8. Location if not on main campus: College of Dentistry
1. Summary of the main learning outcomes for students enrolled in the course.
The overall goal of this course is to deliver the knowledge and skills required to successfully perform endodontic therapy in general practice. Dental students will be exposed to a variety of common endodontic case types, which may include endodontic emergency cases as well as traumatic injuries if there are available. The clinical skills are continuation of the technical skills introduced in RDS 412 with emphasis in increasing clinical proficiency under faculty supervision. In addition, students will be able to recognize the degree of complexity in endodontic cases and subsequently, communicate with faculty members and endodontic residents.
2. Briefly describe any plans for developing and improving the course that are being implemented. (eg increased use of IT or web based reference material, changes in content as a result of new research in the field):
Introduction of Case presentations where in the students are expected to present their cases at the end of each semester. The presentation of cases in each semester will be considered as one of the components of continuous assessment.
Students will perform endodontic therapy using rotary instruments as a requirement.
Self-evaluation has been introduced where student will evaluate his own work before an instructor can evaluate him.
C. Course Description (Note: General description in the form to be used for the Bulletin or Handbook should be attached)
1 Topics to be Covered (First Semester)
List of Topics
Contact hours Lectures and clinics.
Introduction/Biomechanical Basis for Endodontic Instrumentation and Obturation Techniques.
(iii) Methods of assessment of students psychomotor skills
Continuous assessment of clinical cases completed by the student as part of requirements.
Practical examinations include two clinical cases treated by the student.
5. Schedule of Assessment Tasks for Students During the Semester
Assessment task (eg. essay, test, group project, examination etc.)
Proportion of Final Assessment
1st Midterm written examination
2nd Midterm written examination
Submission of logbooks for evaluation
Final written examination
Midterm Exams and Final Written Exam:
The details of the exams will be given to the students at least two weeks prior to the commencement of the exam. The choice of questions i.e MCQ’s / Short Notes is at the discretion of the Course Director and the Faculty taking the lectures.
Each student is expected to complete 10 clinical cases (RCTs) by the end of the year.
Number of cases to be completed during first semester:
Number of cases to be completed during the second semester:
• Two Maxillary Premolars with two canals.
• Three Maxillary/Mandibular Molars
Finishing the clinical requirements is mandatory for passing this course.
*Student Case Presentation Evaluation Form
Response to Questions
Criteria for evaluation:
Clarity of voice &Confidence
Interaction with audience
Effective use of visual aids
Structure and organization
Student Case Presentation
Each student has to present any 3 cases, out of the 10 cases he has completed during the course. First case presentation will take place towards the end of First Semester where all students will present one of their completed cases.
Second case presentation will take place towards the end of Second Semester where student will present two of their completed cases. Cases should include one maxillary premolar with two canals and one maxillary/mandibular molar and must include hand and rotary instrumentation.
The presentation should follow the following sequence
1. Chief complaint
2. Brief History [Medical, Dental & history of present condition]
If the student has encountered any mishaps/accidents, procedural errors, he should be prepared with the reasons for the problem, methods with which he could avoid these mistakes, steps he has taken to overcome these problems and the effect of the mistakes on the prognosis of the restorability / longevity of the tooth.
Students should present all the radiographs and clinical pictures if in case of an abscess or sinus [including the radiograph for tracing the sinus]
Each student will be allocated no more than 8 mins for each presentation.
D. Student Support
1. Arrangements for availability of teaching staff for individual student consultations and academic advice. (include amount of time teaching staff are expected to be available each week)
Students were encouraged to ask anything they didn’t understand during Clinical sessions / lectures. Each staff member involved in the course had dedicated office hours (4 hours/ week) during which students can consult him.
E. Learning Resources
1. Required Text(s)
Endodontics: Principles and Practice. Mahmoud Torabinejad, Richard E. Walton 4th Edition. Elsevier Health Sciences, 2009.
Orientation by department chairman or senior staff member.
Group discussions amongst the faculty.
4. Processes for Verifying Standards of Student Achievement (eg. check marking by an independent member teaching staff of a sample of student work, periodic exchange and remarking of tests or a sample of assignments with staff at another institution)
External course review is not available.
Students have access to course director and other instructors to discuss their performance in any given assessment.
Written examinations validity and questions difficulty levels are analyzed and discussed by course instructors.
Multiple faculty members are involved in the evaluation of clinical procedures and case presentations performed by each student.
5. Describe the planning arrangements for periodically reviewing course effectiveness and planning for improvement.
Identifying academically-challenged students as early as possible in order to provide necessary support and report them to academic advisor according to Academic Performance Policy.
Departmental/specialty staff discussions to review students’ performance.
H. Lecture Schedule, Topics, and Assigned Presenters
Introduction/Biomechanical Basis for Endodontic Instrumentation and Obturation Techniques
Endodontic Clinical Diagnostic Procedures
Vital Pulp Therapy
Endodontic Pain and Emergency
Restoration of Root Canal Treated Teeth
Rotary Files in Endodontics
Evaluation of Endodontic Treatment Outcome and the Role of Modern Technologies in Endodontics
Recognize the role and importance of diagnosis in endodontics.
Recognize that diagnosis of pulpal and periradicular conditions as part of a broader examination and treatment plan.
Identify and explain the importance of medical and dental history and findings to endodontic diagnosis.
Communicate effectively with patients and ask the right questions regarding the history and symptoms of the present complaint.
Conduct extra- and intra-oral examination.
Apply and interpret pulpal responses to different testing methods and document them in data collection sheet.
Identify limitation of vitality tests.
Interpret radiographic findings and synthesis them with other diagnostic information to enable appropriate differential diagnosis.
Identify the endodontic emergencies and integrate their treatment into treatment plan
Identify problems that require treatment modifications (periodontal problems, abnormal root canal system anatomy, restricted mouth opening, isolation difficulties, restorability).
Identify modern diagnostic tools in endodontics.
LECTURE 3: VITAL PULP THERAPY
Describe the cellular components involved in the healing process of the pulp.
Describe the different types of pulpal irritants and their relative clinical significance.
Explain the response of pulp tissues to common biological, chemical, and thermal irritants.
List precautions necessary to maintain pulp vitality during dental procedures.
List clinical factors affecting prognosis of different vital pulp treatment.
Explain different types of vital pulp therapy procedures and their indications/contraindications. (Direct pulp capping, Pulpotomy, Open Apex Apexogenesis, Apexification, Tissue Regeneration).
Recognize the impact of modern regenerative endodontic advances on vital pulp therapy procedures.
LECTURE 4: ENDODONTIC PAIN AND EMERGENCY
Describe the anatomical and functional aspect of dental pulp nerve tissues.
Identify the classification of nerve fibers.
Discuss the approach toward establishing differential diagnoses of endodontic and orofacial pain, and that of non-endodontic in origin.
Explain the mechanism of pulpal pain.
List the common pulpal and periapical endodontic emergencies. And describe their clinical and/or pharmacological management.
Recognize the differences between emergency and urgency.
Define endodontic flare-up.
Identify patients who are greater risk for experiencing pain after endodontic procedures.
Describe the systematical approach to emergency conditions [establish diagnosis and etiologic factors, design emergency treatment plan and then long-term treatment plan].
Explain post-emergency endodontic assessment.
LECTURE 5: ENDODONTIC MISHAPS
Identify the complexity and difficulty of specific cases that may lead to procedural accidents.
Identify the differences between treatment complications and procedure errors.
Recognize the following procedural accidents:
Anesthesia accidents. Such as needle fracture, intravascular injection.
Access-related-mishaps. Such as furcal perforation.
Instrumentation mishaps. Such as canal blockage, ledges, instruments fracture, zipping, canal transportation and root canal perforation).
Root canal filling mishaps. Such as overfilling, over extension, under filling, and sealer extrusion.
Irrigant-related mishaps. Such as Sodium hypochlorite accident, allergies, and spills.
Vertical root fracture.
Restorative procedures mishaps.
List the causes, prevention and management of endodontic mishaps.
Describe the impact of mishaps on the prognosis of root canal treatment.
Recognize the importance of consultation and identify cases that need referral.
LECTURE 6: PERIODONTAL AND ENDODONTIC INTERRELATIONSHIP
Recognize the anatomic communication between the dental pulp and the periodontal tissues.
Describe the effect of dental pulp diseases and root canal treatment procedures on the periodontium.
Describe the effect of periodontal diseases and therapeutic procedures on the dental pulp.
List and explain the etiologic factors associated with endodontic-periodontal diseases.
Identify the classification of endodontic-periodontal diseases and their differential diagnosis.
Discuss treatment plan sequence, requirements and predict prognosis of endo-perio diseases.
LECTURE 7: TRAUMATIC INJURIES
Describe (clinical and radiographic features) the World Health Organization classification of dental traumatic injuries (Enamel fractures, Crown fracture with and without pulp involvement, Crown-root fracture, Root fracture, Tooth avulsion, Tooth luxation, Extrusion and Intrusion, Alveolar fracture).
List possible short and long-term responses of dental pulp, dental hard tissues, and periradicular tissues to the various traumatic injuries
List patient information needed during examination of injuries (health history, nature of injury, and symptoms) and necessary diagnostic tests/ procedures.
Describe appropriate short and long-term treatment strategies for type of injuries.
Recognize outcomes of traumatic injuries.
Describe the differences in treatment strategies and management considerations for traumatic injuries in primary and permanent dentition.
Describe the clinical steps of rigid and non-rigid splinting techniques.
LECTURE 8: RESTORATION OF ROOT CANAL TREATED TEETH
Discuss effect of root canal treatment on teeth and the importance of remaining hard dental tissues.
Describe the main predictors for survival of endodontically treated teeth.
Explain the impact of the coronal seal on long-term success and how to achieve it.
Outline postoperative risks for the non-restored endodontically treated tooth.
Discuss timing of the restoration, temporary restoration and the rational for immediate permanent restoration.
Identify the importance of identification of restorative options before commencing root canal treatment.
Discuss advantages and disadvantages of different restorations.
List common intra-canal post and systems.
List commonly used core materials.
Explain the importance of the ferrule for the success of extracoronal restoration.
Describe techniques for restoring an access opening.
LECTURE 9: ROTARY FILES ENDODONTICS
Discuss the advantages and disadvantages of NiTi endodontic files.
Identify the nomenclatures encountered in rotary instrument designs. Such as flute, radial land, rake angle, maximum flute diameter, torque, and reciprocation.
List different types of commonly used rotary file systems.
Explain the important clinical steps considered during Cleaning and shaping methods using rotary instruments.
Identify single file systems.
LECTURE 10: ENDODONTIC RETREATMENT
List and discuss the possible reasons for root canal treatment failure.
List the indications and contraindications for root canal retreatment.
Identify the root canal retreatment options and cases that need referral to a specialist.
Explain the benefits and risks of root canal retreatment options with the patient.
Describe the materials and techniques available for root canal retreatment.
Explain the potential complications, restorative options, follow-up care and the prognosis of root canal retreatment.
LECTURE 11: ENDODONTIC SURGERY
List the indications and contra-indications for surgical endodontics.
Explain the role of endodontic surgical procedure in the treatment plan.
Describe the pre-operative assessment process.
Describe the common surgical endodontic procedures. Such as incision for drainage, apical curettage, root-end resection, root-end preparation and filling, root amputation, hemisection, bicuspidization and Intentional replantation.
List the main steps involved in endodontic surgeries.
Identify key instruments used in different endodontic surgeries.
List the principles and rationales for flap design and suturing selection.
List and explain the required properties of root-end filling material
List the post-operative instructions and discuss the importance of follow-up examination.
List regenerative procedures and recognize their impact on endodontic surgeries.
List prognosis of endodontics surgeries and influencing factors.
Recognize conditions for referral.
LECTURE 12: EVALUATION OF ENDODONTIC TREATMENT OUTCOME AND