Pre-Clinical Course 323 RDS
323 RDS- Pre-Clinical Endodontics
COURSE DESCRIPTION AND OBJECTIVE
Course Director:
Dr. Sumayah Basudan
2013-2014
I. Course Description:
The scope of the course includes preparing the third year students to understand, recognize, diagnose and successfully treat pulpally involved or potentially involved teeth. Important fundamentals are stressed with emphasis on the correlation between basic clinical and biological principles.
II. The Course Components:
The course has a lecture series, and laboratory exercises to perform endodontic treatment on mounted extracted teeth.
III.Concepts & Skills:
1. Prepare the student to demonstrate a mastery of the morphology of the pulpal spaces.
2. Prepare the student to demonstrate the ability to state the theoretical and biological principles of every endodontic clinical procedure.
3. Prepare the student to demonstrate a mastery of performing the basic and the fundamental operative procedures in the field of endodontics.
4. Prepare the student to demonstrate a mastery of the dental materials and instruments used in endodontics.
5. Prepare the student to demonstrate the mastery of recognizing the different levels of sophistication and complexity of endodontic cases that his patients present.
6. Prepare the student to be able to evaluate his own clinical competency and know the extent of his diagnosis, treatment planning and operative capabilities. Therefore, he will not be hesitant in seeking the counsel of specialist on a colleague.
VI.COURSE REQUIREMENTS:
1.Students must attend all the lectures and lab sessions. Absences will be reported to the administration when it reaches 25% or above.
The lecture starts at 8:00 AM. The lab session starts at 9:00 AM. and should be finished at 11:30 AM Those who come 10 min after 8:00 AM may not be allowed in the lecture hall. The lab session will begin immediately after the lecture. The attendance sheet will be passed around for the first 10 minutes of the lecture and the laboratory.
2. Freshly extracted teeth will be used in this course.
a. The teeth must be clean, free of debris and preferably have sound crown or with minimum caries destruction.
b. The pulp chamber and canals must be accessible as confirmed by radiographs (teeth with immature apices, with calcified canals, with severely curved canals, with previous root canal treatment, with external or internal root resorption, or with too short or too long root should not be used).
c. The selected teeth should be stored in a jar containing 0.9% physiological saline until mounted.
d. All the required teeth (3 anteriors, 2 premolars and 4 molars) must be mounted in acrylic using rubber mould.
e. Additional teeth (3 anteriors, 2 premolars, 3 molars) with inappropriate root morphology (as confirmed by radiographs) should be mounted separately on a plaster of Paris block for access opening exercises and practical assessment.
f. Between the practical sessions, the mounted teeth should be covered with gauze pads soaked with saline solution and kept in a sealed container to ensure 100% humidity and prevent tooth crack during instrumentation and obturation.
3. At the end of the first half of the course, the student must finish:
a. Access openings on one anterior teeth and one premolar.
b. Root canal therapy on three anterior teeth
c. Root canal therapy on two premolars (including one with two canals) teeth
d. The third anterior tooth should be saved for midterm practical exam.
e. Instruments spotting exam will be carried out as the first laboratory assessment
4. At the end of the second half of the course, the student must finish:
a. Access openings on two molars (one maxillary and one mandibular).
b. Root canal therapy on three molar (upper and lower) teeth
c. Retreatment, and Ca(OH)2 application on previously obturated canal.
d. Post space preparation on one previously obturated canal.
e. Three teeth (an anterior, premolar, and molar) should be saved for the second laboratory assessment.
f. The fourth molar should be saved for final practical exam (upper or
V. READING TEXTBOOK:
Endodontics, 6th Ed. J. I. Ingle and L. K. Backland, 2010.
VI. COURSE ASSESSMENT
I. Practical 50%
a. Daily work (12 projects) - 30%
b. Practical assessments (2) - 5%
c. Practical midterm (1) - 5%
d. Final practical - 10%
II. Written (didactic) 50%
a. Quizzes - 5%
b. Oral Exam - 5%
c. Midterm 10%
d. Final exam - 30%
CONTENTS OF THE LECTURES
1. Introductions and Case Selection
- Introduction to the course and the requirements.
- An overview of endodontic therapy
- Endodontic case presentation
- Indications for root canal therapy
- Contraindications for root canal therapy
2. Endodontic Instruments and Standard Isolation
- Hand instruments
- Rotary instruments
- Isolation (principles and rationale)
- Rubber dam materials (armamentarium)
3. Endodontic Access Opening
- Morphology of anterior, premolar and molar teeth
- Principles of endodontic cavity preparation
4. Root Canal Preparation
- Principles
- Radicular cavity preparation
- Instruments and methods for radicular cleaning and shaping
- Determination of the tooth length
- Step-back technique
5. Root Canal Filling materials and Obturation
- Importance of obturation
- Characteristics of an ideal root canal filling materials
- Extension of root canal filling
- Lateral Condensation technique
6. Endodontic Radiography and Local Anesthesia
- Importance of radiographs
- Vertical and horizontal angulation (buccal object rule)
- Infiltration and block anesthesia
- PDL injection
- Intra pulpal anesthesia
- Intra osseous anesthesia
7. Endodontic Mishap
- Access related mishaps
- Instrumentation related mishaps
- Obturation related mishaps
- Miscellaneous and irrigant-related mishaps
8. Histology and Physiology of the Pulp
- Function
- Development and anatomy
- Histology
- Age changes
- Pulp response to inflammation
- Pulpodental physiology
9. Pulpal Diseases
- Hypremia
- Reversible pulpitis
- Irreversible pulpitis
- Internal resorption
- Chronic hyperplastic pulpitis
- Necrotic pulp
10. Periradicular Diseases
- Periradicular lesions of pulpal origin (endodontic origin)
- Non-endodontic periradicular lesions
- Differential diagnosis
11. Microbiology and Immunology
- Role of bacteria in pulpal and periradicular diseases
- Pathways of pulpal and periradicular infections
- Flora of the root canal and periradicular lesions
- Methods of control of root canal infection
- Taking culture
12. Intracanal Medication
- Antibacterial agents
- Mode of action
- Irrigation and chelation
- Calcium hydroxide
13. Pulpal Reaction to Caries and Dental Procedures
- Relationship between pulp and dentin
- Pulpal reactions to dentinal caries
- Effect of various restorative procedures on the pulp
- Effect of local anesthesia on the pulp
- Postoperative sensitivity and preventive measures
14. Endodontic Diagnostic procedure
- Patient history (chief complaint, present dental illness and medical history)
- Clinical examination (vital signs, extra and intra-oral examination, clinical tests and periodontal evaluation)
- Radiographic examination (interpretation, root anatomy, conditions inside and outside the tooth, and importance of radiograph in diagnosis)