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This is mainly a clinical course in advanced oral surgery which is
designed to get the dental student to carry out more complicated minor oral
surgical procedures under local anesthesia. Cases such as retained roots,
impacted teeth, alveoloplasty, and management of orofacial infections are given
to the student to treat under faculty supervision.
Students are also introduced to hospital rules and protocol, which
include medical records, doctor’s orders, progress notes, laboratory and
radiographical results, temperature/pressure/respiration graphics, operation
notes and discharge summary.
The second semester includes a series of formal
lectures that covers topics in major oral and maxillofacial surgery which were
not adequately covered during previous oral surgery courses.
assessment and examination with a scientific identification of the surgical
sequence of surgical care in the overall treatment plan
recognize when it is appropriate to refer patients to a specialist.
learn how to interpret the results of the physical evaluation and understand the
findings that will alter and influence treatment
findings, diagnosis, and treatment plan options with the patient and to obtain
informed consent to carry the treatment.
patients' pain and anxiety through the use of local anesthesia and other
confidence, respect, and trust in the patient-care relationship
management of complications resulting from minor surgical procedures with
appropriate patient follow up.
prescriptions and understanding the use of prescription drugs in the practice of
minor oral surgery.
10- Student can
perform the following procedures: uncomplicated extraction of single or
multi-rooted, non-impacted teeth; uncomplicated removal of fractured or residual
root tips; uncomplicated pre-prosthetic surgery; uncomplicated biopsy of soft
tissues; management of uncomplicated infections of dental origin; and assessment
and management of impacted teeth under a close supervision.
11- The student
should by the end of the course be able to carry out routine minor oral surgical
procedures which include flap designs, cutting of alveolar bone by the use of
surgical burs and bone files. He should also be familiar with suturing
techniques, suture materials and needles.
12- The student
will have a clear idea about in patient oral and maxillofacial surgery patient,
through weekly visits to the hospitals. Special emphasis is put on facial
trauma, orthognathic surgery cases and management of benign and malignant
Hospital based surgery and review of applied anatomy
Management of medically compromised patients
Medical emergencies in dental clinic
Medications and prescription
Sedation in surgery
Surgical management of bone pathology
Management of facial trauma
Orthognathic surgery 
Orthognathic surgery 
Surgical management of cleft lip and palate
Salivary glands surgery
The 411 MDS male students at the DUC are divided
in to four groups. Each group (around 14 students) has its own clinical session.
Female students at the MUC have only one clinical session. These groups will
have their clinical sessions and the visits to the hospitals in their allocated
clinical sessions alternately. The female students are divided into four groups
depending on the number registered for the course. One group visits the Riyadh
Central Hospital or KKUH once a week accompanied by a senior faculty member of
the division of oral and maxillofacial surgery. The rest of the students –
meanwhile – will carry out advanced minor oral surgical procedures at the
College of Dentistry supervised by members of the division of oral and
maxillofacial surgery. Students cases are recorded on a log book and
countersigned by an attending faculty. The groups of students will alternate
visiting the hospital according to pre-arranged schedule.
Students attending the hospital sessions will be instructed in the following:
Hospital admission polices
Clerking of patients
Routine and special hospital
Communication with other
specialties and referrals
Pre surgical patients
draping in the OR
Pre operative medications
Insulin sliding scale
Principles inside the OR
Writing operation reports and
post operative medications
Dealing with complications
Policies of the
surgical intensive care unit
Follow up of the patient in
Continuous patient follow up
Lecture topics in details
During the second semester a series of formal
lectures will be given to students. The topics are as follows:
1. Hospital based surgery and review of
Type of cases treated in hospital, admission,
drugs, and consultations, laboratory tests normal and abnormal values. Doctors
orders, Informed consent. The lecture includes a quick review of the major nerve
and blood supply to the head and neck as they are very important in
understanding the surgical procedures.
2. Management of medically compromised
Review of how to mange patients with different
diseases which can affect the surgical procedures performed on this patient.
Examples include patients with diabetes mellitus, hypertension, thyroid
disorders, and pregnant woman. Methods to
prevent complications in those cases.
3. Medications and prescription:
Different drugs used by dentists. Antibiotics
and analgesics, side effects, allergic reaction and anaphylactic shock
4. Sedation in oral and maxillofacial
Anxiety and apprehension, Nitrons
oxide and relative analgesia, I.V.
sedation: advantages and risks. Medications used
in I.V. sedation.
5. Surgical management of bone pathology:
Different surgical procedures used in treating
bone pathology. For example how to manage fibrous dysplasia, tumors and cysts.
Emergencies at the dental clinic:
This includes prevention and management of
medical emergency that may happen in the dental office; cardiac arrest and
infarction, diabetic coma and hypoglycemia, thyroid crisis, status epilepticus
and status asthmaticus.
7. Pre-prosthetic surgery
Introduction and terminology: Alveoloplasty
[single tooth and multiple sites], removal of tori, other osseous procedures.
Soft tissue preparation, frenectomy, tuberosity reduction, surgery for immediate
denture. Vestibuloplasty, ridge augmentation, implants.
8. Dental implants
Principles of implantology. Patients
assessment. Systems available to dentists. Osteointegration.
9. Management of
An update on management of facial trauma which
will help the student in their hospital visits. This include the management of
mandibular fractures, midface fractures and other facial fractures
10-11. Orthognathic surgery
Diagnosis, planning, and surgical procedures to
correct different facial deformities. For example Le Fort osteotomies, sagittal
12. TMJ surgery
Anatomy of the TMJ, different surgical procedures
to treat ankylosis and dislocation. Conservative treatment versus surgical
13. Surgical management of cleft lip and palate:
Surgical procedures (flaps) to manage the cleft
lip and palate cases. Timing of surgery, effect on the growth. Team management.
Alveolar cleft grafting.
14. Salivary glands diseases:
Anatomy of salivary glands. Pathological
conditions affecting the glands. Diagnosis of diseases affecting salivary
glands. Treatment of: stones, mucoceles, ranulas, infections, neoplasms [benign
Didactic + clinical
Evaluation and Grading:
Topic review/update report (5 marks)
End of term exam (hospital based teaching) (10 marks)
Midterm written exam (15 marks)
Final written exam (40 marks)
Final clinical/viva (30 marks)
Textbook of General and Oral Surgery
By Wray, Lee, Clark, and Stenhouse (2003).
Contemporary Oral and Maxillofacial Surgery
By Peterson, Ellis, Hupp, Tucker; 4