Dental school university of maryland, baltimore, maryland



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BALTIMORE COLLEGE OF DENTAL SURGERY

DENTAL SCHOOL

UNIVERSITY OF MARYLAND, BALTIMORE

BALTIMORE, MARYLAND
PROSTHODONTIC RESIDENCY

PROGRAM

2015-2016

I. INTRODUCTION


INTRODUCTION
The purpose of this manual is to give the resident a general overview of the residency program. The information was current when printed but may not totally reflect the day to day resident activities due to time constraints and scheduling difficulties.
A tremendous amount of knowledge in all aspects of prosthodontics must be acquired in the span of three years. The educational program requires complete dedication of all participants. A strong desire to learn and excel is essential for success.
PURPOSE OF THE PROGRAM
The purpose of the Prosthodontic residency program is to provide progressive clinical, laboratory and didactic training, closely supervised, at the post-graduate level in fixed, removable, and implant prosthodontics. Temporomandibular dysfunction, maxillofacial prosthodontics, implant placement, the interrelation of other medical/dental clinical specialties as well as the role of the prosthodontist is also included. The program integrates all facets of the biomedical sciences with a comprehensive clinical experience culminating in the award of the certificate in prosthodontics. A Master of Science is also available.
PROGRAM GOALS AND OBJECTIVES
The Prosthodontic Residency Program has the following goals and objectives:
1. Preparation of knowledgeable and skilled prosthodontic clinicians.
2. Preparation and qualification of prosthodontists for certification by the American Board of Prosthodontics.
3. All residents will engage in research activities.
4. Preparation of prosthodontists qualified to serve as mentors in academic programs.
SCOPE OF TRAINING
Training will include all clinical and laboratory phases of prosthodontic practice to include implant placement. The resident will be exposed to a broad range of techniques used in fixed, removable, implant and maxillofacial prosthodontics, thus gaining the background and experience necessary to select those techniques which work best in their hands, and to instruct others in their use. New and improved materials will be evaluated as they are introduced to the profession.


II. GENERAL

MASTER OF SCIENCE

The Master of Science is especially designed for the residents enrolled in a clinical specialty program. The program will prepare the dentists for careers in dental education and research. Courses are comprised of both lecture and laboratory formats. A significant portion of the program is devoted to the design and completion of a thesis research project, which is a requirement of the program. A separate application to the Graduate School is required for admission into this program.



PERIOD OF TRAINING
The period of training is three years of not less than 48 weeks each year.
SELECTION PROCESS
Residents are selected with no pre-determined quotas or bias to gender, religious affiliation, or ethnicity. Selection is based on a composite of dental school grades, grades on national tests, interviews and personal attributes. Applicants apply through the PASS program and are screened by the Prosthodontic Residency Screening committee, consisting of the Program Director and two Residency Prosthodontic faculty members. These three individuals reviewed records independently and a candidate is offered an interview if two out of the three members recommend it. Candidates are notified of the available interview dates. An interview day consists of tours of the facilities, meeting with faculty and current residents, clinical observation and lunch. At the conclusion of the interviews, the Program Director, faculty members and current residents discuss each candidate and a ranking is developed. Once the positions are filled, the Program Director notifies all remaining candidates of the decisions made. Those who were highly desirable but were unable to be offered a position immediately, due to limited positions, are offered a spot on the waiting list, should an accepted candidate later decide that he/she wishes to withdraw their acceptance.
AUTHORIZED ABSENCES
Residents are allowed ten days off per school year for any reason: i.e. vacation, personal time, illness, medical or religious reasons. Requests for leave will be authorized, subject to approval by the Director of the Prosthodontic Residency, as long as there is minimum conflict with the training schedule. Any additional days, away from the program, will necessitate an additional period of time at the end of the three years. Residents are required to be present during all scheduled hours unless excused by the Program Director.
TRAINING SUPERVISION
The program was fully accredited by the American Dental Association and the Commission on Dental Accreditation in 2011. The Prosthodontic residents are under the direct supervision and guidance of the Director of the Program and trained prosthodontists. Resident progress is closely monitored and evaluated by oral and written methods. Resident/mentor counseling sessions allow for close communication between the resident and the program director.
ACADEMIC DUE POLICY PROCESS
Voluntary or involuntary withdrawal, probation or termination of residency status is governed by the rules of the Dental School. To avoid any misunderstandings concerning the consequences of unacceptable resident performance of behavior, each resident should be familiar with this policy below, prior to enrollment.
All matters of professional ethics and conduct that involve ADE students will be referred to the Judicial Board of the Dental School for adjudication. The ethical and conduct standards for student enrolled in ADE programs are identical to the standards of conduct for students enrolled in the pre-doctoral and dental hygiene programs. Judicial Board matters are not governed by the policy contained in this document. An Advanced Dental Education student who believes he or she has been harassed on the basis of his/her sex shall be referred to the UMB Policy on Sexual Harassment of Students, VI-1.20(B).
I. Academic Standards
A. Students in ADE Programs are expected to maintain high levels of academic success. Academic dismissal from an ADE Program can result from failure to achieve a Program’s requirements or failure to meet minimal levels of academic achievement as they are defined in the Catalog of the Baltimore College of Dental Surgery. Clinical competence in all areas of patient management and treatment constitutes a vital sector of academic achievement. A student must maintain a B (3.0) or better overall average to remain in good standing. If the student’s performance falls below this level of performance he/she will be placed on academic probation during the following semester. In the event that the student’s overall average remains below a 3.0 at the end of the semester of probation, he/she will be dismissed from the Program. All failing and incomplete grades must be rectified before a certificate is conferred.
B. Faculty will provide feedback to students in all matters related to didactic and clinical performance. This feedback can be oral or written, but must be in writing, at appropriate intervals, as determined by each Program's accreditation standards noted under "Evaluation." Program directors will ensure that each ADE student receives a copy of the Program’s Accreditation Standards as part of the program orientation for new residents.
II. Unsatisfactory Performance
A. Unsatisfactory performance in knowledge, skills, clinical competence and/or patient management may be documented in several ways, and corrective actions or sanctions can range from oral or written counseling to dismissal from the Program. The process for such actions is as follows:

1. Initial notification of a deficiency/problem can be addressed orally by the program director or the faculty identifying the problem. After so doing, a dated notation will be placed in the student's file by the program director.

2. Should the problem continue, or new problems develop, the student will be sent a letter or counseling form by the program director, identifying the deficiency/deficiencies and required actions to be taken by the student to correct the deficiency/deficiencies. A time period for correcting the deficiency/deficiencies will be specified. A copy of the counseling form will be kept in the program or course director's file, and a copy will be sent to the Assistant Dean for Research and Graduate Studies. The student should acknowledge receipt of the letter or counseling form by signing the original and returning it to the program director. The letter or counseling form will be placed in the student's file. The student should keep the copy for future reference.
3. Should student performance still not improve, the program director, or program’s designate acting in (his/her)stead, will notify the student in writing that he/she will be placed on academic probation. Actions required of the student and a time line (not exceeding those of academic probation noted above) to correct the deficiency/deficiencies will be detailed in the letter. The student must sign the letter, keep a copy for his/her files and return the original letter to the program director, who will place the letter in the student's file. Copies will be sent to the department chair and the Assistant Dean for Research and Graduate Studies.
4. If the student fails to rectify the deficiency/deficiencies in the time specified, the program director, in consultation with the program faculty, will recommend dismissal from the program to the department chair, the Assistant Dean for Research and Graduate Studies, and the Advanced Dental Graduate Education (ADGE) Committee. The ADGE Committee will review the recommendation for dismissal.
III. Review

A. The student will be given the opportunity to be heard by the ADGE Committee on the recommendation for dismissal by offering his/her own statements, and, if appropriate, testimony of witnesses and presentation of evidence. The ADGE Committee may choose to call for further testimony and documents. Hearsay evidence is admissible only if corroborated. Any irrelevant or unduly repetitive evidence will be excluded. If the student fails to appear for his/her hearing without good cause, he/she will be deemed to have waived his/her right to meet with the ADGE Committee.


B. Following its review and any subsequent meetings, the ADGE Committee will conduct its deliberation and make a decision on the basis of a majority vote. If the ADGE Committee determines that the student should be dismissed, the recommendation will be forwarded to the Dental School’s Faculty Council for action. In the case of dismissal decisions, the Assistant Dean for Research and Graduate Studies will notify the student in writing that s/he has been dismissed from the Program.


  1. The Assistant Dean for Research and Graduate Studies shall maintain the documentary evidence from the hearing for at least 4 years from the date of the hearing. The student may obtain a copy of the record upon paying the cost of reproduction.

IV. Appeals Process


A. In the event that the student elects to appeal the dismissal decision, the student may not take part in any academic or clinical activities of the program until and unless action on the appeal reverses the decision for dismissal.
B. If the student disputes the dismissal, he/she may contact the Program Director within five business days of notification of dismissal for informal discussion. Should the student remain dissatisfied, the student may file a formal appeal.
C. A student wishing to file a formal appeal of a dismissal decision must initiate the appeal process regarding dismissal from the Program within 10 business days of receiving the written notification. The appeal must be submitted in writing to the Assistant Dean for Research and Graduate Studies. The written appeal must include: the decision the student is appealing; the specific ground for the appeal (only newly discovered evidence or lack of due process); and the academic status that the student is requesting. The student may present and prioritize more than one alternative to dismissal from the Program.
D. The Assistant Dean for Research and Graduate Studies will review the appeal and designate a three person Appeals Panel. Faculty who have been substantially involved in this or any other decision or actions against the student prior to dismissal are excluded from the Panel. Where possible and practical, the Panel will consist of three members of the full-time faculty. The Assistant Dean for Research and Graduate Studies will appoint one of these three as Chairperson of the Appeals Panel.
E. The Chairperson will then schedule a meeting with the members of the Panel within 5 business days when possible or practical. The Panel will determine whether the student's written appeal meets the criteria outlined in C. and report their decision in writing to the Assistant Dean for Research and Graduate Studies. Should the Panel determine that an appeal lacks the required evidence, the appeal will be denied. In these circumstances, there is no further appeal.
F. If the Panel determines that newly discovered information, not originally considered by the ADGE Committee does exist, then the matter should be referred back to the ADGE Committee for reconsideration.
G. If the Panel determines that there was a failure of due process, an appeal on the record will be heard. The decision of this Panel will be final. The student and the Assistant Dean for Research and Graduate Studies will be notified of the decision in writing.

Approved by Dental School Faculty Council: April 8, 2003

Approved by University Counsel: June 19, 2003

Approved by Dean: November 27, 2016


JUDICIAL POLICY
The judicial policy is listed on the dental school’s website.
COMPLAINTS TO THE COMMISSION ON DENTAL ACCREDITATION
The Commission on Dental Accreditation will review complaints that relate to a program's compliance with the accreditation standards. The Commission is interested in the sustained quality and continued improvement of dental and dental related education programs but does not intervene on behalf of individuals or act as a court of appeal for individuals in matters of admission, appointment, promotion or dismissal of faculty, staff or students.
A copy of the appropriate accreditation standards and/or the Commission's policy and procedure for submission of complaints may be obtained by contacting the Commission at 211 East Chicago Avenue, Chicago, IL 60611-2678 or by calling 1-800-621-8099 extension 4653.

RECORDS AND REPORTS
The administrative responsibilities assigned to the resident are designed to enable them to gain the Competency necessary to manage a clinical practice or academic position upon completion of training. Each resident is required to prepare and submit daily records and reports to complete documentation of the program. Additional administrative responsibilities will also be delegated throughout the training.

LIBRARY FACILITIES
A state of art medical/dental library is maintained which contains a diversified collection of current dental, medical and other pertinent reference books. The library contains approximately 2,300 periodical subscriptions and over 325,000 volumes. It ranks among the 20 largest health science libraries in the United States. In addition, the department maintains a complete set of the Journal of Prosthetic Dentistry as well as many other prosthodontic textbooks and journals. Book purchase requirements are kept to a minimum due to our vast resources. Residents are given MEDLINE access free of charge.
CLINICAL PHOTOGRAPHY
Each incoming resident is required to have a digital clinical camera capable of photography from profile to 1/1. Photographic documentation of clinical and laboratory work is required.
SOCIETY MEMBERSHIP
Active membership in professional organizations and societies is essential in maintaining high professional standards. Membership in the American Dental Association, American College of Prosthodontists, American Academy of Maxillofacial Prosthetics, Academy of Osseointegration, and the Maryland Chapter of the American College of Prosthodontists are highly recommended. Student membership rates are available at a considerable reduction in dues or are free.

MANDATORY TRAINING
Residents are required to attend scheduled training such as CPR, Bloodborne Pathogens, Risk Management, HIPPA, Infection Control, and Hazardous Material handling as provided by the dental school.

FINANCIAL ADVANTAGES
A work study program may fund up to $12,600 per year for qualified residents. This amount varies from year to year. There is also a stipend available based on the residency ‘s excess revenue from the previous year. All photocopying is free of charge and to date, all research costs have been borne by the program. Equipment use is included in tuition and fees and includes the use of a variety of articulators. We currently have the following articulator systems: Hanau, Denar, Whip Mix, Panadent, Dentatus, SAM, Stratos, and TMJ.
Costs of fabrication of table clinics, publication fees, local study club dinner meetings, and travel to a prosthodontic meeting each year are provided by the program, if funding is available. In addition, residents who present table clinics at a national meeting are eligible for travel funds.

JOURNAL SUBSCRIPTIONS
Residents are strongly encouraged to subscribe to the Journal of Prosthetic Dentistry, Journal of Prosthodontics, International Journal of Prosthodontics, and the International Journal of Oral and Maxillofacial Implants. Selected articles are reviewed monthly from these and other journals. The Journal of Prosthodontics is a benefit of membership in the American College of Prosthodontists. Many of these journals are included in the membership fees of the above-mentioned organizations.

REQUIRED TEXTBOOKS
Prosthodontic residents are expected to study and review the literature pertaining to prosthodontics. Residents should maintain a personal reference library of prosthodontic and related texts. The only required purchase is Beumer’s Maxillofacial Textbook.
COMPUTERS
All incoming residents will be required to have in their possession a laptop computer.


III. GOALS AND REQUIREMENTS
1ST YEAR RESIDENT:
1. Competency and confidence in the application of basic fixed prosthodontic clinical and laboratory procedures.
2. Competency in basic complete denture clinical and laboratory techniques.
3. Understanding of complete denture occlusion.
4. Competency in basic RPD clinical and laboratory procedures.
5. Understanding of basic RPD principles, design and function.
6. Familiarity with overdenture techniques.
7. Familiarity with immediate denture techniques.
8. Familiarity with reline/rebase techniques.
9. Competency in waxing techniques and restoration contouring.
10. Competency in single survey crown preparation and fabrication.


  1. Competency in use of the semi-adjustable articulators, facebows and familiarity with concepts of occlusion and fully adjustable articulators.

12. Familiarity with basic tissue integrated prostheses techniques.


13. Familiarity with diagnosis and treatment of patients with temporomandibular disorders and facial pain.
14. Identify a research project with a submitted protocol.
15. Understand the requirements of the American Board of Prosthodontics by the end of first year.
16. Prepare a lecture utilizing Power Point and clinical photographs/radiographs.
2ND YEAR RESIDENT:
1. Competency in diagnosis and treatment planning with an understanding of the relationship of prosthodontics to the various specialties of dentistry in the comprehensive care of patients.
2. Competency and confidence in the treatment of combination cases involving fixed, removable, and tissue integrated prostheses.
3. Competency in the application of the various concepts of occlusion for both fixed and removable and competency in the use of pantographic, stereographic and quick mount recorders, semi- and fully adjustable articulators.
4. Competency and confidence in the application of prosthodontic laboratory procedures.
5. Familiarity with the prosthodontic literature and its support of and application to treatment.
6. Develop and present a table clinic at a professional dental meeting.
7. Have placed dental implants for their patients.

3rd YEAR RESIDENT:
1. Familiarity with the maxillofacial prosthodontic literature and with the treatment of patients with maxillofacial developmental or congenital defects..

2. Competency with intra-oral implants in their indications and use.


3. Competency in treating the full scope of prosthodontic patients.
4. Complete a Prosthodontic Board treatment and make a commitment to challenge the Board.
5. Complete a research project suitable for presentation and publication.
6. Display the ability to prepare and present lectures on selected prosthodontic topics to fellow residents.

GRADUATION:
The following requirements must be met before a certificate is awarded from the residency program:
1. Satisfy all academic and clinical requirements as determined by the Program Director.
2. Completed research project. The research paper must be submitted to a refereed dental journal.
3. Completed final write-up and casts for a Prosthodontic Board presentation case. Resident must have taken a Mock Board examination in all sections of Part B.

DIDACTIC OBJECTIVE AND GUIDELINES

PROSTHODONTIC LECTURE SEMINARS:
The prosthodontic lecture seminars are conducted once a week, for one and one-half hours from August through May. Material is presented from the following selected topic areas. Lectures will include Power Point presentations, handouts, and any other items that will help convey the information. These lectures are given by residency staff, dental school professors, private practitioners, residents, and members of the Armed Forces stationed in the area. These include multiple specialties in addition to prosthodontics.

Fixed Prosthodontic Discussion Areas
1. Diagnosis and Treatment Planning
2. Preparations
3. Soft Tissue Management
4. Impressions
5. Interim Restorations
6. Crown Contours, Pontics
7. Articulator Selection, Rehabilitation Techniques, Functionally Generated Path
8. Centric Position, Interocclusal Records
9. Mandibular Movement and Recording
10. Implants
11. Cementation, Failures
12. Ceramics
13. Temporomandibular Disorders


  1. Endodontic Considerations, Build-ups and Posts


Removable Partial Denture Discussion Areas:
1. Introduction
2. Diagnosis and Treatment Planning
3. Design Principles
4. Components and Clasping
5. Distal Extension RPDs
6. Occlusion
7. Fitting and Insertion
8. Swinglock RPDs


  1. Rotational Path

10. Miscellaneous





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