College of Diplomates Manual For Candidates for Certification as a



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Appeal Process for an Adverse Decision


A candidate who has received an adverse decision on the Case History Examination has the right to seek reconsideration of the adverse decision by filing a timely written request for reconsideration with the Secretary of the Board.

To be valid, the Secretary of the Board must receive the request for reconsideration within 30 calendar days after receipt by the Candidate of notice of the adverse decision. The request must contain a statement of why the Candidate believes that the adverse decision was improper and must include any supporting documentation that the Candidate wishes to have considered as part of the reconsideration. The request must be accompanied by a check or money order made payable to the American Board of Endodontics in the amount of $100 to cover administrative costs associated with the appeal process. This fee shall not be refunded, regardless of the outcome of the appeal.








American Board of Endodontics


211 East Chicago Ave, Ste 1100 Chicago, IL 60611-2691

Phone: 312/266-7310 Fax: 312/266-9982


E-Mail: abe@aae.org

Candidate Pledge

I,_________________________, certify that the cases submitted in



Please print full name
this portfolio are those that I have treated/managed during my practice of
endodontics. No case submitted herein is that of another dentist or
endodontist.


_______________________________

Signature___
___________________________________________

Date





Pet Peeves – Case History Examination - ABE Diplomate Newsletter


The following list is in order of the most frequently listed peeves by the Directors, the most frequent to the least frequent. Some members of the Board felt compelled to list more than three.

  • Poor quality radiographs. Films that are too dark, too light, not clear, digitals that are too small are just a few deficiencies.

  • Insufficient radiographs (no angled views, working length measurements, cone fits, etc.).

  • Radiographs that don’t show: 1) the entire periradicular lesion, 2) what is described in the narrative, or 3) all of the canals and their apical terminations.

  • Incorrect diagnostic terminology. You should use only the terms found in the AAE glossary.

  • Too much unnecessary information. The Board is not interested in what clamp you used to retain the rubber dam (just that a dam was used) or what bur was used to open an access.

  • Not enough necessary information; follow-ups, medication dosages and uses, how calcium hydroxide (if used) is prepared, just to name a few.

  • In the medical history, vital signs, pulse pressure, pulse respiration (and temperature if a patient has an infection) are required.

  • Pages and pages of introductory material. Keep the introduction short. Keep technique description short. List important abbreviations. Do not write War and Peace!

  • Spelling errors! The Case History Evaluation Form does not provide “spell check”. An alternative solution is to type your report in a word document and then copy the text and paste into the appropriate section in form. Please remember that “spell check” is a great tool, but it is the responsibility of the writer to present an error free report. Please proof read your report for content and then reproof your report strictly for spelling errors.

  • Failing to include in the narrative that a follow-up was done that night or the next day on your emergency patient or the patient that had pain on their initial visit.

  • Several complaints about the case category called “OTHER”: 1) make sure the case in this category is specialist caliber and 2) explain what the “other” is, i.e. “OTHER-APEXOGENESIS”, or “OTHER-PERF REPAIR”. Reviewers don’t like to guess what the case is all about.

  • Radiographs placed in the wrong order in the radiographic mounts.

  • Dates on the radiographic mounts that are illegible or hard to see on the mounts. Entries written with a pencil are not legible; therefore please use a white label. Using a label maker or printing out the information on a label (and then trimming to fit the space) makes the radiographic presentation legible.

  • Reading extensive pulp testing and diagnostic narrative when a simple chart would do.

  • Recall appointments that fall on a Sunday or Holiday. Check those dates!

  • The Directors spend considerable time evaluating each portfolio. The candidates put in a great deal of time putting them together. Rushing to meet a deadline will often lead to technical errors, such as failure to date radiographs or using the incorrect tooth number for a case. These technical errors reduce the score of the portfolio and are easy to avoid simply by using the check list that is supplied. One of the Directors said it best, “My biggest pet-peeve? I really don’t like to give unacceptable scores!” A sentiment shared by all of the Directors!

The most recent circulation of the Case History Portfolios (October 2006) yielded some unexpected results. After enjoying 88% - 95% pass rates, we were disappointed that the October 2006 circulation resulted in a pass rate of 81%. It is time for another Pet Peeves column to help those of you that are in the process of preparing your portfolio for resubmission and for all of you that are preparing your notebook for the first time. Our goals are exactly the same, you want to submit a passing Portfolio and we want to review a passing Portfolio.

Submitting a successful Portfolio requires no additional time in preparation, it simply requires understanding and following the instructions contained in Case History Portfolio Submission Guidelines. Additional copies of the guidelines are available on the ABE CD-ROM, the ABE Web-site or can be emailed as a PDF document by request at abe@aae.org.

As was done in the first Pet Peeves article in 2004 (available on the 2007 CD-ROM and ABE Web-site), the directors who evaluate portfolios were asked to send me a list of items that they considered detrimental to a passing evaluation of the portfolio. What follows is a general list comprised of the contributions of each director. There is a disturbing similarity between this list and the one published in The Diplomate in 2004 indicating that Candidates are not utilizing the full scope of help that is available to them.

Back by popular demand is this Peeve; not enough radiographic documentation. As Dr. Schindler points out, “Even though the requirements do not absolutely require more than a pre-, post- and recall radiograph, some working radiographs would really strengthen the case, especially in multiple canals in a single root….” Taking multiple views for preoperative films is text book stuff. If you took them, include them. Post-obturation and recalls radiographs must clearly show the apical termination of each canal. Here are some bulleted points from the previous article:



  • Poor quality radiographs. Films that are too dark, too light, not clear, digitals that are too small are just a few examples.

  • Lack of enough radiographs (no angled views, wire measurements, cone fits etc.).

  • Radiographs that don’t show: 1) the entire periradicular lesion if present, 2) what is described in the narrative, or 3) all of the canals and their apical terminations.

Another returnee from the 2004 Pet Peeves article concerns diagnostic terminology. The Board, for consistency sake, would prefer that Candidates use the accepted terminology found the AAE’s 2003 publication of the Glossary of Endodontic Terms. As Dr. Fouad states, “There also seemed to be significant confusion with the use of some diagnostic categories such as chronic periradicular abscess, or using older terms like suppurative apical periodontitis or Phoenix abscess.” Wrong or inappropriate terminology gives the impression that the Candidate may have misdiagnosed the case. Make sure your diagnosis fits the facts of the case! A wrong diagnosis is a fatal error.


A troubling trend in the latest portfolio circulation was seen in diagnostic procedures. You must include diagnostic data on all teeth in the affected quadrant or side, where appropriate. Pulp testing only the tooth to be treated is not acceptable. The same is true of radiographic evaluation. When describing the radiograph, include what is seen in the entire radiograph, not just the tooth in question. And don’t forget to mention the extra-oral exam.
The medical history is a must, along with vital signs. Vital signs should include blood pressure, pulse, heart rate and temperature if swelling is present. This omission is another fatal error. A review of systems should be included. The medical history must be thorough. Make sure medications are listed, their dosages, and why the patient in taking them.
Here is a laundry list of other portfolio conditions, omissions and errors that the Board finds disturbing:


  • Too much unnecessary information. The board is not interested in what clamp you used to retain the rubber dam (just that a dam was used) or what burr was used to open an access, files used to cleans and shape, etc.

  • Not enough necessary information; biopsy reports, how calcium hydroxide (if used) is prepared, just to name a few.

  • Prescribing antibiotics when there is no indication for administration.

  • Pages and pages of introductory material. Keep the introduction short. Keep technique description short. List important abbreviations. Do not write War and Peace!

  • Spelling errors! Please, use the spell check before cutting and pasting into the Case History Portfolio forms!

  • Failing to include in the narrative that a follow-up was done that night or the next day on your emergency patient or the patient that had pain on their initial visit.

  • Several complaints about the case category called “OTHER”: 1) make sure the cases in this category are of specialist caliber, 2) make sure all three are different, and 3) explain what the “other” is, i.e. “OTHER-APEXGENESIS”, or “OTHER-PERF REPAIR”. Reviewers don’t like to guess what the case is all about. (Please contact Margie at 312/266-7310 or abe@aae.org for the updated Case History Report form that includes the section OTHER subcategory       within the form.

  • Radiographs in the wrong slots in the radiographic mounts (radiographs must be placed in the order of sequence they were taken).

  • Dates on the radiographic mounts that are illegible or hard to see on the mounts. Pencil does not show up, therefore don’t use it!

  • Writing an extensive pulp testing and diagnostic narrative when a simple chart would do.

  • Recall appointments that fell on a Sunday or Holiday. Check those dates! If the appointment was held on a Sunday or Holiday explain that in the narrative.

  • Inappropriate dosages of anesthetics

The secretary of the Board, Dr. Carl Newton, does the scheduling of the Portfolio circulation and has this advice about the timelines of submitting your portfolios: “Firstly - waiting until the last minute to meet the deadline results in very avoidable errors...  Don't wait until the last minute to prepare it or send it in.

 

The old adage, “There is only one chance to make an initial impression”, is very true when it comes to your Portfolios. Make sure the first two or three case histories in your portfolio are perfect. Set the example for the rest of the Portfolio. All of the requirements for the Case History Portfolios are in the packets of information that Margie Hannen sends out to all Candidates. But keep in mind that for the most part they are MINIMUM requirements. To paraphrase Harvey C. Fruehauf, go the extra mile with your preparations and they will pay off in the end.




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