OrthoTrain - The Voyage Since 2005

"Orthotrain - Comprehensive  Course  In  Fixed  Orthodontics   

For  The General  Practitioner" 

• Multiple Modules  

• Clinically Oriented 

• Since 2005

1. First Module     4 Days
2. Second Module 2 Days
3. Third Module    2 Days
4. Fourth Module  2 Days
5.      Total           10 Days

• Start Cases In Your Practice After The First Module Itself 

• Learn the most correct and ethical way to manage Orthodontic Cases 

• Simplified Clinical Approach 

• More Than 40 Batches already conducted   

• At Mumbai, Bhubaneshwar, Ranchi, Nashik, Mizorum 

• Participants from all over the world including the Middle East, Australia, Nigeria, Bangladesh 

• No prior knowledge or reading needed 

FREQUENTLY ASKED QUESTIONS:

1. Can a general dentist or non-orthodontic speciality practice Orthodontics?

 Ans. A Dental Surgeon can however practice all branches of Dentistry provided he shows  adequate qualification, competence and bona fide training in the concerned branch or branches. (8.3.3) Revised Dentists (Code of Ethics) Regulations, 2014 DCI.

The DCI is the ruling legal authority regarding the practice of dentistry in India.

2. When was OrthoTrain started?

Ans. OrthoTrain has been regularly conducting its multi-module courses since the year 2005. It has successfully completed more than 40 batches in Mumbai, Bhubaneshwar, Ranchi, Nashik, Mizoram as of 2021.

3. Is this a Diploma or Fellowship Course?

Ans. No. 

This is only a skill enhancement program for clinicians in general practice. Orthotrain is not a degree or a diploma or any DCI recognised course. 

A participant cannot write Orthodontist on his/her visiting card after doing the course.

A participant cannot get the job of an orthodontist after doing the course.

4. Will I be able to do all orthodontic cases after doing OrthoTrain?

Ans. NO. Very complex cases, Surgical cases, Syndromic patients, Cleft cases, etc must not be attempted by the Orthotrainee. The difficult cases must be referred to the competent Orthodontist.

5. Can I do OrthoTrain online?

Ans. No. Lots of hands-on activities like cephalogram tracing, model and X-ray analysis, bonding on models, typodont exercises, live patients, micro-implants on sheep jaws, indirect bonding, banding on typodonts, etc. are done within the structured program - Hence online is not possible.

6. Do I need to prepare or study anything before the course?

Ans. The course is quite comprehensive and it starts with the basics like terminology, classification, etc. All clinically relevant topics will be covered in detail in this program. Additional home assignments and reading materials will be provided. There is no strict requirement of pre-course reading.

7. What materials and equipment will be I need to bring to the course?

Ans. All the material and equipment for all the various hands-on activities and live patients will be provided in the course itself. You need to come with an open mind. All you need to bring is your clinical apron, N95s and PPEs.

No need for any laptops or any accessories.

8. What about my lunch ?

Ans. Hospitality will be well taken care of in OrthoTrain.

Morning tea/coffee with breakfast, Lunch, High tea with snacks are all a part of the course and will be provided for. 

Any specific requirements like Jain or Fasting food can be arranged if informed on time. Food will be strictly vegetarian at the Mumbai and Nashik venues.

9. What happens if I miss a day or a module ?

Ans. First module of 4 days must be attended first. If a participant misses any subsequent module or any day, he/she can attend the same with any subsequent batch at no extra charges.

Any participant can repeat any module at any time complimentary.

10. Will I be confident enough to start orthodontics in my practice? Orthodontic Post graduation is of 3 years and in this course the number of days is so limited !!!

Ans. This is a very common question - Orthotrain has been successfully conducting courses since Feb. 2005. Lots of general dentists and specialists who have done OrthoTrain are all doing orthodontic cases in their practices successfully. There are Orthotrainees who have published orthodontic cases, presented on orthodontic subjects at conferences. Many have referred their spouses who too have done OrthoTrain as the number of cases have increased in their practices. Many have referred their siblings who are dentists to do the course.  Several Orthotrainees have treated their own children themselves. All this is testimony to the success of OrthoTrain as a course and the systematised training process developed and constantly modified by Dr. Akshay Rathi since 2005.

 

 

 

Unilateral Posterior Crossbite

Unilateral Posterior Crossbite

   Fig 1. Unilateral Posterior Crossbite

Unilateral Posterior Crossbite  is manifested as a normal upper palatal cusps in lower central fossa of posterior teeth on one side; but on the other side - the upper buccal cusps of posteriors occlude in the central fossa of the lower posteriors. This is clearly seen on the picture above where there is normal relationship on the left side but cross bite on the right side.

Causes:  The main reason is constriction of the maxilla commonly caused due to -

• Thumb sucking and other non-nutritive digit sucking or long term use of pacifiers.
• ENT issues such as deviated nasal septum, nasal polyps, enlarged adenoids, etc. which all make the patient a mouth or oral breather rather than a nasal or oro-nasal breather.
• Any other developmental issues or syndromes

Is the Constriction Unilateral in Unilateral Posterior Crossbite ?

The Answer Is A Resounding NO

Then what causes a Unilateral Posterior Crossbite.....

In most cases the constriction occurs bilaterally but this results in an unstable 

upper buccal cusps to lower buccal cusps; and 

upper palatal cusps to lower palatal cusps relationship.

There is a Functional Shift of the Mandible towards one side to result in a stable maximum intercuspation position - upper buccal cusps in the central fossa on the side where it shifts and upper palatal cusps in the lower central fossa on the other side (resembling the normal relationship) as seen in the picture below.

 Fig. 2 - Functional Shift of the Mandible👆

 This Functional Shift of the Mandible manifests as a Midline Shift at the centre of the oral cavity as seen   above.

Fig. 3 - Observe the midline discrepancy due to the functional shift of the mandible to the right.👆

The constriction of the maxilla is bilateral but the manifestation is unilateral due to the functional shift of the mandible towards the cross bite side as evidenced by a midline discrepancy.

Clinical Significance : 

• This condition has been associated with Temporo-Mandibular Disorders. Although TMD is multifactorial, and the unilateral posterior crossbow does not cause TMD, it is a co-factor or as associated finding.
• Functional shift of the mandible is better to be corrected as it represents a significant CR- CO shift which is unhealthy.
• The constriction also manifests as clinical crowding in several cases due to decreased arch perimeter.

Treatment :

     The treatment is always bilateral expansion by means of devices such as rapid or slow palatal expansion plates, quad helix and its modifications, NiTi palatal expanders, MARPE or micro-implant assisted rapid palatal expansion, etc.

      The best time for treatment is the Mixed Dentition stage if the patient reports at an appropriate age.

Conclusion:

      The article is meant to dispel all notions about occurrence of a unilateral disorder which is actually a bilateral constriction. 

The First Archwire In Orthodontic Treatment

The first step in most Orthodontic treatments is alignment. Even in a case of Class I bimax, the brackets need to be aligned before starting retraction. Alignment is a primary criteria of a perfect Smile.
The primary determinant of the choice of the first archwire in Orthodontic treatment is the severity of crowding. I would usually recommend starting a case with a round 0.014 Niti. However, a 0.012 Niti can be used in the following cases:

Severe Crowding is an indication of starting with 0.012 Niti

1. A case of very severe crowding can be started with a low force archwire as the degree of deflection of the archwire will be severe. The flip side is that there are increased risks of wire breakage due to the strain on them.
2. A very sensitive child or a very high profile patient, in which you want to slowly initiate the treatment without causing a lot of discomfort in the first few weeks would be another indication in my practice. This is an important practice management fundamental.

Discussion : As we move towards regimes of gentler, biologically adaptive force regimes, starting with 0.012 Niti will soon become a rule rather than an exception.

Fracture of an Upper Incisor Restoration

A crescent fracture of upper left central incisor crown

Occlusion is a potent factor in successfully restoring anterior restorations also. If the overjet is reduced or the palatal contour of a restoration is excessive then the anterior guidance is compromised. Excessive pressure can be generated on a single restoration which results in an abfraction type of fracture of the restoration.

Please note that this excess contour is not seen in MIP and articulating papers will not detect it in MIP. It will become obvious only in protrusive movements when only this overcontoured tooth will make contact and the other upper incisors will not be in contact with the lowers in protrusive.

If all the upper anteriors are restored with excessive contour then the mandible will be pushed backwards in the fossa and this will effect the disc and TMJ.

Moral - Functional Occlusion is important in the final restoration.

Single Tooth Cross-bite

Clinically, a single tooth crossbite is described by many Orthodontists as a true Orthodontic emergency and should be attended to as and when detected. The option that i normally use is fixed brackets on the upper anteriors extending upto the deciduous 2nd molar. A glass ionomer bite platform may or may not be necessary if the bracket is not obstructed by the opposing incisors. Treatment time is usually upto a few months only. Full treatment may be required after complete eruption of the permanent dentition. This is an interceptive Orthodontic procedure.

Single Tooth Anterior Crossbite

Orthotrain stall at Famdent Show from 7 to 9-June 2013

It was a memorable event attended by a lot of Dentists and interns at the exhibition centre at Goregaon. The picture shows the brochures of details of all courses offered under the umbrella of Orthotrain.