orthodontic appliance in the mouth due to a wrong design.

− Score 0: didn’t insert removable orthodontic appliance


3 Post insertion

1. Give instructions on how to remove removable orthodontic appliance 2. Give instructions on how to install removable orthodontic appliance 3. Give instructions on how to clean removable orthodontic appliance 4. Give instructions about allergies


TOTAL SCORE : Instrutor’s notes to the student: Value of DOPS (Total Score/3):

Student’s Sign Instructor sign

32

DIRECT OBSERVATIONAL PROCEDURE SKILL (DOPS) II


Dates: Instructor:

ACTIVATION


1. Preparation 1. Place the patient correctly 2. Pair the patient's chest cover 3. Installing a table mat 4. Provide a glass and mouthwash 5. Prepare tools in sterile conditions:

glass mouth, sonde, tweezers, Adams pliers, universal pliers, 3 finger pliers, cut pliers

6. Wear a handscone and mask

− Score 4: if able to do all items − Score 3: if able to do 4-5 items − Score 2: if able to do 2-3 items − Score 1: if you are able to do 1

items − Score 0: if didn’t able to do all

items

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2. Activation

1. Evaluate removable orthodontic appliance stability and retention in the mouth 2. Determine whether or not to activate the active component again 3. Activate the active component in the right way 4. Activate the active component with the correct direction of movement 5. Perform active component activation with optimal orthodontic strength

− Score 4: if able to do all items − Score 3: if able to do 4 items − Score 2: if able to do 3 items − Score 1: if you are able to do 1-2

items − Score 0: if didn’t able to do all

items

TOTAL SCORE : Instrutor’s notes to the student: Value of DOPS (Total Score/2):

Student’s sign

Instructor sign

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2. ASSESMENT system

Evaluation of Clinical Assessment:

1. First stage of orthodontic clinical assessment a. Clinical assessment : 40%

b. Mini Clinical Exercise (Mini-CEX) : 10%

c. Direct Observation Psychomotor Skill (DOPS) : 10%

d. Soft Skill : 10%

e. Progress : 30%

Minimum value : B

2. Second stage of orthodontic clinical assessment a. Total Score Value : 60%

b. Examination(SOCA) : 40%

Minimum value

Score convert

Score 4 = 75-100 Score 3 = 70-74 Score 2 = 50-69 Score 1 =25-49 Score 0 = 0

Value of Score

Score number Value

75 – 100 A

70 – 74,99 AB

65 – 69,99 B

60 – 64,99 BC

55 – 59,99 C

40 – 49,99 D

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Recapitulation score of Mini-CEX + DOPS + Soft Skill + SOCA discussion

Mini-CEX DOPS Soft Skill Total 3 nilai 10 % SIgn

36

C . Course development

Dentistry profession education is completed within 3 semesters (1,5 years)

Professional education in the field of Orthodontics was completed in 8,610 minutes which was arranged by work scheduling where students were divided into 15 groups (11 students / groups). In clinical work scheduling, divided into several separate meetings

Table 1. Number of student who pass clinical orthodontics

Years Number of student

Number of student who pass (%)

Nilai

A AB B 2015 168 101 (60%) 29 23 49 2016 162 108 (66%) 24 39 45

Nilai kelulusan ≥B

Low cause of graduation

1. The patient is not cooperative

2. The treatment period is too long so it is difficult to get permission from the patient's school

3. Interrupted scheduling, causing failure in patient care (the teeth are no longer indicated, the

patient does not return)

0

20

40

60

80

100

120

140

160

180

JumlahMahasiswa

Jumlah Lulus Nilai A Nilai AB Nilai B

2015

2016

37

Solution

1. Periodically giving KIE and DHE to patients and patients' parents.

2. Cooperating with the school, so that more students can be treated.

3. Change the way of scheduling by uninterrupted schedulers.

4. Use of equipment and technology that follows developments in science and technology

38

D. appendix

1. Document of course activity 2. Contoh modul ortodonti 3. Sample of student work = 4. Recapitulation of assesment =

39

Apendix 1: log book

40

2. Modul Orthodontics

STUDENTS’ GUIDE BOOK OF CLINICAL ORTHODONTICS

This Students’ Guide Book has been formulated to provide a clear statement of the University’s expectations of students in respect of academic matters and personal behavior to provide good and ideal Orthodontic treatment at Universitas Airlangga Dental Hospital.

All students are required to be aware of and act consistently with the following values.

Rules and Regulations :

1. Students must understand the contents of this guide book before treating patients. 2. Students are supervised by instructor for each of their patients during treatment period, and are

allowed to discuss and consult about the case with the instructor. 3. Students need to bring the following instruments while working in Orthodontic Department:

• Diagnostic kits • Impression trays in various sizes • Scaler • Adams forcep • Universal forcep • Cutting forcep • Frazer and stone burs for straight handpiece instrument • Disposable table cloth • Rubber bowl and spatula • Note: Contra-Angle handpiece is not allowed to be used for laboratory activity

4. Students must provide adequeate and clear explanation of the cases and treatment plans to the patients and their parents/family/caregiver before signing the informed consent.

5. Students’ attendance is done twice, at the beginning and at the end of working hour.

The Working Procedures

A. Orthodontic Patient

Students must treat 2 (two) patients in the following order:

1. The first patient is treated in the first term of Clinical Orthodontic. 2. Students start treating the second patient during second term of Clinical Orthodontic, as well

as continue to treat their first patient. The transferred patients are allowed to be recruited as second patient. However, the regulations may change depends on the case.

3. Students must recruit new patients if there is no available transferred patients within 1 (one) month.

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Patients’ Eligibility:

1. He/she is in mixed dentition phase, and their age is within physiological growing period. 2. According to basic competency standard of dentist, the cases must be one of malocclusion

class I, II, or dental class III Angle. 3. Non-extraction cases are preferred.

B. Selecting Patients

Students need to ask their instructor on their working days whether the candidate is suitable or not. Once the permission is received, the instructor and patien’s parents should give signature on the informed consent.

C. Impression Making Proper impression technique is needed to produce good and reliable orthodontic models. The ideal impression must cover representative mold of oral anatomy, such as: vestibule, lingual fold, and lingual frenula so the border of attached and unattached mucosa is visible. The impression must be filled with dental stone as soon as possible to avoid distortion.

D. Determining Occlusion and Medial Line Two layers of pre-heated dental wax are put on the occlusal surface of lower teeth. Patient is instructed to achieve his/her centric occlusion, wait until the wax temperature gets colder and put the wax on the model. The medial line of the model is equal to facial points (glabella, subnasal, and chin) in normal position. Draw thin line on maxillary model passing through rugae palatine mediana, to fovea palatine, until upper surface of the model. Give marks of occlusion in the right and left side of the model in the posterior part prior making basis using dental plaster.

E. Study Model and Progress Model Study model is defined as replica of patient’s teeth that is made prior to treatment. Students are allowed to make progress model as one of evaluation tools after completing clinical orthodontic (usually in week 57). Both study and progress models must possess ideal anatomical image of maxilla and and mandible. Students do not receive score after making progress model, but the instructor must give signature on the medical record for approval. The models must meet criteria as shown in figure 1 and 2. The outer surface of models must contain following informations: Medical record number, patient’s name, patient’s sex, age, operator name, date of impression, first or second patient, working day, and model number (figure 2). The models must be stored in rectangular box, and labelled on its upper, left, and right side (figure 3).

F. Case Analysis Students must filled in the medical record thoroughly and are required to obey the following rules prior to case analysis: 1. The model study has been approved by the instructor. 2. Signed informed consent by patient’s parents and instructor

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3. The clinical photographs (intra and extra oral) were done completely as standard. 4. The radiographs (panoramic, cephalometry, or periapical) have been prepared. 5. The case analysis is done using copy of medical record. The original version would be filled once

the case analysis is finished.

G. Submit Patient to Instructor The patients must be instructed to sit in dental chair. The instruments, models, and medical records must be prepared carefully prior asking the instructor to examine the patients. Unprepared students scored lower according to DOPS and Mini-Cx.

H. Patient Referral Referral is allowed for the following conditions: 1. Tooth extraction 2. Tooth restoration 3. Periodontal treatment 4. Soft tissue therapy or examination (example: stomatitis, etc.) 5. Radiograph examination

I. Making of Removable Orthodontic Appliance (ROA) Students are allowed to produce the removable orthodontic appliance by themselves or submit it to the dental technicians. The laboratory procedures that require approval of the instructor are: 1) after making active and passive components, 2) after acrylic polishing.

J. Insertion of Removable Orthodontic Appliance Students must receive approval and signature of instructor as sign that ROA is ready to be worn by the patient. The ROA must be retentive enough in the oral cavity, but the acrylic plate and wire provides enough space not to block permanent teeth eruption.

K. Instruction During Removable Orthodontic Appliance Wear Students must provide clear and adequate instruction to the patients about how to wear and remove ROA, the ROA must always be worn (24 hours), how to clean the ROA, and maintaining oral health.

L. Technical Guide of Wearing and Removing the Removable Orthodontic Appliance The patient is instructed to stand in front of mirror. Firstly, pull the bridge of Adam clasp using left and right thumb in order to remove ROA. While inserting the ROA, adjust the anterior part first, followed by posterior and the remaining part.

M. Maintaining Patients’ Oral Hygiene The patient must clean and brush the ROA regularly to avoid debris and microorganisms. The oral hygiene affect scoring.

N. Activation of Removable Orthodontic Appliance The first activation is done once the ROA has been successfully inserted in the patient’s, and must be done in light force to let the patient adapts. The activation is done every two weeks, and must be

43

supervised by the instructor. If it is not possible, the available instructor are allowed to check the activation process. However, only 50% of other instructor approval are tolerated.

O. Controlling the Patient Students must do first control with their instructor in 6 (six) weeks after insertion date. The second and following control are done 6 (six) weeks after previous control date, but must be examined by other instructor. For transferred patients, students must do control with the instructor as soon as possible. Students must prepare for the following things every time patient visit the clinic: 1. Brief summary of treatment which consists of diagnosis and etiology of malocclusion, model

discrepancy, treatment type, treatment plan, achieved results, next treatment plan, etc. 2. Able to explain patient’s progress 3. Able to identify the problem and its solution in order to achieve better treatment result. 4. Able to revise is there was any mistake in filling-in the medical record. The revision must be

written in blank page, and signed by the instructor.

P. Reparation of Removable Orthodontic Appliance Reparation is allowed only if the ROA is broken, lost, unfit to the patient, or indicated for additional component. Students get scored for repairing the ROA (with 75% proportion). The maximum number of reparation is 2 (two) during 1 (one) term of clinical orthodontics. However, if the ROA has new design, it is not considered as reparation.

Q. Patient Withdrawal If the patient ask to resign, does not cooperate and obey the operator, they must fill in and give signature on patient withdrawal form. It also requires signature of the instructor.

R. Public Holiday If student’s working day is considered as national public holiday, students are allowed to ask to replace their work in another day as approved by the instructor.

S. Orthodontic Medical Record, Examination Form, Students’ Log Book, Instructors’ Log Book, and Integrated Hospital Medical Record Every step and activity must be written in medical record, students’ and instructors’ log book. While the Integrated hospital medical record must be filled in only if the patient visit clinic. The instructors are allowed to score if students fulfill the administration requirements.

T. Requirements for Completing Clinical Orthodontics Students are considered as successfully pass the Clinical Orthodontics program if: 1. Treating 2 (two) patients with following the regulations. 2. Submit all patient’s documents: study model, progress model and its examination form,

orthodontic medical record, clinical photograph (before and after treatment), radiograph (panoramic and cephalometry). The Orthodontic medical record must be kept neatly in blue folder. The models must be stored in a box that contains information about medical record

44

number, patient’s name, sex, age, operator’s name, and working day. The label is put on the upper, left, and right of the box. The instructors reserve right not to check and examine if the instructions above were not done.

3. Students could attend orthodontic exit exam with the following conditions: the ratio of clinical activity and treatment progress is 60% : 40%, and the accumulation of score in term I, II, III, and progress is higher than 65.

4. The final score is considered as 60 % of clinical score (point 1 and 2), and 40% of orthodontic exit exam score. Students must do additional term of clinical orthodontics if their score is below passing grade. They must continue to treat 2 (two) patients until the score reaches passing grade (as requirements stated in table 2).

U. Evaluation of Clinical Activity

Clinical orthodontics consist of 3 (three) terms, and each term lasts for 22 weeks. Evaluation is done in every term. Students have 66 weeks in total to work in clinical orthodontics, that includes making progress model, exit exam, and 1 (one) chance of remedial exit exam. The examination method used in every term is showed in table 1.

Table 1 : Scoring Proportion of Clinical Activity No. Components Proportion Step I Skill 1 Making impression of upper and lower jaw

Insertion of ROA Activation of ROA

0,75 Reparation of ROA II Theory 1,25 Case Analysis

Control

The proportion mentioned above would be multiplied with the students’ score. Regarding the insertion and activation of ROA, only 1 (one) time score is given. The expected score of students at the end of clinical orthodontics are mentioned in table 2:

Tabel 2 : Requirement of Clinical Work and Scoring Method

No. TERM The Minimum Expected Skill (Score)

Scoring Proportion SKILL THEORY

(1) (2) (3) (4) (5)

1. Orthodontics I (1 patient)

Making model study, insertion, and activation

Case analysis 4 : 1

2.

Orthodontics II (2 patients)

5 times of activation (one of them must be submitted for DOPS)

One case analysis for patient 2 (submitted for Mini-Cx evaluation) and one control Or 2 times of controls.

5 : 2

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3.

Orthodontics III (2 patients) 5 times of activation

One case analysis for patient 2 and one control Or 2 times of controls.

5 :2

Total Clinical Score Accumulated and Divided by 3.

Notes: The colour for scoring form of term I is pink, white for term II, yellow for term III, and green for additional term. The Mini-Cx evaluation must be done in term II during case analysis of patient 2, or control right after receiving transferred patient. While DOPS evaluation must be done in term II, during insertion or activation of ROA.

Scoring during term I, II, and III, is based on clinical and theoretical activity, as described below: (table 2)

1. Score of term I: Total score of skill component is divided by 4, and theoretical theory is divided by 1. Both score is accumulated then divided by 2.

2. Score of term II: Total score of skill component is divided by 5, and theoretical theory is divided by 2. Both score is accumulated then divided by 2 for each patients because students started to treat 2 (two) patients since term II.

3. Score of term III: Total score of skill component is divided by 5, and theoretical theory is divided by 2. Both score is accumulated then divided by 2 for each patients because students started to treat 2 (two) patients since term II.

4. If students fail to complete the requirement, then they have to take additional term (term IV) and continue treating 2 patients until they pass the passing grade.

5. Mini-Cx and DOPS are done on separate forms. 6. Students are allowed to choose between case analysis or control for Mini-Cx evaluation.

Notes:

1. Students are allowed to treat 2 transferred patients or 2 new patients according to their preference.

2. Term II, III, and IV have 2 (two) scoring form for 2 patients.

Evaluation of Treatment Progress

The progress of treatment from each patient is evaluated by the instructor through examining the progress model. Means score of both patients is considered as progress score. The details of progress scoring are described in table 3.

Table 3 : Evaluation of Treatment Progress

75 - 100 Corrected 3 types of malocclusion 56 - 74 Malocclusion is being corrected 55 There is no difference <55 Malocclusion becomes worse compared to initial visit

Notes: Types of malocclusion consists of tooth rotation, overjet, overbite, crowded, space closure, and space opening.

46

Evaluation of Clinical Orthodontics

In order to pass clinical orthodontics, scoring is based on every student’s activities, such as: clinical activity, treatment progress, and exit exam. The percentage of each component is stated in table 4.

Table 4 : Requirements for Attending Exit Exam No. SCORING COMPONENTS PERCENTAGE 1 CLINICAL ACTIVITIES 60 % 2 TREATMENT PROGRESS 40 % TOTAL CLINICAL SCORE 100 %

Table 5: Requirements for Completing Clinical Orthodontics No. SCORING COMPONENTS PERCENTAGE 1. CLINICAL SCORE 60% 2. EXIT EXAM 40 % TOTAL SCORE 100 %

Notes: Students are considered to complete and pass clinical orthodontic is their final score is higher or equal to B. GUIDELINES IN SCORING STUDENTS’ PERFORMANCE (TABLE 6 – 10)

Table 6 : Scoring of Case Analysis

80 - 100 Able to fill in the medical record properly, diagnose and identify the etiology of malocclusion, arranging treatment plan, designing the right ROA for the case.

69 – 79,99 Able to fill in the medical record properly, diagnose and identify the etiology of malocclusion, arranging treatment plan, designing the right ROA for the case with minor revision.

60 - 69,99 Able to fill in the medical record properly, diagnose and identify the etiology of malocclusion, arranging treatment plan, designing the right ROA for the case with greater revision

40 – 59,99 Able to fill in the medical record properly, diagnose and identify the etiology of malocclusion, arranging treatment plan, designing the right ROA for the case with major revision

0 - 39,99 Unable to fill in the medical record properly, diagnose and identify the etiology of malocclusion, arranging treatment plan, designing the right ROA for the case.

Table 7: Scoring of Control

80 - 100 Able to evaluate treatment result, and setting up next treatment plan with no revision. 69 – 79,99 Able to evaluate treatment result, and setting up next treatment plan with minor

revision. 60 - 69,99 Evaluate treatment result with minor revision, and fail to setting up next treatment

plan. 40 – 59,99 Evaluate treatment result with major revision, and fail to setting up next treatment

plan. 0 - 39,99 Unable to evaluate treatment result with major revision, and fail to setting up next

treatment plan.

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Table 8 : Scoring of Impression Technique

80 - 100 The student is able to make good and ideal impression in first attempt that covers anatomical landmarks including vestibule, with no porous.

69 – 79,99 The student is able to make good and ideal impression in first attempt that covers anatomical landmarks including vestibule, but there is porousity.

60 - 69,99 The student is able to make good and ideal impression in second attempt that covers anatomical landmarks including vestibule, with no porous.

40 – 59,99 The student is able to make good and ideal impression in second attempt that covers anatomical landmarks including vestibule, but there is porousity.

0 - 39,99 The student is unable to make good and ideal impression in more than second attempt that covers anatomical landmarks including vestibule, but there is porousity.

Table 9: Scoring of Removable Orthodontic Appliance Activation

80 - 100 Student is able to perform ROA activation in proper technique in first attempt, without asking for instructor’s direction (example: decide which component to activate, acrylic plate grinding, provides proper way and force during activation).

69 – 79,99 Student is able to perform ROA activation in proper technique in first attempt, with one time asking for instructor’s direction (example: decide which component to activate, acrylic plate grinding, provides proper way and force during activation).

60 - 69,99 Student is able to perform ROA activation in proper technique in second attempt with one time asking for instructor’s direction (example: decide which component to activate, acrylic plate grinding, provides proper way and force during activation).

40 – 59,99 Student is able to perform ROA activation in proper technique in second attempt with two times asking for instructor’s direction (example: decide which component to activate, acrylic plate grinding, provides proper way and force during activation).

0 - 39,99 Student is unable to perform ROA activation in proper technique after their second attempt with two times asking for instructor’s direction (example: decide which component to activate, acrylic plate grinding, provides proper way and force during activation).

Tabel 10 : Scoring of Removable Orthodontic Appliance Insertion

80 - 100 Student is able to insert ROA in proper position and good retentiveness, in first attempt. 69 – 79,99 Student is able to insert ROA in proper position and good retentiveness, in second

attempt. 60 - 69,99 Student is unable to insert ROA in proper position and good retentiveness, in second

attempt, 40 – 59,99 Student is unable to insert ROA in improper position and poor retentiveness, but the ROA

still functions, in more than their second attempt. 0 - 39,99 Student is unable to insert ROA in improper position, poor retentiveness, and ROA does

not function normally.

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Table 11: Illustration of Timetable for Preparation of Clinical Orthodontic Exit Exam

No. ACTIVITIES Week (Term III)

56 57 58 59 60 61 62 63 64 65 66 1 Final week of clinical work 2 Making model progress (patient 1) 3 Making model progress (patient 2) 4 Submitting model progress (patient 1) 5 Submitting model progress (patient 1) 6 Progress Evaluation by Instructors 7 Progress Evaluation by Instructors 8 Exit Exam 9 Exit Exam

10 Remedial Exit Exam 11 Remedial Exit Exam 12 RESULT ANNOUNCEMENT

Note: 1. This timetable provides ideal timetable for students to finish clinical orthodontic in required

period. However, the timetable may vary according to students’ amount. 2. The exit exam is scheduled for all students according to their batch and requirements.

TECHNICAL GUIDELINES FOR MAKING STUDY MODEL

The proper impression technique is needed in order to obtain good and ideal replica of patients’ oral anatomy. Students should be aware of technical things when making dental model as described below:

1. The impression should be cleaned to remove saliva and other debris. The pores in impression should be clogged by pouring gypsum on impression surface.

2. The impression should be air dried using air blower to remove bubbles or water that trapped in impression mixture. This avoids unfilled part of impression, so the model is easily removed afterwards.

3. In order to achieve smooth and ideal mixture of gypsum, the rubber bowl should be placed on vibrator during mixing gypsum and water.

4. The gypsum mixture should be carefully poured into the impression that is on vibrator, and flow the gypsum along the impression to make sure that the undercuts are properly filled. Start pouring the gypsum in the crown of teeth first, then continue the remaining parts until little beyond vestibule to help remove model easily after setting.

5. The model study needs basis. It can be made either by using rubber form or not. 6. The filled impression is put upside down against basis. It should be parallel to the table. 7. Let the gypsum sets and hardens. 8. After the gypsum is set, the model could be removed from the rubber form, impression tray,

and impression material. The model is ready for trimming.

49

Distal cut in posterior side

Anterior part of upper surface

5,5 mm

Occlusal plane is parallel to model

surface

Border of vestibule frenulum

Figure 1. Lateral view of Study and Progress Model

Figure 2. Occlusal view of Study and Progress Model with Information Labels.

Notes for Figure 2:

1. The inferior surface should be carefully grinded for easily trimming. 2. The inferior surface of lower jaw is parallel to occlusal plane which is formed through

intersection of incisal line with medial line, and mesiobuccal cusps of lower left and right first molars.

3. Cut the posterior part of the lower basis perpendicular to inferior surface using median line and second molar as guide, but at least 2 mm should be left in distal of second molar.

4. Cut the lateral side of lower model using trimmer in angle of 55o 5. Cut the anterior side of lower model according ideal curve of anterior teeth arch. 6. The left and right corners of posterior side are trimmed in angle of 115o

Lateral Side

Inferior Surface

-No. Rekam Medik : ..…………..... -Nama pasien : ……………… -Umur dan jenis kelamin: ………… -Tanggal mencetak : ……………… - -Model : ke-…. Nama operator : ………………….. Nama Instruktur :……………………

-No. Rekam Medik : ..…………..... -Nama pasien : ……………… -Umur dan jenis kelamin: ………… -Tanggal mencetak : ……………… - -Model : ke-…. Nama operator : ………………….. Nama Instruktur :……………………

50

7. Put the upper and lower jaws in the right occlusion, and check if the occlusion in model is match with patient. The posterior side of upper model is trimmed to match lower model.

8. The upper surface of upper model is cut parallel to inferior surface of lower model. 9. The lateral side of upper model is trimmed in angle of 65o 10. The anterior side of upper model is trimmed in angle of 25o from median line to canines. 11. Put the upper and lower jaws in the right occlusion in order to trim the corner of posterior side

of upper and lower models. 12. The final height of models in proper occlusion is 5,5 cm, with same thickness of basis in both

upper and lower jaw. 13. The basis surfaces are labelled with information (figure 2).

Figure 3. A: The storage box for Study and Progress Model (20 x 10,5 x 8 cm); B: Information label (8 x 18 cm) for the upper side; C: Information label for left and right side of lower box (4 x 8 cm).

DEPARTEMEN ORTODONSIA RSGM UNAIR

PASIEN Ke- 1/ 2/ 3…dst -No. Rekam Medik : ..…………..... -Nama pasien : ……………… -Umur dan jenis kelamin : ……………… -Tanggal mencetak : ……………… - -Model ke-…. Nama operator : …………….. Nim Profesi :……………… Nama Instruktur :……………… Hari Kerja :………………

DEPARTEMEN ORTODONSIA RSGM UNAIR

Nama operator : …………….. Nim Profesi :……………… Nama Instruktur :……………… Hari Kerja :………………

B

C

A

8 cm

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3. Sample of student work

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4. Recapitulation of assessment

fkg.unair.ac.idfkg.unair.ac.id/bcprof/wp-content/uploads/2019/03/ok... · 2019-03-05 · ii . table...

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