Ортодонтия: рабочая тетрадь для самоподготовки и контроля овладения компетенциями ординаторами, обучающимися по специальности

Сергей Аверянов; Девика Акхметова; Рахматулла Нигматов; Ирода Нигматова

Workbook
for self-preparation and control
of mastering the competencies of
residents studying
in the specialty 31.08.77

–

“Orthodontics”

Averyanov Sergei
Akhmetova Devika
Nigmatov Rakhmatulla
Nigmatova Iroda

2

UDC 616.314-089.23(076.1)
BBС 56.6
A 19

Reviewers:

Head of the Department of Foreign languages

Bashkir State Medical Academy

Candidate of Philological Sciences, assistant professor

O.A. Mayorova

Head of the Department of Foreign languages and Latin

Samara State Medical University

Candidate of Medical Sciences, assistant professor

T.V. Rozhkova

AVERYANOV S.V.

Orthodontics: workbook for self-preparation and control of mastering the competen-

cies of residents studying in the specialty 31.08.77 – “Orthodontics”; direction of education:
60910100 - "Dentistry" / S.V. Averyanov, D.Kh. Akhmetova, R.N. Nigmatov, I.M.Nigma-
tova – Ufa: BSMU Ministry of Health of the Russian Federation, Tashkent State Dental
Institute, Ministry of Education, Republic of Uzbekistan, 2025. – 101 p.

The manual has been prepared in accordance with the work program of the basic pro-

fessional program of postgraduate professional education for independent training and con-
trol of the assimilation of the competencies of residents. It has been developed in accordance
with the Federal State Educational Standard for Higher Education (Order of the Ministry of
National Science of Russia dated 27.08.2014 N 1128 "On Approval of the Federal State
Educational standard of higher Education in the specialty 31.08.77 "Orthodontics" (staff
training level highly qualified)" (Registered with the Ministry of Justice of Russia on
23.10.2014 N 34421) and by order of the Ministry of Education and Science of the Russian
Federation Russian Federation No. 1061 dated September 12, 2013 "On Approval of the lists
of specialties and areas of higher education training"; direction of education: 60910100 -
"Dentistry".
The tasks for the independent training of residents and the control of the assimilation of the
module's competence in the specialty 31.08.77 - "Orthodontics", direction of education:
60910100 - "Dentistry" as well as test tasks and situational tasks with answers are presented.
It is intended for classroom work of residents studying in the specialty 31.08.77 – "Ortho-
dontics; direction of education: 60910100 - "Dentistry".

Recommended by the Coordinating Scientific and Methodological Council and approved by

the decision of the Editorial and Publishing Council of the Federal State Budgetary Educational In-
stitution of Higher Medical Education of the Ministry of Health of the Russian Federation

UDC 616.314-089.23(076.1)

BBС 56.6

© Averyanov S. V., Akhmetova D.Kh., Nigmatov R.N.,
Nigmatova I.M., 2025
© Federal State Budgetary Educational Institution of Higher
Medical Education of the Ministry of Health of the Russian
Federation, Tashkent State Dental Institute, Ministry of Educa-
tion, Republic of Uzbekistan, 2025

D 33

3

INTRODUCTION

Orthodontics - the science that studies the organization of orthodontic care, an-

atomical and morphological features of the maxillofacial region in different age peri-

ods, the etiology and pathogenesis of maxillofacial anomalies, modern methods for

diagnosing morphological and functional disorders of the maxillofacial region in den-

toalveolar anomalies, the use of computers in orthodontics, modern methods for the

treatment of maxillofacial anomalies, dental anomalies and deformities, features of or-

thodontic care for congenital malformations of the face and jaws, prevention of dental

anomalies, features of dental prosthetics in children and adolescents, morphological

and functional restructuring of the maxillary system under the influence of orthodontic

appliances, orthodontic laboratory technology, retention of the results of treatment of

maxillary-facial anomalies, recurrence of maxillary-facial anomalies. The study of

these sections is necessary for mastering the basic educational program of higher edu-

cation – the level of training of highly qualified personnel in the сlinical residency in

the specialty 31.08.77 "Orthodontics".

An orthodontist with professional competencies (PC) in preventive healthcare:

willingness to implement a set of measures aimed at preserving and strengthening

health and including the formation of a healthy lifestyle, prevention of the occurrence

and (or) spread of dental diseases, their early diagnosis, identification of the causes and

conditions of their occurrence and development, as well as aimed at eliminating the

harmful effects of environmental factors on human health (PC–1); In diagnostics, will-

ingness for the diagnosis of dental diseases and emergency conditions in accordance

with the International Statistical Classification of Diseases and Health-Related Prob-

lems (PC–5); in psychological and pedagogical activity, the willingness to form moti-

vation among the population, patients and their family members aimed at preserving

and strengthening their own health and the health of others, teaching patients basic

hygienic measures of a health-improving nature that contribute to the preservation and

strengthening of health, and the prevention of dental diseases (PC-10).

4

PART I. ORGANIZATION OF ORTHODONTIC CARE

According to which order are conventional units of labor intensity of work of

dental

doctors

calculated?

____________________________________________________________________

How many conventional units of labor intensity of work of doctors during the

manipulations performed by an orthodontist :

1.

Comprehensive initial medical examination, consultation on bad habits, study

of the functions of the dentoalveolar system ________________________________

____________________________________________________________________

2.

Elastic mass impression (2) after 7 years of age _______________________

3.

Casting of control and diagnostic models (2) _________________________

4.

Activation of the orthodontic appliance _____________________________

5.

Fitting

a

removable

appliance

(single-jawed

one)

_______________________

6.

Storage of a removable device (bimaxillary) ________________________

7.

Acquaintance

parents

with

the

design

of

the

appliance

____________________________________________________________________

8.

Constructive bite type up to 7 years old ____________________________

9.

Grinding of temporary teeth (4 teeth) ______________________________

10.

Myotherapy _________________________________________________

11.

Massage _____________________________________________________

What does the order of the Ministry of Health and Social Development of the

Russian Federation No. 289 of April 14, 2006 indicate? _______________________

____________________________________________________________________

____________________________________________________________________.

According to the order of the Ministry of Health and Social Development of the

Russian Federation No. 289 of April 14, 2006 "Recommended staffing standards for

medical and other personnel of children's dental clinics".

1.

Positions of orthodontists are established at the rate of ____ positions per 1000

children.

2.

Positions of dental surgeons are established at the rate of 1 position ____ po-

sitions of children's dentists.

5

3.

The position of the head of a children's dental department of any profile is

established for every ____positions for each position of a dentists provided for in the

polyclinic by these recommended staff standards.

4.

Positions of nurses of medical offices are established at the rate of ____posi-

tion for each position of a pediatric dentist, a dental surgeon and an orthodontist.

What does the order of the Ministry of Health of the Russian Federation No.

910n

of

November

13,

2012

indicate?

____________________________________________________________________

According to Order No. 910n of November 13, 2012, recommended staffing

standards for children's dental clinics (departments): 1 position of an orthodontist is
established for 10 dentists of children.

Order of the Ministry of Health of the Republic of Bashkortostan No. 976-d

dated March 31, 2015 indicate that ________________________________________

____________________________________________________________________

____________________________________________________________________.

What order approved the medical record of an orthodontic patient?

___________________________________________________________________

6

PART II. ANATOMICAL AND MORPHOLOGICAL

FEATURES OF THE MAXILLOFACIAL REGION

AT DIFFERENT AGE PERIODS

The period of intrauterine development of the fetus

At ____ week, the oral and nasal cavities are separated by the development of two

palatine processes, which, growing together with each other and with the nasal septum,

form a primary palate. At ____ week, temporary teeth are laid. There is a high position

of the tongue and a prognatic ratio of the jaws.

At ____ week, the two mandibular processes are fused together.

At ____ week, the alveolar process of the upper jaw and the rudiments of incisors

(central and lateral), canines and the first permanent molars are laid.

During the

______

week, enamel organs and dental papillae of the rudiments of

teeth are formed.

Oral cavity of newborns and infants

This period of development is characterized by the following age features:

−

A vertical gap of ________ mm remains in the frontal part;

−

infant _________________________________________________;

−

sagittal gap between the alveolar processes of the upper and lower jaws within

______________________________________________;

−

by the time the baby is born, the temporomandibular joints are formed

___________________________________________________________________.

In a child under six months of age, the physiological state is ________________

_____________________ type of swallowing. After incisor eruption, the physiologi-

cal type is gradually transformed into a physiological one: ______________________

____________________________________________________________________.

7

Characteristics of the maxillofacial region in preschool age

Write dental eruption schedule of primary teeth:

Tooth

Eruption (in months)

I

II

III

IV

V

The dental arches of the upper and lower jaws have the next type of shape

____________________________________________________________________.

Bite – closing of the dentition with the usual position of the lower jaw – in children

of this age_________________________________________.

In the central closure, the distal surfaces of the molars are located in

____________________________________________________________________.

Characteristics of the maxillofacial region

in preschool age (from 3 to 6 years)

On the upper jaw, the dental arch has the next type of shape: ________________,

and on the lower jaw –________________________________________________.

The

most

characteristic

symptom

is

___________________________________________________________________

both front teeth and molars.

Due

to

the

development

of

permanent

incisor

rudiments,

____________________________________________________________________

______________________________________________________________ occurs.

8

The maxillofacial region of a person during the period of junior and senior

school age

Write dental eruption schedule of permanent teeth:

Tooth

Eruption (in years)

1

2

3

4

5

6

7

8

Write the main signs of the following physiological bites:

Orthognathic occlusion:

1. _____________________________________________________________

____________________________________________________________________.

2. _____________________________________________________________

____________________________________________________________________.

3. _____________________________________________________________

____________________________________________________________________.

Edge-to-edge occlusion:

1. _____________________________________________________________

____________________________________________________________________.

2. _____________________________________________________________

____________________________________________________________________.

Maxillary and mandibular prognathism (Bimaxillary prognathism):

1.______________________________________________________________

_______________________________________________________________

2.______________________________________________________________

_______________________________________________________________

9

Opistognathia:

1. _____________________________________________________________

____________________________________________________________________.

2. _____________________________________________________________

____________________________________________________________________.

Write the six keys to normal occlusion (Andrews, 1972):

Key I:

_________________________________________________________

____________________________________________________________________.

Key II:

________________________________________________________

____________________________________________________________________.

Key III:

_______________________________________________________

____________________________________________________________________.

Key VI

: ________________________________________________________

____________________________________________________________________.

Key V

: ________________________________________________________

____________________________________________________________________.

Key VI

: ________________________________________________________

____________________________________________________________________.

10

PART III. ETIOLOGY AND PATHOGENESIS OF

DENTOFACIAL ANOMALIES

Hypofunction of the pituitary gland can lead to __________________________

____________________________________________________________________

___________________________________________________________________.

Breathing disorders can lead to ______________________________________

____________________________________________________________________

____________________________________________________________________.

Write three groups of bad habits by V.P. Okushko

1) _____________________________________________________________

____________________________________________________________________;

2) _____________________________________________________________

____________________________________________________________________;

3) _____________________________________________________________

____________________________________________________________________.

What

does

bad

habits

mean

in

dentistry?

____________________________________________________________________

____________________________________________________________________.

Types of chewing dysfunction:

1. _____________________________________________________________.

2. _____________________________________________________________.

3. _____________________________________________________________.

What

the

types

of

swallowing

do

you

know?

____________________________________________________________________

____________________________________________________________________.

Reasons of mouth breathing: ______________ ________________________;

___________________________________________________________________;

___________________________________________________________________.

11

Macroglossia– _________________________________________________.

Signs of a short lingual frenulum (ankyloglossia, tongue-tie):i

____________________________________________________________________

____________________________________________________________________.

There are _____ types frenulum of the tongue that limit tongue mobility (Khoro-

shilkina F.Ya., 1965, 1986).

The first type is __________________________________________________

____________________________________________________________________

____________________________________________________________________.

The second type is _______________________________________________

____________________________________________________________________

____________________________________________________________________.

The third type is _________________________________________________

____________________________________________________________________

____________________________________________________________________.

The fourth type is ________________________________________________

____________________________________________________________________

____________________________________________________________________.

The fifth type is __________________________________________________

____________________________________________________________________

____________________________________________________________________.

12

PART IV. MODERN METHODS OF DIAGNOSTICS OF MOR-

PHOLOGICAL AND FUNCTIONAL DISORDERS OF THE MAX-

ILLOFACIAL REGION

According to the Facial Morphological Index (IFM),

G.. Izard

(1930) the length

of

the

face

is

measured

by_________________________________________________________________

____________________________________________________________________

___________________________________________________________________

,

and the width_________________________________________________________

____________________________________________________________________

.

What data on the length and width of the face is used to calculate the facial index

of Izard?_____________________________________________________________

____________________________________________________________________

____________________________________________________________________.

The ratio of length and width of the face from 104 and more characterizes

the________ face, 97-103 – ___________, 97 and less– _______________.

13

The form of a person's profile is determined by ________________, which is

formed as follows____________________________________________________.

The value of the angle 170-190° characterizes _____________ face profile, more than

190° – _____________, less than 170° – ______________ face profile.

With a healthy TMJ, the mouth opens at

____________________________

____________________________________________________________________

.

When evaluating the soft tissues of the vestibule of the mouth, it is necessary to

study the condition of the frenulum of the lips. There are 3 main types of abnormal lip

frenulum.

Type I

__________________________________________________________

____________________________________________________________________

____________________________________________________________________;

Type II

_________________________________________________________

____________________________________________________________________

____________________________________________________________________;

Type III

_________________________________________________________

____________________________________________________________________

____________________________________________________________________.

14

Normally, the frenulum of the upper lip is attached at the distance

_____________ from the interdental papilla, it has a sufficient length and does not

limit the mobility of the lip.

Normally, the depth of the vestibule varies __________________. The shallow

vestibule has depth

________________________________________

.

Study of plaster models of jaws

Dental measurements.

The width is determined by _________________________________________,

at the lower incisors ____________________________________________________.

The height of the crown part of permanent teeth is measured ________________

____________________________________________________________________

____________________________________________________________________.

The thickness of the crown part of the tooth is __________________________

____________________________________________________________________

____________________________________________________________________.

Relationships between tooth sizes.

Tonn

revealed ____________________________________________________

____________________________________________________________________

____________________________________________________________________.

The Tonn Index is equal to ________________.

Pont

(1907) derived the relationship between __________________________

____________________________________________________________________

____________________. The width of the dentition is measured in the area of the pre-

molars at the points suggested

by Pont

:

−

on the upper jaw ___________________________________________

____________________________________________________________________

____________________________________________________________________;

−

on the lower jaw ____________________________________________

____________________________________________________________________

____________________________________________________________________.

15

The width of the dentition is also measured between the first permanent molars

at the points:

−

on the upper jaw ___________________________________________

____________________________________________________________________

____________________________________________________________________;

−

on the lower jaw ____________________________________________

____________________________________________________________________

____________________________________________________________________.

Pont

derived the premolar and molar indices:

Premolar index = _________________________;

Molar index = ___________________________.

Korkhaus

proposed to determine the length of the anterior segment of the dental

arch depending on _____________________________________________________

____________________________________________________________________.

Measurements are carried out ______________________________________

____________________________________________________________________

___________________________________________________________________.

Measuring the size of apical bases

Apical basis ______________________________________________

____________________________________________________________________

____________________________________________________________________.

The size of the apical base is studied in the transversal and sagittal directions

using the

Howes methods

________________________________________

____________________________________________________________________.

The width of the apical base on the upper jaw is measured between

____________________________________________________________________

__________________________________________________________________ on

the lower jaw ______________________________________________________

16

____________________________________________________________________

____________________________________________________________________.

Normally, the width of the apical base of the upper jaw is _______ of the lower

- ________ from the sum of the mesiodistal dimensions of 12 permanent teeth in each

jaw.

The length of the apical base of the upper jaw is measured from the point

____________________________________________________________________

____________________________________________________________________.

Normally, the length of the apical base of the upper jaw is ______ of the lower

one– _________ from the sum of the mesiodistal dimensions of 12 permanent teeth in

each jaw.

Orthopantomography, or panoramic tomography, provides the following re-

sults:________________________________________________________________

____________________________________________________________________

___________________________________________________________________.

When deciphering the TRG in the lateral projection, it is advisable to follow the

scheme proposed

by L. S. Persin

(1996), which contains the estimate: ____________

____________________________________________________________________

____________________________________________________________________.

When decoding telerentgenograms in the side projection, the following lines and

points are used:

A

– ____________________________________________________________

____________________________________________________________________

____________________________________________________________________.

B

– ____________________________________________________________

17

____________________________________________________________________

___________________________________________________________________.

DT

(skin point

pogonion

) ______________________________________

____________________________________________________________________

____________________________________________________________________.

Gn

(

gnathion

) – __________________________________________________

____________________________________________________________________

____________________________________________________________________.

Go

(

gonion

) – ___________________________________________________

____________________________________________________________________

____________________________________________________________________.

EN

– ___________________________________________________________

____________________________________________________________________

____________________________________________________________________.

L L

– ___________________________________________________________

____________________________________________________________________

____________________________________________________________________.

Me

(

menton

) – ___________________________________________________

____________________________________________________________________

____________________________________________________________________.

N

(

nаsion

) – _____________________________________________________

____________________________________________________________________

____________________________________________________________________.

Or

(

orbitаl

) – ____________________________________________________

____________________________________________________________________

____________________________________________________________________.

Pm

(

pterygomaxillary

), a synonym

for

PNS (

spina nasalis partrior

) – _______

____________________________________________________________________

___________________________________________________________________.

Po

(

porion

) – ___________________________________________________

____________________________________________________________________

____________________________________________________________________.

18

Sе

(

sеtlа

) – ______________________________________________________

____________________________________________________________________

____________________________________________________________________.

S

(

sеllа

) – ______________________________________________________.

SNА

(

sрinа nаsаlis аntеrior

) – ______________________________________

____________________________________________________________________

____________________________________________________________________.

UL

____________________________________________________________

____________________________________________________________________.

EN-DT–

_______________________________________________________.

FN

– ___________________________________________________________

____________________________________________________________________.

NL

– ___________________________________________________________

____________________________________________________________________.

M L

– __________________________________________________________

____________________________________________________________________.

Cephalometric anthropometric points

Angle SNA

characterizes the position ________________________________

____________________________________________________________________.

Its average value is ___________.

An increase in the angle SNA

characterizes ______

___________________ (forward position).

A decrease of the angle SNA

characterizes

19

the upper retroposition (distal position).

Угол The SNB angle

characterizes the position

____________________________________________________________________

____________________________. Its average value is____________________.

In-

creasing the SNB angle

characterizes ___________________________________.

Re-

ducing the SNB angle

characterizes ____________________________________.

Cephalometric lines and planes

NSL

– _________________________________________________________

___________________________________________________________________.

N-Se–

_________________________________________________________

____________________________________________________________________.

OcP

– __________________________________________________________

____________________________________________________________________

____________________________________________________________________.

Face

profiles

are

distinguished

by

the

Ricketts

method

:

____________________________________________________________________

____________________________________________________________________.

A person's profile is determined by evaluating ___________________________

____________________________________________________________________

________________. The upper lip point (

UL

) must be located at ________________

20

____________________________________________________________________.

The protrusion of the lower lip anteriorly from the aesthetic plane by 1-2 mm

corresponds

to ______________________________. The concave profile of the face

is determined when the lower lip is located posteriorly from the aesthetic

plane.________________________________________________________________

.

Convex and concave profile types according to Ricketts

Functional diagnostic methods

Rheography– ___________________________________________________

____________________________________________________________________

____________________________________________________________________.

Photoplethysmography-method ______________________________________

____________________________________________________________________

___________________________________________________________________.

Electromyograph

y- _____________

__________________________________

____________________________________________________________________

____________________________________________________________________.

A functional chewing test allows you to determine

__________________

____________________________________________________________________

____________________________________________________________________.

Masticationography– _____________________________________________

____________________________________________________________________.

21

PART V. USE OF COMPUTERS IN ORTHODONTICS

Electromyography allows you to _____________________________________

____________________________________________________________________

____________________________________________________________________.

Arthrophonography– _____________________________________________

____________________________________________________________________

____________________________________________________________________.

Axiography– __________________________________________________

____________________________________________________________________.

In orthodontics, the method allows you to evaluate ______________________

____________________________________________________________________

____________________________________________________________________.

Rheography allows you to study ______________________________________

____________________________________________________________________.

Orthopantomography (panoramic zonography) allows you to get ___________

____________________________________________________________________

____________________________________________________________________.

To evaluate the orthopantomogram, it is recommended to study five topographic

areas sequentially:

____________________________________________________________________;

____________________________________________________________________.

Intraoral radiography of teeth allows you to get a detailed, high-quality image:

___________________________________________________________________;

____________________________________________________________________;

22

____________________________________________________________________;

____________________________________________________________________.

Digital intraoral radiography (radiovisiography), based on obtaining an image of

an object _________________________________

____________________________________________________________________.

Radiography of the palatine suture is performed using dental X-ray machines

using a direct close-focus method in order to determine:

____________________________________________________________________;

____________________________________________________________________.

Tomography allows you to study the following characteristics of the TMJ:

____________________________________________________________________

____________________________________________________________________.

Indications for the use of MRI in orthodontics are: _____________

____________________________________________________________________

____________________________________________________________________.

Cone-beam computed tomography (CBCT). Indications for the use of this

method are __________________________________________________________

____________________________________________________________________

____________________________________________________________________.

Radiography of the hand is used in the following cases:

23

____________________________________________________________________

___________________________________________________________________;

____________________________________________________________________

___________________________________________________________________.

Cephalometry allows you to: