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									  University of Medicine and Dentistry
             of New Jersey
       New Jersey Dental School
      Department of Orthodontics




    Handbook for
     Orthodontic
Postdoctoral Residents



                April 2009
                            Welcome !

Welcome to the start of your orthodontic postdoctoral program at the
University of Medicine and Dentistry of New Jersey. The purpose of
this handbook, in coordination with NJDS student handbook (which in
cases of conflict supercedes this handbook and is located at:
http://dentalschool.umdnj.edu/handbook/residenthandbook/notice/Dear
Student.htm), is to provide you with a source of information about the
Postdoctoral Orthodontic program, the Department or Orthodontics, and
the New Jersey Dental School. The entire faculty, residents and staff
look forward to sharing your new experience with you.




Robert E. Binder, D.M.D.     Rene S. Johe, DMD
Professor & Interim Chair    Director of Post Graduate Orthodontics
University of Medicine and Dentistry of New Jersey

                   Handbook for
               Orthodontic Residents


   Department Mission Statement . . . . . . . . . . . . . 5
   Useful Information. . . . . . . . . . . . . . . . . . . . . . . 6
          Abbreviations
          Bank Services
          Books
          Child Care
          Clinic Hours
          Communication
          Computer Center
          CPR Training
          Eating Options
          Financial Aid
          Graduate School
          Harassment Policy
          HIPAA
          Honor Code
          Institutional Review Board
          Parking
          Patient Treatment Payments
          Pharmacy
          Student Identification
          Student Health
          Telephone
          Vacations
          Leave Time
          Vaccinations
          Who's Who
   Graduation Requirements. . . . . . . . . . . . . . . . . . . . . . 15
          Coursework
          Research Project
          Case Completion
          Resident Evaluation
                  Comprehensive Examination
                  Board Cases
                  Faculty Review
                  Mechanism for Appeal
          Transfer of Patients
          Attendance of Graduation and Convocation
           Clinic Information . . . . . . . . . . . . . . . . . . . . .22
                   Patient Records
                          Photographs
                          Radiographs
                          Models
                          Required Records
                   Patient Charts
                   Instruments
                   Patient Management
                   Clinic Dress Requirements


Appendix I -                 Orthodontic Patient Chart

Appendix II -                Requirement Log Forms

Appendix III -               Oral Biology MDS/MSD Requirements & Application

Appendix IV –                Commonly Used Forms
         University of Medicine and Dentistry of New Jersey
                      New Jersey Dental School
                     Department of Orthodontics

                                   Mission

Mission: The mission of the Advanced Education Program in Orthodontics
at the UMDNJ-New Jersey Dental School is to prepare qualified dentists to
practice the clinical specialty of Orthodontics and Dentofacial Orthopedics.
The program will provide the academic background and clinical experience
appropriate to the specialty. Graduates of the program will be prepared for
scientific and technical advances in the field as well as the changing
orthodontic needs of society to become the future generation of
orthodontists as clinicians, researchers, and educators.

Goals:


   1. To educate and train postdoctoral residents in the knowledge, skills and
      critical judgment required to practice the specialty of orthodontics and
      dentofacial orthopedics.
   2. To develop the postdoctoral resident’s ability to interpret, evaluate and
      contribute to clinical research by participation in scholarly research
      activities.
   3. To prepare the postdoctoral resident to fulfill the requirements necessary
      for certification by the American Board of Orthodontics.
   4. To prepare the postdoctoral resident as an educator.
   5. To encourage the postdoctoral resident to provide service to the
      community by participating in voluntary activities.
                      Useful Survival Information

Abbreviations

      ADMC          Administration Complex (the tan buildings across the street).
                    There are 18 of them and each has a separate number.
                    Functional units housed in these buildings include financial aid,
                    parking and ID services, public safety, personnel, human
                    resources, and grants management.

      MSB           Medical Science Building

      DOC           The Doctor's Office Center: The DOC is a center for faculty
                    practice as well as for student health (first level) and optical center
                    (sixth level).

      DS            The Dental School (also referred to as NJDS).

      GSBS          Graduate School of Biomedical Sciences

      NJDS          New Jersey Dental School

      SSB           Stanley S. Bergen Building, located across from the ADMC on
                    Bergen Street.

      SPH           School of Public Health

      SHRP          School of Health Related Professions

      UH            University Hospital


Banking Services

ATMs (Fleet Bank) are located in the Medical Science Building B level lobby, DOC
pharmacy, and in the cafeteria. The North Jersey Federal Credit Union has a branch in
ADMC 11. They offer quality financial products and services. There is also an ATM at
this location. A branch of Summit Bank located in the University Plaza Shopping
Center offers full service during regular banking hours and a 24-hour ATM.

Books

Matthew's (University) Bookstore is located in the University Plaza Shopping Center
(800) 791-BOOK or in NJ (973) 643-BOOK

                                  2008 Handbook - 6 -
Child Care

Child care is available close to the school at Kindercare, 132-142 Cabinet Street, 973-
623-0182.

Clinic Hours

Clinic hours are generally from 10-1 and 2-5. There may be some exceptions
depending upon special courses residents may be taking, or dental school functions.

Commission on Dental Accreditation

The Commission on Dental Accreditation will review complaints that relate to a
program’s compliance with the accreditation standards. The Commission is interested
in the sustained quality and continued improvement of dental and dental related
education programs but does not intervene on behalf of individuals or act as a court of
appeal for treatment received by patients or for individuals in matters of admission,
appointment, promotion or dismissal of faculty, staff or students.

A copy of the appropriate accreditation standard and/or the Commissions policy and
procedure for submission of complaints may be obtained by contacting the
Commission at 211 East Chicago Avenue, Chicago, IL 60611-2678 or by calling 1-800-
621-8099, extension 4653.

The NJDS and all postgraduate programs were reviewed by the CODA in November
2005 and were awarded full accreditation with many programs, including orthodontics,
receiving commendations.

Communication

The New Jersey Dental School has moved toward a completely paperless system of
communications which has resulted in the necessity that all faculty, staff and students
must have UMDNJ e-mail addresses. Most information between faculty, students,
department, and schools are sent by email and basic information may be found on the
website of the University or Department of Orthodontics.

Computer Center

The academic computing center is located in MSB C-630. Computers, help, and
courses are offered in the center. Phone: X 2-4973. All students and faculty are
required to have campus email addresses.




                                  2008 Handbook - 7 -
CPR Training

CPR training and certification is mandatory. Without proper certification, clinic
privileges will be denied. Training courses are available through the University
Hospital    Community     training   Center.     Registration   is   online    at
http://www.theuniversityhospital.com/ctc/cpr.htm

Dining Options

Within school/university complex:
       Garden Cafe (Cafeteria)- UH B-level
       Burger King- UH B-level
       Student Lounge - DS B-level (vending machines)
       NJDS Lobby – C level

Other options are available outside the University, including the University shopping
plaza which offers pizza, sub sandwiches, and Chinese food, and on Bergen Street a
KFC and IHOP.

Financial Aid

Financial aid for dental post graduates is administered by Cheryl White, located in
ADMC 1208 (building 12). Phone: X 2-7436.


Graduate School: Department of Oral Biology

Advanced degree programs are available to all post graduate students under the
auspices of the Department of Oral Biology. The MSD and MDS degrees are granted
by the NJDS and a MS in Oral Biology is granted through the Graduate School of
Biomedical Sciences (GSBS). The office of the GSBS is located in ADMC 110. Phone:
X 2-4511 or -7349. Director of Graduate Studies, NJDS: Dr. Daniel Fine, office: MSB
C-636; Phone: X 2-3728.

Harassment Policy

The University AA/EEO office has developed and implemented a policy prohibiting
sexual and other types of harassment. Each student is urged to review the website at
http://www2.umdnj.edu/aaeeoweb/policies.

HIPAA

As an institution that utilizes electronic transmission of patient related data, we must
comply with the federal HIPAA (Health Insurance Portability and Protection Act)
regulations. Information concerning UMDNJ HIPAA compliance is available at

                                   2008 Handbook - 8 -
http://www2.umdnj.edu/hipaaweb. Each individual dealing with patient information is
required to take and pass the web based HIPAA exam. In addition, all patients must
sign a label stating that they have received information on their rights under HIPAA. If
a patient refuses to sign this label, which is an acknowledgement only of receipt of
information, a witness must sign that patient refused signature.

Honor Code

All residents are required and expected to adhere to the NJDS honor code as
described in the NJDS Student handbook, located at:

http://dentalschool.umdnj.edu/handbook/student.pdf


IRB – Institutional Review Board

Any individual involved in research must submit an IRB application to the Newark IRB
office and receive approval prior to beginning the research. In addition, it is a
requirement that all researchers pass a web based course on human subjects
protection. Information concerning the IRB may be found at http://umdnj.edu/irbweb.

OSHA / Cleanup

In order to comply with OSHA and EPA standards, all exam chairs and unit surfaces
need to be sprayed with disinfectant and wiped down. All instruments are to be
sprayed prior to replacement in the cassettes and returned to the dispensary “dirty”
cart. The entire manual may be found in on the dental school website
(http://dentalschool.umdnj.edu/administration/envsafety/envpolicy.htm). Please keep
units free of personal material, as proper disinfection cannot take place. (All elastics,
wires, etc must be cleaned from tray.) Only those instruments which were in tray
initially should be returned to it. No fans or radios are allowed in the clinic.


Parking

Parking permits can be purchased for approximately $150/year. The parking permits
can be arranged in ADMC building 5. Alternatively, street parking is usually available
near the school if you arrive early enough. Many of the surrounding streets have
parking meters, with stiff fines if they expire. Do not use any of the shopping centers for
parking or your car will be towed.

Patient Treatment Payments

Payments for orthodontic treatment are collected within the department. The primary
person responsible for collections and issuing receipts as well as payment books is

                                    2008 Handbook - 9 -
Magaly Flores-Rios. If she is not available, the Senior Management Assistant, Maria
Sierra, (supervisor for the reception area),or the Principal Receptionist, Dianie Collado,
can receive payments.

Dental School Cashier - The dental school cashier is on the C-level. The cashier is
responsible for deposit of our patient payments, which the financial coordinator
manages. Cashiers can also receive payments for courses, or reimburse petty cash
receipts. The cashier will not cash personal checks or make change.


Pharmacy

Bergen Pharmacy: located in the DOC building lobby.
Eckert Pharmacy: located across Bergen street from DOC building.

Student Identification

UMDNJ Identification badges are required to be worn at all times. Identification cards
are issued in ADMC building 5.

Student Health

The Student Health Center is located in the DOC. It is available for immunizations and
for outpatient treatment.

Telephone

Numbers for the Department:
     General Department                                   973 972-4729
     Chairman – Dr. Binder                                973-972-6858
     Post graduate Director – Dr. Johe                    973-972-1892
     Clinic reception supervisor (Maria Sierra)           973-972-6286
     Clinic Scheduling                                    973-972-4704
     Clinic Financial (Magaly Flores-Rios)                973-972-0165
     Department secretary                                 973-972-9054
     Dispensary                                           973-972-1893
     Student area phone                                   973-972-5073
     Program Administrator (Christian Cardenas)           973-972-8106

To inform the department of a late arrival or sick day, please use the main number
(973-972-4729).
To reach on-campus numbers from campus telephones, dial 2 and the extension. To
reach a New Brunswick extension, dial 5 and the number. The local area code is 973.
To call numbers within the 973, 908, or 201 area codes, dial 9, then the number. Long-
distance calls require an authorization code, which will be provided to you, and is

                                   2008 Handbook - 10 -
limited to patient-related calls. To place these calls, dial 9-1-and the full number. At the
prompt, enter your authorization code. The use of an authorization code for long
distance phone calls is a privilege and abuse will lead to loss of authorization code.
Phone calls are reported to the department by authorization code number and are
checked on a monthly basis.

Telephone calls for personal matters are discouraged during class time and clinic
hours. Use your personal calling card if long distance personal calls are necessary.
Use of cell phones is prohibited in all clinical areas of the school.

Vacations / Holidays

Orthodontic residents are allowed one week (5 days) vacation a year (July through
June) in addition to scheduled school holidays and breaks. Residents are allowed two
(2) additional “floating” holidays only for religious observances not included in the
UMDNJ calendar. In addition to the NJDS winter / spring vacations the orthodontic
program closes for one week in the summer. This is usually the first full week in
August. The 5 vacation days can be requested when desired by submitting a “Resident
Vacation/Leave Request” form to Christian Cardenas.

To apply for vacation time, a vacation request form must be completed at least one
month in advance and submitted to the Program Administrator (Christian Cardenas).
The director will provide approval status and the request will be given to the patient
scheduler to block out clinic time. The Senior Management Assistant (Maria Sierra)
should be notified of vacation plans as far in advance as possible so that your clinic
time can be blocked out and patient rescheduling minimized. If vacation notice
requires rescheduling of patients, the resident must provide a list of all patients to be
rescheduled and times for when they should be rescheduled to. If many patients
require rescheduling, the resident may be asked to help reschedule patients.

Leave Time, Meetings

To attend meetings which conflict with the orthodontic or relevant MS graduate school
programs, leave time should be requested (submit a vacation/leave form). Instructors
for courses from outside of the department of orthodontics should be notified in
advance and their approval obtained. Please note that it is the resident’s
responsibility to verify that any vacation / leave days requested do not interfere
with activities outside of the department, including CORE examinations. Under
no circumstances does a signed vacation form imply that residents may miss
such examinations. Generally all residents will be allowed leave time to attend the
annual meeting of the American Association of Orthodontists (May). Except for one
resident, all residents / fellows will be allowed leave to attend the three meetings of the
New Jersey Association of Orthodontists. One resident will remain to assist in the
dentofacial deformities clinic if scheduled on the same day. First year residents are not
allowed leave time in addition to the NJAO, AAO, or other meetings for which the entire

                                    2008 Handbook - 11 -
clinic is closed. Second year residents are allowed up to five days of leave time a year
(July-June) to attend additional meetings. Third year residents have ten days leave
time for additional meetings pending approval of the program director or chairman.
Some meetings may be recommended or required by certain faculty, in which case,
those meetings will not be counted against leave time. Requests must be submitted
well in advance (4 weeks or more) so that clinic time can be blocked out without
rescheduling patients. In instances where additional leave time is necessary for
research purposes the same protocol should be followed. Patient rescheduling and
approval criteria is the same as described above in “Vacations”. Residents who take a
medical leave of absence must notify the department in writing and contact the Office
of Student Affairs where mandatory paperwork will be completed. This policy may be
updated pending notification by NJDS administrators at any time.

Participation in all of the didactic and clinical activities is an essential part of the
orthodontic learning experience and absences for any reason have a dilatory effect.
Therefore, absences for any reason, greater than three days or six half days per year,
including medical leaves, must be made up at the end of the program prior to the
issuance of a certificate. Available vacation days may be used to “cover” unscheduled
absences.

The program director and/or the department chair will exhibit their discretion for certain
situations such as a death in the family.

Absences for religious holidays or observances not incorporated into the NJDS
academic calendar, beyond the 2 allowed floating holidays, will also necessitate make
up time. If such absences are anticipated to occur on a regular basis throughout most
of the academic year, it may be appropriate for the resident to switch his/her half day of
research to the anticipated day. Such a switch will reduce the negative impact on
clinical activity but it also must not have an adverse effect on research quality or
results. All such changes in schedule must be approved by the program director and
chair.

Late Policy

It is important that all residents arrive on time each day. Lateness is a disruption to the
entire program and will not be tolerated. For unexcused lateness, the policy states that
one late arrival results in a written warning in the resident’s file. Two late arrivals within
one 12 month period, results in the assignment of a topic to be researched and then
presented in a Powerpoint format to the rest of the residents. Topic is determined by
the program director. Three late arrivals within one 12 month period, will result in the
loss of one vacation day.

Issuance of Certificate

Please be aware that it is required that you comply with the policies listed in this

                                     2008 Handbook - 12 -
handbook, announced either verbally or in writing to you, or posted on the dental
school website. Failure to adhere to the policies or complete requirements can result in
the withholding of your certificate at the end of the program. It may be necessary to
make-up missed time, or complete additional requirements for failure to adhere to
policies, as deemed appropriate by the administration of the department. Individual
cases will be reviewed.

Vaccinations

The school requires up to date hepatitis and tetanus vaccines, and yearly negative TB
(PPD) test findings.




Who's Who

Department of Orthodontics:

Faculty:

       Robert Binder, DMD (Interim Chair)
       Rene Johe, DMD (Director of Orthodontic Education)
       Anil Ardeshna, DMD (Director of Research)
       Peter Antonellis, DMD
       Richard Bloomstein, DDS
       Frank Bogdan, DMD
       Jeffrey Cooper, DDS, MSD
       George Langer, DMD, MSD
       Joseph Lohner, DMD
       Robert Montemurno, DMD
       Isaac Post, DDS, MSD
       Susan Rider, DDS, MSD
       Todd Sherwood, DDS, MDS

Administrative Staff:
      Adela Aleman – Principle receptionist
      Magaly Flores-Rios – Financial Coordinator
      Christian Cardenas - Program Administrator

                                  2008 Handbook - 13 -
      Maria Sierra – Senior Management Assistant

Dental Assistants:

      Sheila Rooks
      Fiordaliza Nunez (dispensary clerk)
      Ruth Droz
      Roz Morrow
      Dione Epps

In the Dental School:

      Dean: Dr. Cecile Feldman, DS B-815, Phone: 2-4633
      Executive Assistant to the Dean: Robin Wright, DS B-815, Phone 2-4634
      For a listing of all Assistant or Associates Deans, Directors and Chairmans,
      please visit the NJDS website sections of Departments or Administration.


      Registrar - Joanne Lametta, DS B-826, 2-4728

      Note: All administrators, their assistants and most faculty have e-mail
      addresses. Feel free to use this method of communication as it is often the
      most time-efficient. To find someone’s address use the “Search” option on
      the UMDNJ Web Homepage www.umdnj.edu.




                                2008 Handbook - 14 -
                         Graduation Requirements
Coursework
In keeping with the American Association of Orthodontics (AAO) and the Commission
on Dental Accreditation of the American Dental Association (ADA) requirements, the
post-graduate program in orthodontics includes the following topics:

       First Year                           Second Year                         Third Year
Summer Bio-Materials                        Dept Project                        Research
       Bio-Mechanics                        Research                            Clinic
       Cephalometrics                       Research Methods & Biostatistics II
       Clinic Orientation                   Clinic
       Diagnosis
       Orthodontic Records
       Typodont/Edgewise Orthodontics
       Wire Bending
       Clinic
Fall   Bio-Materials                        ABO Literature                     ABO Preparation
       Bio-Mechanics                        Advanced Bio-Statistics            Case Presentation
       Case Presentation                    Case Presentation                  Case Reviews
       Clinic                               Clinic                             Clinic
       Cranial Osteology                    Damon Technique                    Clinical Rotations
       Edgewise Technique                   DFD Clinic                         Cranio-facial Team
       History of Orthodontics              Functional Orthodontics            DFD Clinic
       Journal Club                         Journal Club                       Ethics and Jurisprudence
       Research Methodology                 Laboratory Course                  Journal Club
       Seminars in Orthodontics             Pre-Doc Lab Teaching               Practice Management
       Straight Wire Technique              Reanalysis                         Research
       Tip Edge Technique                   Research                           Seminars in Orthodontics
       Treatment Planning                   Seminars in Orthodontics
       Ethics                               Surgical Orthodontics
       Head & Neck Anatomy                  Cariology
       Inflammation & Immunology            Clinical Pharmacology and
                                            Therapeutics
         Research Methods & Biostatistics   Ethics
                                            Genetics
                                            Social Sciences in Dentistry




Spring   First Year                         Second Year                        Third Year
         Biology of Tooth Movement          ABO Literature                     ABO Preparation

                                        2008 Handbook - 15 -
         Case Presentation               Case Presentation                 Case Presentation
         Clinic                          Clinic                            Case Reviews
         Growth & Development            DFD Clinic                        Clinic
         Informatics                     Journal Club                      DFD Clinic
         Journal Club                    Lab Visit                         Journal Club
         MBT system Technique            Multi Disciplinary Orthodontics   Practice Management
         Research                        Pre-Doc Lab Teaching              Research
         Segmented Arch Technique        Research                          Seminars in Orthodontics
         Seminars in Orthodontics        Retention                         Transfer Protocol
         Treatment Modalities            Seminars in Orthodontics
         Microbiology                    TMJ Seminars & Workshop
         Pathobiology                    Biology of Mineralized Tissues
                                         Nutrition
                                         Oral Pathology
                                         Pain/Neurosciences/Oral
                                         Physiology
                                         Radiation Biology

Core curriculum courses (italicized) cover fundamentals of biomedical science applied
to dentistry and includes head and neck anatomy, inflammation and immunology,
microbiology, pain and neuroscience, pathobiology, temporomandibular disorders,
clinical pharmacology and therapeutics, social and community issues in the delivery of
dental care, clinical pathology, biomedical imaging, clinical nutrition, and office
computerization.

In addition to the orthodontic-specific courses, additional post-baccalaureate credits
must be completed to meet the requirements for the Master’s degree. A number of
Master’s programs are possible. A Master of Science in Oral Biology is available
through the Graduate School of Biomedical Sciences, a Master of Science in
Dentistry, and Master of Dental Science is available through the Department of Oral
Biology. A Master of Science in Biomedical Informatics is available through the School
of Health Related Professions, and a Master of Public Health is available through the
School of Public Health. Generally, an additional 25 credits are needed to fulfill the
requirements for MSD, MDS or MS (including the core curriculum). Particular
information is available from the specific programs and Appendix III of this handbook.
Enrollment in a Master’s program is optional and additional fees apply.

Fees

In addition to tuition, postdoctoral residents are responsible for student health fees,
instrument rental, purchase of laptop, purchase of textbooks, and technology fees.
The instrument rental fee is currently $1000 per year, technology fee of $325/year, and
the imaging fee is $350 (one time fee). Please visit the Department of Oral Biology
website at http://dentalschool.umdnj.edu/masters/index.htm for fees related to the
Master’s program.

                                     2008 Handbook - 16 -
The imaging and technology fees accrue to a departmental account for replacement of
digital cameras and digital radiographic sensors.

Equipment Utilization

Each postdoctoral resident will be supplied with a Dolphin key, for use in the
department. The department provides three digital cameras and individual flash cards
to use for record taking purposes. Care and maintenance of all loaned items are the
responsibility of the resident and loss or breakage costs will be assessed. Routine
maintenance of the computer will be managed by the department and IST.

Research Project

A research project and thesis on a topic in orthodontics is required to complete both
the Orthodontic Certificate and/or the Master of Science Degree requirements. When
the Certificate and degree are pursued concurrently, only one research project is
required. At the completion of the research, a thesis is written and formally defended
through oral presentation to the faculty. Each resident is also required to complete a
draft of a journal article based on the research findings and thesis, as well as a one
page abstract of the paper. These requirements must be completed prior to the formal
granting of the degree and/or certificate can occur.

In order to ensure that both the quality and quantity of the research experience is
adequate to be accepted for certification by the Department of Orthodontics and/or for
a Master of Science degree through the Department of Oral Biology, residents are
encouraged to initiate their projects as soon as possible after starting the program and
before the end of the first calendar year.

Each first year resident will be required to present a half hour to one hour oral review
with Powerpoint support, on their review of the literature and preliminary discussion of
their purpose, methods and materials. Each second year resident will make a similar
presentation at the end of their second year on the final methods and materials section
and preliminary findings of their research.

Online/Digital Orthodontic Texts and Journals

The department library includes extensive texts and journals available for resident
review. The UMDNJ online library also has several orthodontic journals available
online in full text format. This means the entire journal and all included articles are
available from anywhere on the world wide web. Information on access can be
obtained from the UMDNJ Library.

List of Orthodontic Journals that are available online or on CD in full text format:

American Journal of Orthodontics and Dentofacial Orthopedics
Seminars in Orthodontics
                                      2008 Handbook - 17 -
Angle Orthodontist
European Journal of Orthodontics
Journal of Clinical
(British) Journal of Orthodontics
Orthodontic Products
Orthodontics and Craniofacial Research

Several journals are available on CD in the department. Ovid literature searches are
also available online through the UMDNJ library website with the database. Any
journals not available online are generally available, in hard copy, either at the UMDNJ
Newark library or in the Department Library.

In order to access the UMDNJ library and these online journals and searches, you
must have registered for library access IN PERSON at the library. All that is needed is
a valid UMDNJ ID.

Case Completion

By the time a postdoctoral resident graduates, a total of 15 cases started by the
resident must be completed (debonded). In addition, another 15 active transfer cases
must be completed (debonded). Thus, a total of 30 cases must be completed through
debanding and final records. As patients are debanded, each resident should
complete the appropriate “Cases Completed” log sheet (“Started by Resident” or
“Transferred to Resident”) and obtain the assigned faculty instructor’s signature
(Appendix III).

Model Fabrication

A requirement for the orthodontic program is that each postdoctoral resident will
fabricate 10 pre-treatment models. These will recorded and signed of by assigned
faculty instructor in the resident’s “Model Fabrication” log (Appendix III). Only models
that are evaluated as “pass” (minimally) will be acceptable. Models may be of the
”hand-held” form or articulator mounted. All patients will require impressions and bite
registration fee “fabrication” of digital models.

Cephalometric Tracings

A requirement of the orthodontic program is that each postdoctoral resident will hand
trace 10 pretreatment radiographs and perform the appropriate cephalometric analysis
as required by the assigned faculty. These tracings will be recorded in the resident’s
“Cephalometric Tracing” log. Only tracings and analyses that are evaluated as pass
will be acceptable. Once the minimum number of hand tracings are performed the
resident may employ the Dolphin system for digitalization and analysis.

Appliance Fabrication

                                      2008 Handbook - 18 -
A requirement of the orthodontic program is that each postdoctoral resident will
fabricate 2 Hawley-type retainers for their patients. These should be recorded and
signed off by the assigned faculty instructor in the resident’s “Appliance Fabrication”
log. To count, the retainers must be rated “pass” or better. All Nance holding arches,
lingual arches, and transpalatal arches will be fabricated by the assigned resident.

Patients may choose “designer” type retainers for which an additional fee (currently
$15.00 per appliance), will be charged and must be collected prior to insertion. The
cost of replacement of lost retainers is the responsibility of the patient/parent and the
fees (currently $150/appliance 1 arch, and $300 both arches), must be paid prior to
insertion.



Resident Evaluation

Residents are evaluated through three mechanisms: comprehensive examinations,
board case presentations, and faculty reviews of clinical, didactic, and research
performance. In addition, third year residents are required to participate in and pass
the Phase II written examination of the American Board of Orthodontics prior to
graduation. No certificate will be issued prior to passing this exam. The cost of the first
examination is currently born by the department. Any examination retake fees are the
responsibility of the resident.

Comprehensive Examination. A comprehensive written examination is given at the
end of each academic year. Questions are prepared by faculty covering topics
discussed in lectures and seminars. If performance of any resident is not sufficient,
three things could happen, depending upon the severity of the inadequacy. The
resident may be asked to prepare an in-depth literature review addressing the area of
insufficiency, he or she may be asked to repeat the academic year, or, in extreme
cases, be asked to withdraw from the program.

Grades

In order to be promoted from each year and to be approved for graduation, a passing
grade must be received in all department and other courses required for certification
and/or masters degree programs.

Board Cases. A total of three cases must be prepared for presentation according to
the American Board of Orthodontics (ABO) requirements. Specific instructions
prepared by the ABO will be provided. One of these cases will be selected for display
at the Mock Board presentation at the Annual AAO meeting which is sponsored by the
College of Diplomates of the ABO (CDABO).

Cases selected for documentation must be approved by Dr. Johe, Postgraduate
Program Director, by November 1st of the third year, before the write-up begins. By
                                       2008 Handbook - 19 -
February 1st of that year, all case analysis and write-ups must be completed.
Completed cases must be formally presented to the Department of Orthodontics
Faculty and invited ABO members of the practicing community. At the time of the
formal presentation, each resident will be asked to discuss their cases and analyze at
least one new case presented by the invited ABO members. The invited members will
critique the performance of each resident.

Faculty Review. The didactic, clinical, and research performance of each postdoctoral
resident is evaluated on a continuous basis. In addition to review at each monthly
faculty meeting, a written evaluation is completed at least once each year. Information
from the faculty will be collated and presented to the resident by the Director of
Postgraduate Studies, the Department Chair, or their designee. Resident performance
at case conferences is also evaluated on a continuing basis.

Postdoctoral residents are asked to evaluate the faculty once each year. That
information is collected by the Chair and reviewed with the faculty.

Transfer of Patients

Patients may be transferred to different assigned faculty ONLY if the transfer is
necessary due to patient schedule constraints. Such transfers should be kept to a
minimum. Any patient transferred to a different assigned faculty member must have an
entry to that effect in the treatment record, and this entry must be signed by the
original assigned faculty member PRIOR to the transfer. The department
administrator must also be notified in order to change the faculty assignment
electronically.

Near the end of the third year of the postdoctoral resident's training, patients in active
treatment are formally transferred to another resident. Ideally, each postdoctoral
resident will introduce the patients in active treatment to the new resident to whom the
patient is to be assigned and will work with the new resident to facilitate the transfer.
The graduating and new postdoctoral resident should plan on seeing each transferring
patient at the same time for a minimum of one appointment. Patients debonded must
have final photographs, cephalometric and panoramic radiographs taken by the
treating resident prior to the patient being transferred to another resident.


Attendance at Graduation and Convocation

Attendance at the UMDNJ graduation and the NJDS convocation is mandatory. If, due
to some unforeseen circumstances, that becomes impossible, a written excuse must
be presented to the bursars office. Failure to attend graduation will result in a hold on
the resident's orthodontic certificate and/or the appropriate MS degree.

Attendance at Classes and Clinics

                                       2008 Handbook - 20 -
Although attendance is not taken within the Department of Orthodontics, residents are
expected to arrive promptly and attend all scheduled sessions of all courses and
clinics. During the regular academic year the daily schedule is usually seminars and
lectures from 8:00AM to 10:00AM, clinic from 10:00AM to 1:00PM, and lunch is
scheduled from 1:00PM – 2:00PM. Afternoon clinic is from 2:00PM to 5:00PM. To
cancel patients you must obtain permission from the chair, postgraduate director or
administrator.

Time Management

It is impossible to predict patient problems in advance, but when treating patients in the
clinic, please make every effort to stay on schedule. When you run late it may keep
other patients waiting and encroach upon the personal time of staff and faculty.




                               Clinic Information

Faculty

Faculty provide supervision for all clinical activities in the department.

Assigned faculty – faculty assigned to a particular patient. This faculty member is
responsible for reviewing and signing the treatment plan for the patient, as well as
directly supervising the patient’s treatment at regular intervals. Whenever possible, the
assigned faculty should also be the attending faculty.

Attending faculty – faculty covering the clinic when the assigned faculty is not
present. Attending faculty may sign for records and treatment notes, but may not
approve or sign treatment plans, lab prescriptions, or resident completed appliances if
they are not also the assigned faculty.

Patient Records

All patients require records at various stages of treatment. These include digital
photographs, radiographs, and models.

Photographs. A complete set of digital photographs includes the following:

                                       2008 Handbook - 21 -
      Frontal View - a view of the patient’s full face taken with the patient looking
      forward, directly into the camera. The patient’s head and top of their shoulders
      should fill the entire frame. Glasses are to be removed before the photograph is
      taken. The patient’s lips should be closed. Both ears should be visible. Large
      earrings should be removed.

      Frontal View with Smile - the same as the frontal view but with the patient
      smiling naturally.

      Profile View - a right side view of the patient’s face taken with the patient
      looking directly forward. The patient’s head and top of their shoulder should fill
      the entire frame. Glasses are to be removed before the photograph is taken.
      The patient’s lips should be closed. Hair should be pulled back so that their ear
      is exposed. The patient should be facing toward your right. Large earrings
      should be removed.

      Maxillary Occlusal View - a view of the entire maxillary arch is captured using
      a reflected image. Teeth from central incisors to at least the distal of the first
      molars are required. The arch should fill the entire frame of the picture.

      Mandibular Occlusal View - the same as for the maxillary arch but for
      mandibular teeth.

      Anterior Teeth - a view of the anterior teeth with the teeth in maximum
      interdigitation. Cheeks should be retracted. The teeth should fill the entire
      frame of the picture.

      Right Side View - a view of the teeth from the right central incisor to at least the
      mesial of the first molar with the teeth in maximum interdigitation. The teeth
      should fill the entire frame of the picture.

      Left Side View - the same as the right side view but of the teeth in the left side
      of the arch.

Formatting

All photographic images will be formatted using the Dolphin imaging system. This
may be done using your lap top computer or the desk top computer in the resident’s
study area.

Radiographs. At the start of treatment (for comprehensive treatment patients), digital
panoramic, lateral cephalometric and periapical radiographs of maxillary and
mandibular incisors are required unless suitable and diagnostic radiographs have been
recently obtained and are available. Additionally, depending upon the age of the
patient and the type of treatment they are likely to receive, some patients may also
require posteroanterior cephalometric and/or hand-wrist radiographs.
                                      2008 Handbook - 22 -
Models. Digital or plaster study models are required for patients at the start of all
treatments as well as at the completion of active treatment and upon dismissal. Plaster
models may be required for DFD and CFA cases. If hand-held models will be unstable
or if there is a significant centric relation to maximum intercuspation shift, models
should be articulator mounted. The orthodontic dispensary has an articulator, that can
be signed out or articulators can be checked out from the dental school (Hanau). A
soft wax bite should be taken to enable proper model trimming and/or articulator
mounting.

Residents should check with each assigned faculty member regarding the ordering of
digital or plaster models. Generally, all Class I patients with a reasonable occlusion
should have only digital models ordered. Faculty may decide on a case by case basis
which type of model they desire. If both digital and plaster models are desired, the
plaster models should be completed in house by the resident and trimmed as
instructed by the faculty.


Required Records. Different records are to be taken at different times throughout the
treatment and for different levels of treatment (summarized in Table 1). Additional
records and/or information may be required for special patients and will be specified by
the assigned faculty. Lack of appropriate pre-treatment, treatment progress, and post-
treatment records can be cause for dismissal from the program. All records obtained
must be signed off and checked by attending faculty on the day records are
taken.

Start of Treatment: At the start of treatment, the following records are required for all
patients:

              ▪ Photographs
              ▪ Radiographs – panoramic & incisor periapical (lateral cephalometric for
                comprehensive treatment patients only)
              ▪ Digital or plaster models (hand or articulator mounted)

      In addition, all adult patients must have periodontal clearance prior to starting
orthodontic treatment as required by the ABO. Specifically, the patient must have one
or more of the four following items completed:

       a.     Full mouth periodontal probing recorded prior to initiating orthodontic
       therapy

       b. Written documentation of pretreatment periodontal status, including a full
       periodontal charting, received from a periodontist, general or pediatric dentist

       c.   Pretreatment panoramic, vertical or conventional bitewings, and maxillary
                                      2008 Handbook - 23 -
       and mandibular (anterior) periapical radiographs

       d.    Full mouth series of periapical and bitewing radiographs

Obtaining copies of such records from other departments or referring dentists is
acceptable.

During Treatment: During treatment, periapical radiographs are required during
torquing procedures. These radiographs are to be taken at intervals prescribed by the
assigned faculty.

Intraoral digital photographs should be obtained whenever a specific stage of treatment
is completed or unique appliance or wire is utilized.

Digital photographs should be taken to record significant changes in dental/skeletal
relationship and to demonstrate treatment techniques and progress. It is better to have
too many photographs than too few. Such photographs enhance the presentation of in
progress and post treatment case reviews.

Whenever there is a significant change in the treatment plan, records are to be taken.
Specific records will be determined by the assigned faculty.


3-6 Months before Active Treatment Ends. A panoramic radiograph is required to
assess root position. A lateral cephalometric radiograph may be needed to assess
torque.


At the End of Active Treatment. The same records as for the start of treatment are
required. These are to be taken at the debanding appointment, or within two months
after debanding has been completed.


Final Records. Prior to patient dismissal, usually one year after removal of the fixed
appliance, a set of records is required. These are the same as start of treatment
records.


Other Records. At the time a patient is transferred to another resident, a full set of
photographs is required. Surgical patients are to have a full set of records (as in
starting records) immediately proceeding surgery and 4-8 weeks after surgery (as soon
as the patient resumes orthodontic treatment and can open sufficiently comfortably to
permit impressions to be made). Additionally, submental vertex radiographs and head-
oriented TMJ laminographs may be indicated for surgical patients.

At the end of phase I of a two-phase treatment and at the start of phase II treatment, a
                                      2008 Handbook - 24 -
  full set of records (as in starting records) is required.




                                Table 1. Required Records

Time                  Photos     Pan     Lateral     Frontal    Hand-    PA's    Models
                                         Ceph.       Ceph.      Wrist
                                                                x-ray
Start of                  x        x         X           3        1        x     x
Treatment
3-6 mo. pre-                       x     Possible
debond
End of Active             x        x         X           3                 x     x
Treatment
Prior to dismissal        x        x         X
Post-Retention
Surgical Patients        x, 2      x         X           3        1        x     x,4
- Presurgery
Surgical Patients        x, 2      x         X           x                 x     x
- Postsurgery
End of Phase I            x        x         X           3                 x     x
Treatment
Beginning of           x        x            X           3        1        x     x
Phase II
Treatment
  (numbers are for notes - see below)

  Notes:

       1. Hand-wrist radiographs are required only when growth will play a role in
          treatment decisions. The attending or assigned faculty members will advise you
          of the need for this type of radiograph.

       2. Additional photographs are required for surgical patients. These include right
          and left 3/4 views plus both right and left profile views. Typically all surgical
                                         2008 Handbook - 25 -
       photographs are to be made with the patient in CR. If the patient has a large
       CO-CR discrepancy or functional shift, intra-orals photographs in CO are also
       required. Opening deviations are to be recorded photographically.

   3. Frontal (posteroanterior) cephalometric films are required when the patient
      displays a significant transverse skeletal and/or dental defect that may affect
      treatment results obtainable by conventional orthodontic treatment or that may
      require orthognathic surgery. The attending or assigned faculty member will
      advise you of the need for this type of radiograph.

   4. Pre-surgical models should be mounted. (Impressions, bite registrations and
      face bow transfers are obtained by Oral Maxillo-facial Surgery Residents.)

               Additional records may be required by assigned faculty.

Patient Charts and Privacy

Patient charts are a permanent record of patient data, treatment plan, and treatment
delivered. It is critical that they be kept current, private and complete. No part of the
patient’s chart is to be shared or divulged outside of the school, including by email
communication, without express consent and approval by the patient and the
department. Following acceptance of the treatment plan, it must be signed by the
patient and/or parent / guardian, as well as by the assigned faculty and the
treating resident, BEFORE any appliance is placed. Failure to comply with this
requirement could result in dismissal from the program.

A summary of treatment provided is to be completed on the day of the treatment, and
signed by both the resident and the attending faculty (including resident/faculty
ID numbers). Appropriate signatures are required on the treatment plan, records
page, HIPAA compliance form, treatment specific informed consent, generic informed
consent (you & your orthodontist), all record logs, and history and clinical exam form.
Appendix I lists the appropriate assembly sequence for orthodontic charts. Orthodontic
charts are red or black, LTM charts are green, and Pediatric charts are blue.

Instruments

Instruments are usually provided by the Department at no direct cost. Four sets of kits
are available:

       Standard Plier Kit (marked with an S on its sterile wrap) includes:

              1 light wire plier
              1 ligature cutter
              1 Tweed plier
              1 Howe or Weingart plier
              1 distal end cutter
                                      2008 Handbook - 26 -
              1 needle holder
              1 mosquito hemostat
              1 ligature director/seater
              1 explorer
              1 mirror

       Exam Kit

              1 explorer
              1 periodontal probe
              1 mirror
              1 cotton plier
              1 plastic ruler

       Retainer Adjustment Kit (marked with an R on its sterile wrap) includes:

              1 bird beak plier
              1 three-prong plier

       Banding Kit (marked with a B on its sterile wrap) includes:

              1 band pusher
              1 band seater/biter
              1 posterior band removing plier
              1 spatula

Other instruments not in the kit are available in the dispensary or on the mobile carts.
If an instrument becomes contaminated and needs to be replaced while you are
working on a patient, the dispensary may have it available as a single instrument (so
you may not need to open a whole new kit).

Defective or broken instruments should not be replaced in instrument kits. They should
be placed on top of the kit and the problem reported to the dispensary clerk or an
assistant for replacement and/or repair.

Patient Management

Patients are to be seen only during regular clinic hours when a faculty member is
present in the clinic. Rendering care without appropriate faculty supervision may result
in suspension or dismissal from the program.

Residents are responsible for ensuring that patients come to their appointments. If a
patient misses an appointment, it is the resident's responsibility to contact them and
reschedule them and/or contact them by mail. Each resident is expected to treat their
assigned patients as if they were patients in their own private practice.

                                      2008 Handbook - 27 -
One important issue regarding patients is timeliness of payments. Before a patient can
be debonded or dismissed, financial obligations must be complete. The financial
coordinator can provide financial status to you and work with you to ensure payments
are complete. Except in special circumstances, if payments are not completed and the
patient is debonded, the resident can be held personally responsible for the balance in
that patient's account. Months prior to the expected debonding date, please notify the
financial coordinator of your intent to debond, so that the financial status can be
ascertained and delinquent balances addressed. Note: if at any time a patient transfers
from one type or phase of treatment to another, a new contract will be required.
Please notify the financial coordinator so that financial adjustments can be made.

When a patient needs restorative or other dental procedures, a notation on the consult
page of the patient's regular dental school chart is needed. If the type of restoration
and tooth number are indicated, a dental student can be assigned to complete the
work quickly. If the request is made without specifics, the patient must go through an
extensive screening and assignment process, which takes considerably longer.

Laboratory Work

Residents are required to trim the first 10 sets of patient models and make a minimum
of 2 removable appliances or retainers. After these, commercial laboratories can be
used. Assigned faculty must approve the quality of each model and retainer made by
the resident, and initial the checklist. All laboratory prescriptions must be signed by the
assigned faculty member.

Clinic Dress

Residents are expected to dress professionally. All residents are to wear business
attire (shirt and tie or turtleneck) while at the school, whether or not they are seeing
patients. Male residents have the option of wearing a tie during the summer months
(Memorial Day to Labor Day). Residents also have the option of wearing full scrubs,
but scrub tops and bottoms must match. No T-shirts are allowed. In addition, male
residents must be clean shaven every day. Running shoes (unless wearing scrubs),
open toed shoes, and T-shirts or tank tops are not permitted. On the clinic floor, either
disposable or blue fabric gowns are to be used. These gowns, however, are not
permitted away from the clinic floor. Eye shields and/or protective eyewear and face
masks must be worn at all times during patient treatment procedures which produce an
aerosol. Use of eyeware and facemasks at other times is made at the discretion of the
operator. Infection control regulations regarding appropriate attire must be followed.
Residents should wear lab coats when not wearing disposable gowns.

Area Clean Up and Disinfection

All instruments must be returned to the dispensary for the appropriate sterilization, after
they have been surface disinfected at the unit. Appropriate head rest covers and
plastic covers and sleeves must also be used. All working surfaces and chairs must be
                                       2008 Handbook - 28 -
disinfected following each treatment visit.




                                      2008 Handbook - 29 -
       Appendix I

Orthodontic Patient Chart




        2008 Handbook - 30 -
                                           CHART SEQUENCING

1. Inside Front Cover
         a. (Record keeping) Top Left – Patient Tracking label – including current resident
         b. (HIPPA) Bottom left – HIPPA Compliance label
         c. (Medical Alert) Top Right – Medical Alert Label if applicable

2. (Record keeping) Chart Face Sheet with Ortho Case number and NJDS Chart Number

3. (Treatment Plan) Diagnosis and treatment Plan Summary Form
         a. Signed and dated by parent
         b. Signed and dated by patient
         c. Signed and dated by resident, with ID number
         d. Signed and dated by faculty, with ID number

4. (Consent Signed) Treatment Specific Informed Consent
        a. Signed and dated by parent
        b. Signed and dated by patient
        c. Signed and dated by resident, with ID number
        d. Signed and dated by faculty, with ID number

5. (Consent Signed) Generic Informed Consent Form (You and Your Orthodontist)
        a. Signed and dated by parent
        b. Signed and dated by patient
        c. Signed and dated by resident, with ID number
        d. Signed and dated by faculty, with ID number

6. (Active care) Treatment Sheets – Entries must always be dated. No shows, lates and issues of non-compliance
must be entered in red. Charts should be signed by faculty by end of day.

7. Record Log
        a. (Radiology) Record date and type of radiograph obtained
                 1. Indicate A for Analog and D for Digital in the appropriate column
                 2. Analog radiographs must be labeled with patient name and date
                 3. Signed and dated by resident, with ID number
                 4. Signed and dated by faculty, with ID number
        b. (Treatment Record) Record date and type of photograph obtained
                 1. Indicate A for Analog and D for Digital in the appropriate column
                 2. Analog photographs (slides) must be labeled with patient name and date
                 3. Signed and dated by resident, with ID number
                 4. Signed and dated by faculty, with ID number
        c. (Treatment Record) Record date of models (date when impressions were taken)
                 1. Indicate A for Analog and D for Digital in the appropriate column
                 2. Models must be labeled with patient name, age and date
                 3. Signed and dated by resident, with ID number
                 4. Signed and dated by faculty, with ID number

8. (Medical/Dental history) History and Clinical Exam Form
        a. Signed and dated by resident, with ID number
        b. Signed and dated by faculty, with ID number

9. (Treatment record) Slides and Photographic prints, if any

10. (Treatment Record) Ceph Analysis – Labeled with name and date in sequence

                                                2008 Handbook - 31 -
11. (Treatment Record) Ceph tracing – Labeled with name and date in sequence

12. (Treatment Record) Analog Radiographs – Labeled with name and date in sequence

13. (Medical/Dental History) Ortho Initial Screening sheet

14. (Record keeping) UMDNJ Registration (copy)

15. (Medical/Dental History) NJDS/Med/Dental History (copy)

16. (Treatment Record) Laboratory Prescriptions

17. (Other) – Correspondence with other medical professionals

18. (Other) – Correspondence to patient

19. (Record keeping) Ortho Contract

20. (Record keeping) Insurance Information

(edited 6-07)




                                                2008 Handbook - 32 -
                             Appendix II

             Program Requirement Log Forms

      1st year residents must have all log forms filled out and signed
by the appropriate faculty and turned in to the department administrator no
           later than Sept 1st at the beginning of their 2nd year.




                                2008 Handbook - 33 -
                              Cephalometric Tracing Log


Name:________________________

Requirements: 10 tracings and analyses                Minimum grade: Pass

 #        Patient             Date    Tracing           Grade      Analysis    Grade     Faculty
                                                                                         Initials
 1
 2
 3
 4
 5
 6
 7
 8
 9
10
11
12
13
14
15



                               Removable Appliances

Name: ______________________

Requirements: 2 Appliances / Retainers                  Minimum grade: Pass

     #              Patient          Date            Appliance         Grade           Faculty
                                                                                       Initials
     1
     2
                                            2008 Handbook - 34 -
                      Study Model Log


Name:________________________

          Requirements: 10 models        Minimum grade: Pass

             #       Patient          Date      Grade   Faculty
                                                        Initials
             1
             2
             3
             4
             5
             6
             7
             8
             9
            10
            11
            12
            13
            14
            15




                               2008 Handbook - 35 -
           Appendix III

Oral Biology MDS / MSD Requirements
             & Application
         (see online materials)




              2008 Handbook - 36 -
    Appendix IV

Commonly Used Forms




      2008 Handbook - 37 -
               Orthodontic Department Sign-Off Sheet
               For PG Resident: ____________________


1)   Keys to Study Desk                          ___
     Keys to Dental Unit                         ___           _____________________________
     Extra items (handpieces, etc) returned      ___           Sheila Rooks


2)   Keys to Resident / Conference Room          ___           _____________________________
     Vacations / Sick days made up               ___           Christian Cardenas
     ID cards

3)   Patients Transferred                        ___
     Patients Dismissed                          ___           _____________________________
                                                               Maria Corley

4)   IRB Closure Form Completed                  ___
     Models/Tracings/Appliances completed        ___           _____________________________
     Dolphin Data updated to Server              ___           Dr. Rene S. Johe
     15 Start / 15 Transfer patients completed   ___
     Course / Faculty Evaluations Completed      ___

5)   Laptop returned                             ___
     Memory card returned                        ___           _____________________________
     Dolphin key returned                        ___           Dr. Robert E. Binder


6)   ABO Written Board Exam taken                ___
     Mock Board Passed or Remediated             ___
     (6 cases completed to Board Standards)      ___
     Thesis Completed and Signed                 ___           ______________________________
     Publishable Article submitted               ___           Dr. Robert E. Binder




                                        2008 Handbook - 38 -

								
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