I - Post-Graduate Training

Article 1

The minimum theoretical and practical training in order to apply for the specialist examination shall be a full-time programme carried out by a university or other institution of higher education accredited by the OMD, with duration of at least three years.

Article 2

Post-graduate training must meet the following requirements:

a) the treatment of patients shall be tutored by certified orthodontists;

b) the theoretical subjects of graduate teaching must not account for more than 10% of the post-graduate programme;

c) the applicants must carry out a research Project (clinical, experimental or bibliographical review) and present the results and conclusions in a thesis or a scientific paper.

Article 3

The compulsory theoretical subjects of the post-graduate programme in orthodontics are:

1 - Basic medical sciences

- human growth and development

- anatomy of the head and neck

- genetics 

- embryology of the head and neck

- cellular biology

- physiology of the stomatognathic system

- craniofacial syndromes

- child, adolescent and adult psychology

- biostatistics

- epidemiology

- methods of scientific research

2 - Orthodontics - Basic topics

- teething development

- craniofacial growth

- physiology of the stomatognatic system

- biology of tooth movement

- radiology and imagiology

- cephalometry

- orthodontic materials

- biomechanics

3- Orthodontics - General topics

- aetiology

- diagnosis techniques

- diagnosis and treatment plan

- growth analysis and treatment

- relapse and retention

- iatrogenic effects of orthodontic treatment

- epidemiology in orthodontics research

- literature on orthodontics

4 - Orthodontic techniques

- removable appliance

- functional appliance

- extraoral appliance

- partial fixed appliance

- fixed appliances

- retention appliance

5 - Multidisciplinary treatments

- treatment of palatoschisis

- orthodontic-surgical treatment

- orthodontic-periodontal treatment

- orthodontic-restorative treatment

6 - Specific treatment techniques

- serial extraction

- adult orthodontics

- craniomandibular dysfunction

7 _ Hygiene, asepsis and sterilisation

- oral hygiene and prevention

- sterilisation and disinfection

8 - Professional conduct, management and administration

- rules of professional conduct

- forensic medicine

- clinical management and administration

- computers

- ergonomics.

Article 4

From the clinical point of view, the applicant must show actual and significant intervention in the following areas:

- Diverse abnormalities, considering the classification of Angle, facial type and deviations in the three special planes.

- Diagnosis procedures, treatment plan and respective mechanic sequences for at least 20 cases (not necessarily treated by the trainee).

- Use of interceptive removable, functional and fixed appliances.

- Control of the eruption sequence (serial extractions).

- Control of abnormal or delayed eruption (ectopic eruption, inclusions, etc.)

- Retention procedures.

II - Quality of post-graduate institutions

Article 5

Portuguese dental schools or other teaching institutions offering post-graduate programmes in orthodontics shall apply yearly for the OMD's accreditation, enclosing a report of the previous year¿s activities, in order to guarantee appropriate and sufficient training for all those seeking specialist certification.

Article 6

Further to the previous Article, all the documentation relevant for accreditation shall be sent to the OMD by the end of October each year.

Article 7

It is the responsibility of the College's Direction to approve the activities report and appraise the quality of the post-graduate institutions, sending their report to the OMD¿s Board of Directors within the following 30 days (that is, by 30 November).

Article 8

If a member of the College¿s Direction is also part of the faculty of the institution applying for accreditation, this member shall not be allowed to vote and be replaced by the Chairperson, or by other members of the Specialist Roll should the Direction be reduced to less than three members.

Article 9

Whenever considered necessary, the institutions seeking accreditation may be asked to produce confirmation or substantiation of all the information provided, using the means regarded as most adequate.

Article 10

Failure to comply with the previous article within the following 30 days may determine the denial of the accreditation, which shall be communicated to the OMD's Board of Directors, who in turn will notify the institution and its authorities.

Article 11

Those who have completed post-graduate education in a foreign university shall be allowed to apply for certification after the OMD has received confirmation from its foreign counterpart regarding the teaching quality of the institution, except when the course has already been recognised.

Article 12

An institution suitable to offer post-graduate education leading to orthodontist certification shall meet the following requirements:

A - Head of the Department (requirements)

- be a certified orthodontist

- practise orthodontics actively and exclusively

- have a full-time contract with the institution

B - Faculty

- In addition to the Head of the Department, it shall be made up of one full-time post (occupied by one or more orthodontists) for every four trainees.

- It must guarantee sufficient clinical training, in accordance to the regulations in force.

Article 13

Each department shall define the maximum number of trainees admitted to each post-graduate course, in cooperation with the OMD and the College¿s Direction.

Article 14

Whenever necessary, the OMD, through the College¿s Direction, shall supervise the accredited institutions and departments at any given time and by the available means, in order to verify their compliance with these requirements.

Article 15

The Direction of the College of Orthodontics shall have the right to recommend to the OMD the denial or revocation of an institution¿s accreditation, when the requirements defined in these regulations have not been observed or when sufficient information has not been provided.

Article 16

The revocation of an institution¿s accreditation means that that institution¿s trainees shall not be allowed to apply for the specialist certification in orthodontics, as granted by the OMD.

Article 17

Every year the College¿s Direction shall provide the Board of Directors with the list of accredited institutions, to be included in the OMD¿s official publication. College of Orthodontics

III - Documents and Rules for the Presentation of Clinical Studies

Article 18

The applicant's curricula shall contain:

- Detailed list of theoretical subjects completed including their time table and credits of each.

- List of the practical subjects with their timetable and credits.

- Report including the number of clinical cases treated and/or in which the applicant participated, as well as the type of disorders observed and the techniques used.

- List of the faculty involved in the applicant¿s training.

- Affidavit by the head of the department, about the veracity of the curricular information provided by the applicant.

Article 19

The applicant shall present 6 (six) clinical studies, which must comply with the following requirements:

- the treatment must have been carried out exclusively under the applicant's surveillance;

- the studies must reflect the selection criteria which reveal the applicant¿s technical skills;

- both arches must have been treated;

- the case must be concluded and retention procedure must have begun.

Article 20

All the cases must be accompanied by a declaration stating that:

- the treatment was planned and carried out only by the applicant;

- authorisation by the patient or by the patient¿s representatives if he/she is under age, allowing the records to be examined by the jury and displayed during the examination;

- full name, address and phone number of the patient or of the patient's representatives if he/she is under age, so that they can be reached by the College's Direction or the examining jury.

Article 21

Requirement for the clinical studies:

- Case #1 malocclusion treated with extractions

- Case #2 class II malocclusion treated without extractions

- Case #3 class III malocclusion *

- Case #4 malocclusion with significant transverse discrepancy

- Case #5 malocclusion in adults

- Case #6 applicant's free choice

* pseudo class III shall be accepted

1 - Records to be presented:

a) Before any active treatment (including extractions) = "A" records (compulsory)

- study casts 

- (panoramic or periapical) dental X-rays 

- (front and side) facial photographs 

- colour intraoral photographs (including at least front and side views) 

- cephalometric records

b) At the end of most active treatments = "B" records (compulsory)

- study casts 

- (panoramic or periapical) dental X-rays (not required if included in "C" below) 

- (front and side) facial photographs 

- colour intraoral photographs (including at least front and side views) 

- cephalometric records

c) At least a year after the removal of fixed appliances = "C" records (optional)

- study casts 

- (panoramic or periapical) dental X-rays (not required if included in "B" above)

- (front and side) facial photographs

- colour intraoral photographs (including at least front and side views)

The above-listed minimum requirements shall not discourage the applicant from presenting any additional relevant records. Records from other stages of the treatments must be clearly identified so as not to be confused with the records required above.

Exceptions: The College is aware that strict compliance with the requirements above may lead to the exclusion of a case worth being analysed. Photographs and X-rays may occasionally be missing and this omission may be accepted when clearly explained, as long as they are not a vital part of the presentation. It must be pointed out, however, that in general, the records must be complete.

2 - Clinical history

In addition to the clinical records listed above, each case study must include a written report containing the case history, in compliance with specific rules.

3 - Additional information

- Dental X-rays: the right and left sides must be clearly identified on both sides.

- Cephalometric X-rays (teleradiographs): they must face right.

- Cephalometric tracings: they must face right.

Computer tracings shall be accepted provided that they represent the most important anatomical structures and their size is the same as that of the X-ray.

The contours must have the following colours:

1. Pre-treatment - black

2. In progress - blue

3. Post-treatment - red

4. Retention/post-retention - green

- Cephalometric evaluations: the applicant may choose the variables, as long as they characterise the skeletal relationships in the sagittal and vertical planes, as well as the dental and soft tissue proportions.

- Photographs: printed on paper.

- Casts: they must show texture and reliable details.

- Identification: each item, including casts, tracings, X-rays and photographs, must contain the following information:

1. Case number or patient¿s name

2. Date of the record

3. patient's age at the time of the record

4. Stage of the treatment (indicated through letter and colour): "A" - initial records / "A-B" - progress during treatment / "B" - end of active treatment / "C" - final records, at least one year after the active treatment is concluded. "A" and "B" records are compulsory, all the rest are optional. Colour dots must be used to improve identification:

1. "A" records: black

2. "B" records: red

3. "C" records: green

For overlaying, Bjork's technique is recommended, although other published procedures shall be accepted. In the overlaying, the line and dot of the record must be written down (ex.: line S-N on dot S).

4 - Presentation structure

Page 0-1 Table of contents

A - Pre-treatment (compulsory)

A-1 Clinical history and general background

A-2 Facial photographs

A-3 Intraoral photographs

A-4 Intraoral X-rays / panoramic X-rays

A-5 Cephalogram

A-6 Tracing A (black)

A-7 Cephalometric analysis

A-8 Comment on: X-rays, casts and cephalometric analysis

A-9 Aetiology, diagnosis, treatment schedule

A-10 Case progress

B - End of the active treatment (compulsory)

B-1 Facial photographs

B-2 Intraoral photographs

B-3 Intraoral X-rays / panoramic X-rays (not required if included in C)

B-4 Lateral cephalogram

B-5 Tracing B (red)

B-6 Drawing of the general overlaying A-5 and B-4

B-7 Drawing of the maxillary and mandibular overlaying A-5 and B-4

B-8 Cephalometric analysis. Comment on cephalometric changes

B-9 Post-treatment results

B-10 Post-treatment evaluation, retention

C - Retention / Post-retention (optional)

C-1 Facial photographs

C-2 Intraoral photographs

C-3 Intraoral X-rays / panoramic X-rays (not required if included in B)

C-4 Lateral cephalogram

C-5 Tracing C (green)

C-6 Drawing of the general overlaying B-4 and C-4

C-7 Drawing of the maxillary and mandibular overlaying B-4 and C-4

C-8 Cephalometric analysis

C-9 Results of retention / post-retention

C-10 Evaluation of retention / post-retention and prognosis

5 - Example - still in progress